by Bobby Akart
“Yes, well, good job in containing it. Now, these other two cases appear to be isolated, am I correct?”
“Not necessarily,” she protested. “Trinidad is up to four cases now and—”
“Yes, Port of Spain. All four cases appear to be related to an explosion, am I correct? And further, there have been no other reported cases in the region, right?”
“Well, yes, but it is too early to declare the outbreak subdued,” replied Mac. Why is he downplaying this?
“Okay, good,” said Baggett, ignoring the premise behind Mac’s statement. “Now that these cases of the plague have subsided, I’m going to ask you to travel to Washington and provide a report to the White House and the National Defense Team. Book a flight this afternoon, as they’re expecting you in the morning at 7:00 a.m. at the White House.”
Mac sat back in her chair. “The White House? I mean, shouldn’t there, um, isn’t there a person for stuff like that?”
“Not this go-around, Dr. Hagan. You’re the most familiar with the situation. They want a full briefing. You’ll need to educate them about the disease, as well as inform them of the present status of the outbreaks.”
“Okay,” said Mac with a shrug. Mac held back her concerns about the antibiotics, which arguably needed one or two more days to determine their effectiveness. In the meantime, she had to get ready. Tomorrow, I’m going to the White House. Ain’t I special?
Chapter 44
Day Sixteen
The Situation Room in The White House
Washington
Attending the morning briefing was not a regular occurrence for Jablonik, who as a master sergeant rarely had the opportunity to sit at the table with generals. But in his capacity as the coordinator of Project Artemis, he was best suited to brief the President’s National Security team.
Jablonik had the requisite security clearance to be privy to the contents of the Morning Book, which was prepared by several intelligence agencies on a daily basis. These representatives, known as the Watch Team, compiled diplomatic cables, the contents of the State Department’s National Morning Summary, and the National Intelligence Daily Report in the early hours of the morning. The final product was delivered to the National Security Advisor, who then provided a copy to the President, the Vice President and the Chief of Staff.
Chief of Staff Andrew Morse conducted the meeting. After some preliminary matters such as the President’s schedule and Secret Service matters were disposed of, the topic of Project Artemis was discussed.
“Who do we have from the DTRA this morning?” asked Morse, looking at the chairs lining the perimeter of the wall, which were filled by a variety of staff members.
“Good morning, sir,” said Jablonik as he rose out of his chair. “I’m Master Staff Sergeant Jablonik, sir. I’m the coordinator of Project Artemis for the DTRA.”
“Yes, of course, Jablonik. Tell us what you have.”
“Thank you, I’ll be brief.” Jablonik moved to the head of the room and drew the attention of the most powerful military and intelligence personnel on the planet. He was awestruck for a moment, but then found his groove.
“The intelligence we’ve received from the NSA and reports obtained via the DOD leads us to believe that ISIS terrorists are planning a bioterror attack upon Europe in the coming weeks. Further, they’ve deployed hundreds of operatives into South and Central America, quite possibly for a move northward toward our border with Mexico.”
Morse interrupted as he thumbed through the Morning Book. “I take it that the weapon of choice, based upon the CDC report, is the plague. Am I right?”
“Yes, sir. I can’t speak to those details, naturally, but that is the information that we have at this time.”
“Okay, proceed,” said Morse. “Is there something imminent?”
“Not that we know of, although their activity indicates a mobilization that we’ve not seen before. ISIS has all but abandoned Syria and Northern Iraq. Our intel and satellite imagery has shown caravans of women and children headed for the northeastern highlands near Mosul and Kirkuk, along the borders of Turkey and Iran.”
Morse chuckled. “Sounds to me like we’ve got ’em on the run, you know, head for the hills!”
Many of the attendees laughed along with the President’s Chief of Staff, but Jablonik did not.
“Sir, I might add—” Jablonik paused to allow the playful banter time to subside “—I might add that the fighters, the jihadists, are traveling as I stated earlier, into Europe and Latin America. In addition, several days ago, an ominous message was posted to social media websites that we monitor for ISIS interaction. The message read the flag of Allah and jihad has been raised. Since then, they’ve gone dark.”
“Do you have any intelligence that leads you to the conclusion that a credible threat exists to the United States?”
“No, not at this time,” replied Jablonik, before adding, “But, clearly, they’re setting the table for something.”
“Also, has there been any form of threat levied at the Olympic Games, which are right around the corner?” asked Morse.
“No, sir. Not at this time.”
“Well then, Sergeant, stay the course and continue to monitor these events. If a bioterror action is planned, or undertaken, I suspect that you’d inform us. Now, let’s hear what the CDC thinks about all of this.”
Jablonik sat down, dejected. He wasn’t there to raise an alarm, but he didn’t expect to be dismissed out of hand. Bioterrorism was every bit as dangerous as a nuclear attack or the latest threat—cyber warfare. What will it take for the Chief of Staff to take this threat seriously?
*****
Mac was startled by the abrupt opening of the door leading to the hallway where she waited. The soundproof corridor prevented her from hearing any of the conversations within the Situation Room, not that she would have eavesdropped anyway. She was too nervous, frantically reviewing her notes like a college freshman cramming for her first semester final. In the end, she reassured herself as she followed the aide into the room. She was very knowledgeable on the subject and that gave her plenty of confidence as she caught her first glimpse of admirals and generals, cabinet members and other leaders of our government.
