by Bobby Akart
“Okay. Is this project something I’ve heard about?” asked Mac.
“No, but we can discuss it over dinner if you and Janie are up for it,” he replied. “But you need to be aware of the situation in Guatemala City and the rest of the country. I’ve heard about the thousands of dead monkeys. It’s spooked the locals and caused local law enforcement to become inundated with calls.”
“I’m aware,” added Mac. “Twenty thousand plus, and they’ve tested positive for the plague. This disease is zoonotic, Hunter. We might be wrong about its origin. It could have started naturally in the primate population and spread from there.”
Hunter looked at his face in the rearview mirror and then shook his head grimly. He responded to Mac. “It may be propagating that way, but I don’t believe that this is natural.”
“Truthfully, neither do I,” said Mac.
“Mac, listen, there’s one more thing. You need to be extremely careful while you’re on station. The country is on the brink because of the void created by the lack of law enforcement personnel. The military plays an active role in day-to-day police functions, but they’re running all over the country putting out fires related to the spread of the disease via the monkeys.”
“Thank you for the heads-up, but we’re very careful about sanitation and handling of infected patients,” said Mac.
“No, it’s not that. The local gangs are filling the void left by the undermanned police force. They’re brutal and should not be underestimated. Guatemala City is a powder keg.”
Chapter 54
Day Nineteen
CDC
Guatemala City
Guatemala’s public health sector was just rebounding from its worst crisis in history with hospitals and clinics across the country suffering due to lack of funds and government corruption.
Several Guatemalan public officials had been implicated in a massive tax-evasion scheme that forced public hospitals to pay the price. The scheme, called La Linea, was orchestrated by the former President and Vice President of Guatemala. The officials received bribes from health-industry businesses to provide them favorable tax breaks. When the scheme was discovered, the government’s health care budget collapsed, leaving the hospitals in debt.
Budget cutting had finally taken its toll, reducing personnel and needed medications. Guatemala’s government spending on healthcare was the lowest in Latin America. Currently, it hovered around one percent of the nation’s GDP, whereas the average public investment in Central America ranged between four and six percent. During an interview, one physician told the local media that her hospital was running on the supplies their patients provided when admitted.
Now, a new crisis overwhelmed the health care system—patients experiencing flu-like symptoms. In Guatemala, the number of patients seeking treatment in the last forty-eight hours might collapse the health care system of even a developed nation.
Mac and Janie were greeted at the airport by Lawrence Brown, who was his usual amicable, British self. But within minutes of their ride to the Hospital San Juan de Dios, their friendly banter disappeared and the scenes of Guatemala City shocked the travelers from Atlanta.
“This looks like the streets of Athens except a thousand times worse,” said Mac. “Look at all of the dead animals!”
Carcasses of dead pets and strays littered the sidewalks, alleys, and even the middle of the road as they entered the city.
“This has happened in the last thirty-six hours,” said Brown. “In addition, the number of walk-in patients into local emergency rooms has skyrocketed. A frail system is on the verge of collapse.”
“Since yesterday?” asked Janie.
“Yes,” replied Brown. “Two days ago, local radio stations reported the problems with the diseased animals around the country. Yesterday, the U.S. Embassy issued two vague advisories. One closed the embassy for the quote safety of their personnel and visitors and the other one warned of travel restrictions in the northern part of the country where the outbreaks occurred.”
“Did they mention the outbreaks?” asked Mac.
“No. The closing of the embassy was due to increased gang violence—namely, MS-13, La Mara Salvatrucha.”
Mac thought of Hunter’s warning the night before. “I’ve heard of them. They have large operations back home in LA and Boston.”
“They rule the roost in Guatemala City,” added Brown. “The majority of the gang members are transplanted El Salvadorans. They’re notorious for their use of violence and acts of merciless revenge.”
“In Boston, they’ve established a major human-trafficking operation,” said Mac. “I investigated an outbreak of salmonella that was transported into East Boston by illegal aliens courtesy of MS-13. I’m familiar with their brutality. A thirteen-year-old girl who’d been forced into prostitution confided in me. She offered to assist the police in a child prostitution sting. Four days later, they found her body floating in Boston Harbor.”
Brown wheeled the Ford Explorer onto Avenida Elena following their brief ride from the airport and that was when Mac caught her first glimpse of the chaos. The military had cordoned off the hospital perimeter with razor wire and heavily armed soldiers. The hospital resembled one in Fallujah, Iraq, not in America’s backyard.
“Are they gonna let us in?” asked Janie.
“Yes, our CDC credentials will suffice,” replied Brown, who worked his way to the emergency room entrance. After a few minutes, the armored vehicles were moved out of the way, allowing them entry. Mac looked to the rear to see if they were followed in by any of the locals demanding entrance. She was suddenly afraid for their safety.
“How far is the CDC facility from here?” asked Mac.
“Only seven or eight blocks,” replied Brown. “It’s relatively quiet over there. The Guatemalans are focused on the three hospitals in the city, small doctor clinics, and the pharmacies.”
Brown parked the truck and led them to the rear hatch. He retrieved two large rolling aluminum carrying cases packed with doses of colistin. He also popped open an oversized duffle bag full of personal protective clothing.
