by Bobby Akart
Those words stung the President and accounted for his foul mood for the rest of her visit. He resisted the urge to sneak a snifter of brandy, but only because the chancellor was a teetotaler and would surely say something.
The next step in the President’s bad-news day occurred when he joined Chancellor Müller for the traditional media photo op in front of the fireplace in the West Wing. President Garcia, who was known to be somewhat of a germaphobe, didn’t shake hands with the chancellor, a courtesy usually extended to foreign leaders visiting the White House.
At one point, she leaned over to his chair and whispered, “Do you want to shake hands?”
President Garcia pretended not to hear her over the cameras, which snapped photo after photo. Perhaps it was the reports of the sickness in Guatemala, or maybe his germaphobic nature got the better of him. Either way, the tension was thick as the media pool photographers began to ask questions, hoping to get a sound bite. Neither leader responded.
Finally, after a moment, the President leaned in to deliver private assurances to Chancellor Müller, a conversation that was later aired on every major network. The President had been caught in the dreaded open-mic moment when he said, “On all of these issues, particularly the influx of refugees, they can be solved. I just need you to give me a little space.”
Chancellor Müller nodded and smiled after the President added this, “I’ll have more flexibility to deal with this after this election. It’s going to be my last, you know.”
Those quotes became media gold, alongside this exchange between the President and the mainstream media in the Rose Garden.
“Chancellor Müller and I have time for a few more questions before we have lunch, Jim.”
Jim Acosta of CNN news stood and asked, “Mr. President, your opponent has called for more border control in light of reports that ISIS terrorists are working with the Mexican drug cartels. Do you plan on assigning more agents in response to your opponent’s suggestion?”
“I have all the confidence in the world in our intelligence agencies to keep me abreast of terroristic threats to our country. There is nothing more important for a President to do than to protect the citizens of the United States. Naturally, I’d like to assign more personnel, and throughout my first term, I have called on Congress for the necessary funding. But as you know, we inherited a considerable deficit, and cuts must be made across the board to sustain our nation’s credibility to repay our debts.”
Acosta persisted. “But, Mr. President, what about the allegation that ISIS has gotten into bed with the Mexican drug cartels?”
“Jim, I have no intelligence that would suggest that. Perhaps my opponent should quit riding up the Rio Grande in his kayak and pay attention to the real concerns of American citizens like jobs and health care.” This drew a laugh from the attendees.
The President pointed to Olivia Lopez with Reuters. “Mr. President, the death toll in Guatemala continues to rise as the nation is in the grips of some type of flu outbreak. Will you be suggesting travel restrictions to and from that country, or Central America in general?”
Great, the President thought to himself. Do these vultures not miss any tidbit of information?
“Olivia, at this point, the Department of Homeland Security has not suggested travel restrictions. Our outstanding doctors and scientists at the Centers for Disease Control are familiar with this situation and will keep us abreast of the outbreak.”
Lopez continued standing, and asked, “A follow-up, Mr. President. Is there any connection between the illnesses in Guatemala and the recent advisory issued by the New Mexico Department of Health regarding the deaths of small animals and the corresponding cases of fever and flu-like symptoms in the southern portion of the state?”
President Garcia shot a glance at his Chief of Staff, who attempted to cower behind the shrubbery that surrounded the rosebushes. The President decided to lie about his knowledge of the New Mexico reports.
“Olivia, I’m not familiar with the New Mexico cases, so I can’t comment at this time. But I will say this. We will follow the advice of the CDC and the World Health Organization. What we will not do is repeat the mistakes of the past that resulted in Ebolamania. I will not pit citizen against citizen because of fear of the unknown. Frankly, to report that the two isolated events are connected would be reckless, expanding beyond the concept of irresponsible news, but rather, into dangerous fake news.”
Chapter 64
Day Twenty-One
Memorial Medical Center
Las Cruces, New Mexico
Dr. Kwame Okoli came to America after successfully battling Ebola in Nigeria since March of 2014. Born and raised in Lagos, he was destined to attend the College of Medicine at the University located there. Growing up in Africa didn’t provide a young man the best of odds. Dr. Okoli knew suffering, famine, and disease—not from a medical perspective, but because he had been surrounded by it. At an early age he vowed that although the world was full of suffering, it was also full of possibilities to overcome it.
He began hanging around the Isolo General Hospital, which was walking distance from his home. At thirteen, he’d procured a janitorial job, taking out trash, cleaning floors, and washing bed linens. Over the years as he continued with his schooling, he became a hospital mascot of sorts, earning himself an honorary uniform with his name, Okoli, Kwame, embroidered on the chest. Soon, he was affectionately called Dr. OK.
With the financial help and encouragement of the contacts he’d made at Isolo General, Dr. Okoli earned his way into the College of Medicine, where he graduated with high honors. His chosen field, infectious disease, was a given considering the widespread incidents that occurred throughout Africa.
Ebola had been around Africa since the mid-seventies when it was discovered in DR Congo, formerly Zaire. Ebola outbreaks had been common in the decades to come until the widely publicized 2014 epidemic.