“Good morning, Dr. Hagan. Is that correct?” asked Morse.
“Yes, good morning. Dr. Mackenzie Hagan,” she replied proudly, wearing her dress whites.
“My notes tell me that you are also Lieutenant Commander Hagan, daughter of now-retired Major General Barbara Hagan, Commander at USAMRIID. Is that also correct?”
Mac set her jaw slightly. Obviously, Morse was reminding the participants in the morning briefing of who her mother was. Well, I know you just as well, Mister Former Lawyer.
“Yes, sir.” Mac was led to the head of the table by an aide, who offered her a glass of water, which she declined.
“Let’s get right to it,” said Morse, thumbing through the pages marked with yellow Post-it notes. “I’ve read the summation provided by the CDC and noticed that a more detailed analysis was not provided. Was that an omission on your part, Dr. Hagan?”
Mac bristled at the implication that she was unprepared. “Not at all, sir. I only learned of my involvement in this briefing less than twenty-four hours ago. In addition, this is some heady stuff and I wouldn’t want your eyes to gloss over. It will be easier for me to hit the high points, if you’ll allow me to, sir.”
Mac was forceful, yet respectful. In the past, she’d watched as bureaucrats ran over her mother because she was trying to protect the dignity of her position and rank within the military. Mac had learned from her mother’s experiences and was thick-skinned as a result.
Morse scowled at her and dropped his pen on the Morning Book. He leaned back in his chair and put his hands behind his head. “Please, proceed, but keep it brief. We have matters of national security to discuss.”
Listen, Morse, if you didn’t want me here, why did you request my presence?
Mac refused to get
flustered. Instead, she focused on the people in the room who seemed genuinely interested in what she had to say. She opened her planner and referred to the notes she’d prepared yesterday and last night. As she spoke, she never once referred to her planner. She didn’t have to.
“Yersinia pestis, or its common name, the plague, is an ancient disease that continues to rear its ugly head from time to time around the world. At the CDC, we have characterized it as a re-emerging infectious disease. Last year, worldwide incidents of the plague reached three thousand cases, of which four hundred eighty-two died.
“The disease is endemic in rodent populations in much of Southern Asia, parts of Africa, and rural areas in the Americas. It is extremely rare in the United States, with only five to fifteen cases occurring each year.”
“Where?” asked one of the generals seated to Mac’s left.
“Primarily in the Southwest, sir. Half of all cases arise in New Mexico, and the rest in California, Texas, and Colorado. Advances in living conditions, public health awareness, and aggressive antibiotic therapy make future natural plague pandemics improbable.”
One of the cabinet members to Mac’s right leaned forward and addressed her. “You’ve mentioned the word natural twice so far. I take it that unnatural is something quite different.”
“Yes, ma’am,” replied Mac. “For the most part, naturally occurring cases of the plague are few and far between, and manageable. Plague outbreaks following a bioterror attack would pose a serious risk. At the CDC, we consider plague to be one of the most serious bioterrorism threats along with anthrax and weaponized smallpox.”
The general to her left interrupted. “The plague was developed as an aerosol weapon by several countries in the past, most notably Russia. Fortunately, it hasn’t been deployed by anyone that I’m aware of.”
“Yes, sir, that’s true. Aerosol dissemination of the Yersinia pestis bacteria would expose the population to an otherwise uncommon, highly lethal, and contagious infectious disease—pneumonic plague.”
“If plague is so rare, why would terrorists use it as a bioterror agent rather than anthrax, which is more readily available?” asked one of the cabinet members.
“There are many reasons. First, let me address availability. Because pneumonic plague still occurs naturally in the endemic areas and is held in numerous microbe banks around the world, it is easily obtained compared to smallpox, for example. Second, the fatality rate with plague is high, not only for the immediately infected, but for those who come in contact with the infected patient—what we call the secondary spread. Anthrax, to put it bluntly, doesn’t contain the same punch as pneumonic plague.”
Morse leaned forward in his chair and studied the reports provided in the Morning Book. “It does have a high fatality rate, but that’s because of misdiagnosis. According to this, and what I can recall, the proper antibiotic treatment will cure most infected patients, correct?”
“That’s true, but not in all cases. Studies have shown that some strains have developed an antibiotic resistance in nature. Further, there is the possibility of genetic modification of a pneumonic plague strain to couple it with an antibiotic- and antimicrobial-resistant cell.”
“Do you have evidence that has occurred in your present outbreaks?”
“No, not yet,” Mac lied, sort of. She was concerned this had happened in Guatemala, but it was too early to make that declaration. In a way, she was glad that Baggett’s request to participate in the morning briefing stopped her from sharing her theories with him. She didn’t want to be labeled an alarmist. Whether it was a fair label or not, Mac would always carry the burden of her mother’s history on her shoulders and would be unfairly tainted as a result.