“We’ll want to suit up,” said Brown. “Not only for the obvious reasons, as you can see. But the hospital doesn’t have enough to protect their own staff, much less outsiders.”
Mac and Janie suited up with masks, eye protection, and gloves, in addition to the protective suit. It would be hot as blazes in this older-style gear, but better than being infected.
If the madness surrounding the outside of the hospital wasn’t eye-popping, the mayhem inside the facility was. Gurneys were full, so infected patients lay slumped in the hallways and stairwells. The frenzied, limited staff was ineffective at rendering treatment. Their state of mind prevented them from helping anyone properly.
Mac pulled Janie and Brown aside before they approached the hospital’s admissions area. “Guys, this won’t work. The purpose of our trip was to gauge the effectiveness of the colistin on newly infected patients. There are plenty of those to go around, but this is not a controlled environment.”
“There’s no way to monitor their progress,” added Janie.
“Exactly,” Mac said. “This situation is unsustainable. It’s only been a day and a half since the media broke the story full of half-truths, and look around you. Imagine what tomorrow will bring?”
“No, imagine what will happen when they know the whole truth,” interjected Brown.
Mac pressed her body against the wall as an orderly ran past them, pushing a gurney with a vomiting child. “Lawrence, do you have any medical facilities on the CDC’s premises? I know it’s out of the ordinary.”
“Well, not part of our complex, but next door in the same block is a veterinarian’s office,” replied Brown.
“That’ll do,” said Mac. “Do you have a relationship with them?”
“Well, not the vet, who left the country yesterday. But I have sort of dated his assistant, Camille. She lives in the small apartment above the vet’s
office. Why?”
Mac looked around the hospital one last time and then arrived at a decision. “Come on, let’s go. Lawrence, can you sweet-talk your lady friend into letting us use their examination rooms to see patients?”
“It would be my pleasure,” he replied with a half bow.
Chapter 55
Day Nineteen
Hospital San Juan de Rios
Guatemala City
Oscar Paz and his two trusted lieutenants, Manuel Abrego and Jose Alvarez, leaned against his 1970 Chevelle Super Sport. As Paz rose up the ranks of MS-13 in Guatemala City, he was rewarded with the muscle car that would have been valued at over thirty thousand dollars in the States. The black paint and chrome wheels shone in the hot sun, but it was the Chevelle’s three-hundred-and-fifty-horsepower motor that provided the real heat in Guatemala City.
Oscar Paz was a top producer and captain for Hector Quintero, the son of famed Mexican drug lord Rafael Quintero. When MS-13 established a working relationship with the Sinaloa drug cartel in the mid-eighties, the Quintero family married into the leadership of MS-13. As a result, Hector became part of the leadership team.
He and his associates were carefully watching the activity around the hospital. They didn’t have to read the newspaper to know that something extraordinary was happening in Guatemala. Many of their soldiers and their families had come down with the mysterious flu illness in the last several days. The military police were preoccupied dealing with the sick and trying to keep order around medical facilities like the Hospital San Juan de Rios.
When the white Ford Explorer was granted entry into the hospital, the trio of MS-13 gangbangers studied the occupants. The truck was marked CDC in blue letters and the passengers appeared to be Americans. This piqued the onlookers’ interest, and when they wheeled the large aluminum cases inside, they smelled opportunity.
“Drugs,” Paz said without elaboration. The three continued to watch and their adrenaline spiked when the CDC personnel suited up into their protective gear. “Medicamentos importantes.”
Paz pulled his cell phone out of his faded jeans and called Hector Quintero. Paz explained what he’d seen and Quintero promised to send him additional men. They were instructed to wait for them to leave and follow safely out of sight. Quintero thought American-made pharmaceuticals used by the CDC would be more valuable than MS-13’s beloved cocaine under the circumstances.
“Oscar, they’re coming out,” said Abrego, causing Paz to wind up the call with the big boss.
Paz calmly walked to the driver’s side and got in. Alvarez slid into the backseat of the two-door muscle car and Abrego rode shotgun, literally, as he pushed a sawed-off Remington out of the way to make room for his ample frame.
They sat quietly for a moment while they watched the three Americans remove the protective suits and pack the rear of the Explorer. Both of the women unfurled their long hair from the hair bands that held it up, allowing the wind to straighten and blow it back into shape. A smile came across the face of Oscar Paz as he began to accept the praise of his boss in his mind. Perhaps he would earn a turn when Hector was done with them.
“Let’s see where they go and what they’ve got for us.”
Chapter 56
Day Nineteen
CDC Offices
Guatemala City
Brown navigated the busy downtown streets of Guatemala City, using alleys and side streets to avoid main thoroughfares to avoid congestion. This was not a typical day for the city inhabited by three-point-three million, many of which were from the twenty-three distinct Mayan groups present in Guatemala. The indigenous people of Guatemala had packed the city in the last thirty years, fleeing the impoverished rural areas of the country. Those who couldn’t find a living in Guatemala City headed north, seeking opportunity in America—the shining city on a hill.