In Lagos, Dr. Okoli was one of the physicians who treated Patrick Sawyer, a Liberian-American attorney who flew into Nigeria in July of 2014. Upon arriving at the airport, Sawyer became violently ill and was transported to the hospital. It was Dr. Okoli who recognized the telltale signs of Ebola and alerted the Nigerian government. His quick thinking saved the lives of his co-workers that day, except for the admitting nurse, but it did not prevent Ebola from spreading throughout Lagos and Nigeria.
After years of battling the disease, Dr. Okoli settled down and married a USAID worker from New Mexico. USAID played a critical role in stabilizing West Africa following the AIDS epidemic and the Ebola crisis. His wife encouraged him to bring his expertise to New Mexico, which had been known as a hotbed of activity for emerging infections, Ebola, and plague.
“Well, I must say, that was a first,” said Dr. Okoli as he emerged from the decontamination chamber at the new infectious disease unit of Memorial Medical Center. The rest of his team began to peel off their protective clothing as well. “I’ve never received a directive like that in all my years of dealing with governmental agencies. I mean, since when does it become a matter of national security to perform an autopsy on a cat?”
Two days prior, a stray cat was found dead and the initial determination of death by a local veterinarian was plague. This was not unusual for felines in New Mexico, as the plague had been prevalent among dogs, cats, and small animals for years in the region.
Dr. Okoli continued. “Does the CDC not realize that in the Southwest, fleas are a common carrier of the plague after they bite rodents. Cats are especially susceptible to the Y. pestis bacterium and usually die.”
A lab technician joined them with a hospital administrator in tow. “Were you able to procure the lung specimens as requested, Doctor?”
“Sure, you’ll find them safely stored in quarantine. Can you tell me if there is something in particular the CDC is looking for?”
“No. I mean we don’t know,” replied the administrator. “We have been told to issue a fever watch warning for the neighborhood whe
re the animal was found. Also, local authorities are asking residents to report sightings of sick domestic animals or wildlife.”
Dr. Okoli, who had seen real sickness, shook his head. “Am I to expect a phone call every time a dog drools or a cat coughs?”
The administrator simply shrugged, turned on a dime, and headed for the exits. Dr. OK had become disenchanted as he got older. He didn’t have much respect for Americans, who had no idea what real suffering was.
As a parting shot, Dr. Okoli stuck his head out the door and shouted to the backs of the hospital personnel as they headed for the elevator, “Call me when there is a real disease to fight!”
PART FOUR
WEEK FOUR
Chapter 65
Day Twenty-Two
U.S. Customs and Border Protection Processing Facility
Tucson, Arizona
The goal of migrants crossing the U.S.-Mexican border in recent years was to simply set foot on American soil. The policy of the United States, which had been designed to protect Cuban political refugees known as wet foot, dry foot, was being applied to the nation’s southern border. In essence, once you’d entered the country, you’d be detained in a holding facility maintained by the U.S. Customs and Border Protection Agency for further disposition.
In recent years, the majority of migrants were released into the country and given a court date to appear before an Immigration Court operated under the Executive Office for Immigration Review. Most of the migrants failed to appear for court.
At the same time, the number of unaccompanied minors crossing the border increased ninety percent between 2013 and 2014, which drew the attention of the mainstream media. The nearly one hundred thousand children were provided Temporary Protected Status and were placed in hastily created processing facilities.
These detention centers were understaffed and undersized. In Tucson, a former warehouse was retrofitted to handle the unprecedented surge of mostly Central American child migrants. When it reached eleven hundred children, nearly double its capacity, a whistleblower contacted the local media about the overcrowded and unsanitary conditions.
The media gained access, and explicit photographs emerged of the facility. Ten-foot-tall chain-link fences were constructed and topped with razor wire. Within the compartments of fencing divided by gender and age lay hundreds of children on prison mattresses, covered by nothing more than Mylar blankets. Portable toilets, which lined the perimeter of each pen, as it was described by the reporters in attendance, provided an odor described as a combination of feces and Mr. Clean.
The uproar regarding the detention facilities reached a fever pitch when the images surfaced, resulting in lawsuits filed by Grassroots Leadership in the four border states.
Immigration activists were abuzz at the prospect of a decision being handed down in the next couple of weeks that should order the facilities closed, or in the alternative, the population greatly reduced by releasing the children to sponsoring families in the cities where the CBP housed them.
During the pendency of the litigation, in CBP processing facilities from San Diego to Brownsville, unaccompanied minors from Latin America were admitted by the dozens per hour—many of whom were feverish and weak from the grueling days of travel to America.
Chapter 66
Day Twenty-Two
CDC
Atlanta
It was all hands on deck as reports flooded the CDC from around the globe. Mac created teams split up by continent for information gathering and to liaise with local health care officials. For days, after her experience in Guatemala City, Mac could sense a building up of pressure regarding this plague outbreak. The cases were proliferating in regions that just a week ago reported an isolated patient or two. This rarely used conference room had become Mac’s personal war room for this outbreak, and the teams would meet here daily to provide an update on their regions.