Morse leaned back and folded his arms. “There appears to be an increase in terrorist movements in Central America and Southern Europe. Is there any connection between these minor outbreaks in Guatemala, Trinidad, and Greece and bioterrorism, in your opinion?”
“Not definitively, sir, although the next week or so will reveal more.”
Morse looked over the heads of those seated at the main conference table and sought out Jablonik. “Dr. Hagan, I suggest that you establish a line of communications with Jablonik over there. If something more comes out of this, run it up the proper channels. In the meantime, I don’t see a need to create a panic. Fear and rumor are far more dangerous than the virus itself.”
No, not in this case.
Chapter 45
Day Sixteen
Park Place on Peachtree
Buckhead
After she arrived back in Atlanta, she took the MARTA red line train into Midtown and then caught the North Springs train until her stop in Buckhead. During the ride, she called Henri le Pen for an update on the condition of the patients destined for the hospital at El Naranjo. The body count had risen with three more deaths since she’d spoken with him yesterday. He did confirm they would be ready to transport the most critical patients to the hospital tomorrow. El Naranjo’s hospital would belong to the CDC by the end of the week.
The fact that the strain appeared to be antibiotic resistant bothered Mac. Like she’d advised the attendees in the Situation Room, there had been extremely rare cases of Y. pestis in nature that had been determined to be antibiotic resistant, but the testing had occurred in primates and laboratory rats, not humans.
If the Guatemalan patients were unresponsive to normal medication protocols, including colistin, which hadn’t been administered yet, then the situation would turn catastrophic in Guatemala. They still had not located the boy, Fernando. Further, the number of deceased monkeys was in the tens of thousands, too many to count. With an incubation period of up to six or seven days, Mac expected to be receiving more reports from the region of Y. pestis-positive patients.
She needed to make a decision on the use of colistin and whether the alarm needed to be sounded via GPHIN—the Global Public Health Intelligence Network, a network created by Canada’s Public Health Agency and designed to provide a public health early warning system when potential disease outbreaks occur around the world. Part of the WHO’s Global Outbreak Alert and Response Network, GOARN, the electronic system at GPHIN monitored Internet posts, media and news reports, and data shared with the WHO, compiling the information for use by health care professionals around the world.
GPHIN—GOARN—WHO.
The acronyms bombarded Mac’s mind as she grabbed a beer out of the refrigerator. She decided to run it up the flagpole to a higher-ranking officer—her mom the general.
When her mother answered the phone, she secretly breathed a sigh of relief. She loved her father dearly, but tonight she was too consumed with all of these events to endure his jokes. She’d make it up to him in the next call.
“Hi, dear,” her mom greeted her in the same even-tempered tone as always.
“Hey, Mom. Are you busy? I’ve had an interesting day.”
“Do tell.”
Mac settled in a chair and stared out the window as daytime came to a close and the night life of Hotlanta took over. “If I told you that I was locked in a room in the basement of the White House, with Andrew Morse, would you believe me?”
“Sure. Now, do I need to get you a lawyer? Do you need bail money?”
Mother and daughter shared a good laugh. Mac had contemplated taking up her mother’s fight in the past, and considered destroying the man responsible for her resignation, but murder or bodily harm was not an option.
“Would you blame me for giving him what he deserves?” asked Mac.
“No, because you wouldn’t do anything that I haven’t contemplated myself. But, you know, I’m in a pretty good place now and time has allowed the anger to float away with the tide.”
Mac smiled and propped her feet up. She was glad that her mother was able to let go of that dark time that ended her career. As a protective daughter, Mac might never forgive the political lynching her mother had endured, which had been driven by one Andrew Morse.
“Mom, there are several new wrinkles in the plague cases that I’d like to run by you. Are you up for it?”
“Are you kidding, dear? I live for your phone calls. That’s why I’ve started carrying the cordless around the house with me when your dad’s home. I’m tired of him monopolizing your phone time.”
“He means well, Mom.”
Her mom coughed away from the phone. “Sorry about that.”
“Are you sick?” Mac had concern in her voice. She’d been around the plague for the better part of two weeks. You never knew where it would rear its ugly head next.
Her mom coughed again and then cleared her throat. “No, I’m fine. They adjusted my meds and the blood pressure pills have given me a tickle. No big deal. So you really went to the White House?”
Mac gave her the details of the encounter with Morse but also the details of her trip to Greece. She didn’t tell her about Hunter for fear of the conversation getting sidetracked into the is-he-the-one conversation. She’d only had drinks and dinner with the guy, who, Mac just realized, hadn’t called her since. Although it wasn’t a date per se, which might warrant a follow-up call, Mac wasn’t sure what to make of the silence on his end.
She brought her mind back to the present and explained to her mother how the patients weren’t responding to the antibiotics. They considered the colistin option. Colistin had been developed decades ago as an antibiotic drug of last resort when a particularly difficult pathogen invaded a human host. Its initial use caused kidney toxicity in patients, but its effectiveness in preventing death from the pathogen outweighed the potential for kidney damage.
Her mother had suggested colistin while fighting the Ebola outbreak for those patients who were not responding to the regular course of treatment. She’d had some success with the drug and suggested that Mac try it in Guatemala with select, closely monitored patients.