by J P Whitney
The flu took a heavy human toll, wiping out entire families and leaving countless widows and orphans in its wake. Funeral parlors were overwhelmed as the bodies piled up. Some people even had to dig graves for their own family members.
The flu was also detrimental to the economy. In the U.S., businesses were forced to shut down because so many employees were sick. Basic services such as mail delivery and garbage collection were hindered due to flu-stricken workers. In some places, there weren’t enough farm workers to harvest crops. Even state and local health departments closed for business, hampering efforts to chronicle the spread of the 1918 flu and provide the public with answers about it.
FLU PANDEMIC COMES TO AN END
By the summer of 1919, the flu pandemic came to an end, as those that were infected either died or developed immunity. Almost 90 years later, in 2008, researchers announced they’d discovered what made the 1918 flu so deadly: A group of three genes enabled the virus to weaken a victim’s bronchial tubes and lungs and clear the way for bacterial pneumonia.
To this day, no one knows why the flu virus suddenly mutated into such a deadly form. Nor do they know how to prevent it from happening again. Scientists and researchers continue to research and learn about the 1918 Spanish flu in the hopes of being able to prevent another worldwide pandemic of the flu.
The facts and figures summed up what had become the accepted truth about the pandemic. But the conclusions of bacterial pneumonia as the leading cause of death made no sense. Pneumonia couldn’t kill in a matter of hours. Ruth turned back to the CDC database and scrolled through pages of search results until she found what she was looking for. A cryptically named file that was marked top secret. 1918 Pandemic Redux. She attempted to open the file but her normal password didn’t work. Apparently, the author of the paper wasn’t kidding about this being top secret. But as Deputy Directory of the CDC, she was also provided with a special security code that granted access to the most dangerous labs around the world. It also provided clearance for sensitive compartmentalized information that was shared with DC. She had never had to use it to open CDC files before but the passcode did the trick.
She skimmed through several pages, taking mental notes along the way until finally reaching the summary.
“After reviewing hundreds of top-secret WWI medical reports, it has been determined that army physicians panicked after being pressured by political leaders to do something about the unusually high number of sick days that were starting to impact the war effort. As a last resort, they administered the most powerful tools at their disposal. Inoculations against typhoid, smallpox, and diphtheria. Plus a new hybrid vaccine derived from streptococcal and pneumococcal bacteria along with B. influenzae bacteria, and anti-malaria medication. Navy hospitals in San Francisco, Philadelphia, and Puget Sound, along with a hospital in Minnesota, administered the drugs to well over 100,000 patients. In our estimation, the Spanish flu became exceptionally lethal due to this potent cocktail of drug’s ability to supercharge immune systems. In doing so, immune systems attacked not only the influenza virus but also the lung tissues where it was hiding. We now believe this released a cytokine storm that triggered almost immediate hemorrhaging. The stronger the immune system, the more drastic the results. Many died within hours … literally, days before pneumonia bacteria even had a chance to cause infection.”
As Ruth closed the archives one thing became painfully evident. In comparison to the top-secret findings, almost all of the news of that time was a watered-down version of reality. Information on both combat and flu-related deaths were censored during the war so the reported 20 to 50 million deaths were grossly inaccurate. The latest estimates from these reports put the death toll closer to 250 million.
“Oh god,” she thought to herself. “They may have inadvertently created the Spanish flu. And the symptoms are so similar to Blue. If it mutates to person-to-person transmission, then 8 billion people combined with high rates of travel could easily result in the deadliest pandemic in history. We may be facing a human extinction event!”
Out of the blue, a rope-skipping rhyme from the ’20s popped into her head.
I have a little bird
named Enza.
I opened the door
and in-flu-enza.
“Where in the hell did that come from?” Ruth asked the otherwise empty room. “Strange, one of the newspaper clippings I skimmed through must have mentioned the catchy rhyme but I don’t recall reading about it.”
“Focus, damn it!” she scolded herself.
She couldn’t afford the time but Ruth thought it best to organize her thoughts before responding to Vice President Shepard. Pulling up her journal app, Ruth began to write.
June 30, 2021
Influenza Outbreak of 2021 (aka Blue flu)
Facts:
Lethal but no bacterial infections detected. No link to pneumonia.
No evidence of person-to-person transmission.
All victims test positive for H1N1; antibodies are present in high quantities.
Initial symptoms (stage 1) are similar to severe flu strains: sudden onset of headache, severe muscle, and joint pain, dry cough, runny nose, dizziness, labored breathing, flushed skin, sneezing and fever.
Stage 2 symptoms present as very rapid degeneration of lung tissue resulting in extreme hemorrhaging and facial cyanosis.
~10,000 cases in the US; fatality rate of nearly 100%.
No reports of unusual bird deaths but viral genetic material recovered from Oregon high school case indicates H5N1 is present as well.
2 million pre-pandemic H5N1 vaccines available for tier 1 personnel.
Antigen stockpiles could yield another 25 million H5N1 vaccines.
~100 million flu shots available (includes H1N1 strain).