“Team Africa, you’re first,” started Mac as she approached a whiteboard at the end of the room. In a world full of electronic gadgets and PowerPoint presentations, Mac still preferred to write on a wall. In a way, it helped her grasp the gravity of the situation when she wrote it down.
Jamaican-born CEFO Michelle Watson headed up the team tracing back the origins of the young teenager who died in Greece after traveling there from Libya. “We’ve confirmed that the first patient to die in Greece from the disease originated in Beni, a midsize city in the Democratic Republic of Congo. She came into contact with two research scientists that possibly worked with the Madagascar strain of Y. pestis at the BSL-4 in Gabon.”
“Are there new cases in Congo, Gabon, or anywhere in Northern Africa?” asked Mac.
“Yes,” replied Watson. “There are twenty-seven cases in DR Congo and ninety-four more in Libya. Seventy unexplained deaths in Congo and Gabon are under investigation.”
Mac took to the whiteboard and wrote Africa at the top and underlined it. Then she scribbled Congo – 27 and Libya – 94. “Team Europe, what’s your update?”
Alexis Mikonos, a second-generation Greek immigrant, stood with a legal pad full of countries, numbers and arrows pointing in every direction. “Dr. Hagan, to say that my notes are obsolete would be an understatement. I prepared for this meeting during breakfast, but with my hourly updates, it keeps changing. In a word, the spread through Europe is astonishing.”
“Go ahead, Alexis,” said Mac.
“Keep in mind, to the best of our knowledge, patient zero in Europe was the teen that Michelle spoke of. She died on Greek soil ten days ago, but while contagious, she had contact with as many as two hundred refugees on a boat. Upon reaching Greece, there were countless other direct contacts with immigration officials, doctors, and civilians before she died.”
Mikonos scratched through some numbers and wrote in the margins. She seemed deep in thought when Mac interrupted her. “Alexis, just give us what you’ve got so far, even if they’re ballpark numbers.”
“Okay, sorry, Dr. Hagan. Greece has two thousand ill throughout the country, five hundred fifty deaths under investigation by the Hellenic Centre for Disease Control and Prevention, and nearly two hundred confirmed plague-related deaths.”
Mac recorded the findings on the whiteboard under the heading Europe. She wrote South America on the board and turned toward that team when Mikonos interrupted her.
“Dr. Hagan, there’s more. We now have cases in Turkey, Bulgaria, and Italy. In the past seventy-two hours, the cases have increased tenfold each day.”
“Numbers, please.”
“Turkey, thirteen hundred infected, one hundred fifty deaths. Bulgaria, seven hundred infected, fifty deaths. Italy, four hundred infected, forty-nine deaths. If I created a map of the outbreaks in the Mediterranean, the color red would emanate from Libya and Turkey and gradually spread north and east into Bulgaria and Italy.”
Mac filled in the whiteboard by creating a crosshatch in order to compartmentalize each region. Under the word Europe, she wrote 10X, meaning a possible proliferation rate of ten times. After she’d received the reports, she planned on sitting down with Janie to create an epi curve.
“South America, go.”
“Trinidad and Tobago reports three hundred fifty infected and one hundred twelve deaths. Venezuela, to the extent they are cooperating, advises eight hundred infected and four hundred twenty dead. We are still awaiting numbers from Columbia and Brazil. They are low at this time.”
Mac compared the death-to-infected ratio for these countries. The number of deaths was considerably higher. The Trinidadian health care system was woefully unprepared for a disease outbreak of this nature.
The high death toll there was expected. In Venezuela, economic collapse of what was once the leading economy in South America had taken its toll on all government-run facilities, including hospitals. To complicate matters, the government refused any outside help from the United States, which doomed the infected patients to a certain death, after they infected countless others, of course.
> Mac continued. “Last, but not least, our original outbreak, Guatemala and the rest of Central America. Chris Patterson is receiving reports from the Guatemala City office. What’s the latest, Chris?”
“The numbers are off the charts in Guatemala. Honestly, I’m not sure how accurate they can be. The hospitals are too overwhelmed to keep Lawrence up to date. The military police are more interested in keeping order than counting the sick or dead.”
“We understand, Chris. Give me the best estimate,” interrupted Mac.
“In Guatemala, eight thousand dead and over one hundred thousand infected. Also, the World Wildlife Fund reports that as many as thirty thousand primates are dead and even more are infected. One can only imagine the potential of thirty-thousand-plus monkeys roaming the country, infected with the Y. pestis bacteria.”
Mac noted the figures on the whiteboard while Patterson continued.
“Let me add one more thing about the spread of the disease in Guatemala. Based upon our analysis of the original outbreak and the date of discovery of the second village, it appeared that Guatemala was experiencing a twenty times spread, higher than Europe.”
Mac nodded and turned to the whiteboard. She quickly scribbled 20X under Central America.
Then Patterson continued. “Dr. Hagan, my 20X number was based on the early figures. Like Europe, in the initial stages of the outbreak, Guatemala experienced a ten-times-per-day increase. Today, the number is 20X. For each infected person, twenty more will become infected per day, and so on.”