“This is utter madness,” yelled Brown as he carefully drove through a group of children begging for food. “Look, there! They’re breaking into that small grocery store. This city has delved into chaos in the last twenty-four hours.”
Mac had never experienced anything like this firsthand. In Africa, during the Ebola outbreak, she observed unrest, but it was more out of despair for the spread of the illness to loved ones than out of economic conditions deteriorating. Africans had never experienced economic prosperity, even on the level of Guatemala City. Despite its poor economic state, Guatemala was far better off than West Africa nations.
No, this was different. The people appeared panicked. These were not the looters of New Orleans after Hurricane Katrina, seeking out big-screen televisions and laptop computers in order to survive. They appeared to be desperate for anything that might save them or a family member from the disease that was sweeping their nation.
Hour by hour, the plague had blasted the population with panic. “Janie, let’s run through the timetable again.”
“Okay,” she responded. “In rough terms, keeping in mind that we still don’t have a controlled environment to establish a case study because of where the outbreak has occurred, this is what we’ve surmised. The incubation period is one to eight days, double what the Y. pestis bacterium has indicated in the past. The infected become symptomatic days nine through twelve, roughly. After day twelve, usually around day fourteen, the infected die with, thus far, a one hundred percent mortality rate.”
“Contact to death is one to fourteen days,” summarized Brown. “That’s at least five to six days longer than a normal case of the plague.”
“Normal, right,” added Janie.
Mac sat quietly for a moment as she did the math in her head. It was difficult to focus with the activity going on outside the vehicle. A woman collapsed on the sidewalk next to their truck, and no one stopped to help her. Mac resisted the urge to assist, knowing that the elderly woman was infected and it was too late to start a course of treatment. It was heartbreaking.
Mac gathered her thoughts and continued the discussion. “We have to look at Fernando, from village number two, as our patient zero for sake of argument. Based upon the timetable that Janie just provided us, other deaths caused by the disease would’ve surfaced already. That means the first outbreak in village number one was isolated and contained.”
“Correct,” said Janie. “Twenty-one days ago, Fernando discovered the deaths in village number one and left. He would’ve become infected on that date.”
“Yes,” interjected Brown. “Our investigation shows that Fernando was seen boarding the chicken bus seven or eight days ago, probably close to death.”
“At which time, he would’ve infected the forty passengers, if not more who boarded the bus, depending on how long Fernando lived,” said Mac. “During the last eight days, those forty-plus infected passengers started their incubation period and in the last forty-eight hours began to exhibit symptoms. The timing is just about right.”
Janie counted on her fingers until she reached eight on the middle finger of her left hand. She grabbed it with her right and wiggled it, as if to drive the point home regarding her feelings about this killer bacterium. “Assuming the bus riders were more socially interactive than the remote villagers, it’s likely that each of them came into contact with hundreds of others in the last eight days.”
Mac shook her head in disbelief as the aggressive transmission of the disease swirled through her own calculations. “And then there are the monkeys.”
“The monkeys are spreading the disease faster than the human carriers,” said Brown. “The bottom line is that this outbreak has hit the country all at once. The combination of the infected and fear associated with the news reports has detonated the psyche of Guatemalans.”
“Undoubtedly,” said Mac. “Panic can go from zero to a hundred in an instant. The question is which can race faster, the panic or the spread of the disease?”
Chapter 57
Day Nineteen
CDC Offices
Guatemala City
“Listen, Mac,” Brown whispered in
to her ear. “This situation is deteriorating by the hour. There’s an Avianca flight that leaves around 10:00 tonight. I think you and Janie need to be on it.”
“I’d be lying if I said I hadn’t thought about it,” Mac whispered in response. “But my guess is that the flight is full. We’ll be fine until our American flight departs at two tomorrow. It’s only twenty-four hours, right?”
“Okay, it’s your call, but I’ve got this if you wanna go this evening. Tomorrow will be worse, I suspect.”
“Thank you, Lawrence.” Mac smiled as she patted the young man on the back. She’d come to admire him since they’d met nineteen days ago at the original hot zone. In the frenzied aftermath, he’d become a reliable resource on the ground here. “Now, go find your friend while Janie and I unpack the truck.”
Lawrence nodded and smiled as he hustled off towards the rear entry to the vet’s office next door. She watched as youthful exuberance sent him off on a new adventure. Although Brown sensed the impending danger caused by the instability of the city, he still soldiered on in his duties. Mac would be sure to mention this to the head of the Central American Regional Office.
Mac casually walked to the rear of the Explorer as Janie hoisted the heavy aluminum cases out of the cargo space. The classic Chevelle caught her eye as it slowly drove past them, three sets of eyes rubbernecking them as it picked up speed and left. The car gave her an uneasy feeling, sending a slight chill up her spine. Suddenly, she felt vulnerable and wished she had her guns.
Inside, two office personnel and a research assistant manned the fort. They spent most of their days on the phone, attempting to track down people on the contact lists generated over a week ago. Mac didn’t have the heart to tell them it was a waste of time. From what Mac had observed since their arrival in the city, chasing down people in contact with the original carriers would involve calling every name in the Guatemalan phone book, if there was one.