~200 million more needed.
Unconfirmed:
H5N1 present in all victims? David believes there is a link.
Unusually long incubation period coupled with delayed onset of symptoms (>>2 weeks) masking person-to-person transmission?
Globally dispersed without person-to-person transmission: are birds the carrier?
Natural mutation to superinfection highly unlikely, does that point to an Act of Bioterrorism?
Superinfection theory: H5N1 dormant until H1N1 infection (trigger)?
Will seasonal flu shots guard against the H1N1 infection?
Will H5N1 (pre-pandemic) vaccine prevent or reverse cytokine storm and fatal hemorrhaging?
Conclusions:
It’s early in flu season and relatively low number of cases but global dispersion and fatality rate require pandemic declaration.
Start production of both vaccines
Try to detect Blue H5N1 in otherwise healthy avian species to confirm carrier status
Confirm superinfection (H5N1 + H1N1) is at play and impact of respective vaccines on it
If cases grow to 100,000:
Home Quarantines to guard against potential jump to person-to-person
Vaccinations become mandatory
Laying out the puzzle pieces in this manner made it easier for her to visualize what they were dealing with. There were still gaps in their knowledge but she felt better about calling DC.
∆∆∆
Upper Senate Park
Russell Senate Office Building
Washington DC
Stan Shepard, affectionately referred to as the shepherd by most on capitol hill, was the former Republican Senator of Virginia for over 50 years and the current Vice President of the United States. His personal aide opened the door to his office, "I have Ruth Atkins of the CDC on line one. Should I take a message?"
“Give me a minute then put her through please.”
Stan took a deep breath and swiveled his chair so he could look upon the grounds of the Upper Senate Park on the west side of DC. Though he was no longer part of the Senate branch, Stan liked the close proximity to those there were, and he loved the view so decided not to move to the w
hite house when elected VP.
Stan had been impatiently waiting for Ruth to call with her recommendations. More than a few texts had been sent her way to elicit a response and that would have normally irked him. In emergency situations like this, health organizations typically came to him as a rubber stamp to influence the FDA, or get approval for FEMA, or with any number of questions. Always afraid to make decisions with dire consequences on their own so they typically ran things up the flag pole. But not Ruth. She took personal accountability for the emergencies she worked on. He knew she wouldn’t call until she had reached some conclusions. And after his exchanges with David, he had a pretty good feeling for the direction she was leaning. But much of what was to come next was at least partially her call. So he had tried his best to remain patient.
Stan had known Ruth for years, even hand-picked her for the appointment at the CDC. She was thorough, talented, and ethical but also stubborn and he liked being in control. It's partially what made him tick and also why he was damn good at politics. While Senator, his state was always one of the most prosperous and he was often tagged to head up the most challenging and crucial committees during his five decades of civil service and they all led to this particular place in time and history. Plus he was responsible for the largest budgets in Washington. Military spending, the CDC, and financial sector stimulus packages were often under his charge. So before he picked up the phone he’d already decided what Ruth should tell him. Mandatory flu vaccinations. That was the desired, but also necessary, outcome of this call.
"Sorry for making you wait, Deputy Director Atkins. The damned press is reporting no one has a handle on the Blue flu and it has kicked up a hornet’s nest of a mess for my office. What do you have for me?"
"It's what I don't have for you that is interesting."
That was not how he expected this call to begin. "I'm not following."
"After all of our testing, we still don’t understand the mode of transmission. Even in controlled lab experiments, we haven’t been able to replicate the spread of the disease so it's been impossible to test if we can find a way of slowing it down.”
“Are you telling me you still don't know what is making people sick or killing them?”
“It’s complicated sir. Hospitals worldwide have detected antibodies for the H1N1 influenza virus. That should make this clear cut … but it’s actually baffling because that strain of influenza doesn't cause the pulmonary edema we’re experiencing with Blue.”
In response to his uncommon silence on the other end of the line, she quickly added, “Bleeding of the lungs. That's the main cause of death. People suffocate as blood fills their lungs and results in the telltale blue face, lips, and ears. Hence, Blue flu. But that isn’t a typical symptom of H1N1 influenza.”
“So, if it isn’t the flu …”
“I didn’t say it wasn’t the flu,” Ruth correctly quickly. “It’s just this strain doesn’t normally present in this manner.”
“Then what the hell are we dealing with here Ruth?”
“Nothing definitive at this point but we have a few theories. Most hospitals use rapid influenza tests which aren’t very accurate and they may have missed what was masked behind all those H1N1 antibodies. Sir, our data suggests there are multiple viruses at work. A more deadly influenza strain may be lying dormant until triggered by the typical flu virus.”
“Two viruses working together? Is this common?”
“No, it’s quite rare in fact. Hypothetically, one of the strains could have mutated and formed receptors for the other. But I should also mention we’ve never seen this occur in nature.”
“Are you telling me this is man-made?”
Ruth tried to respond with a feeble No, sir but Shepard was on a roll.
“Jesus Ruth, if North Korea or China catch wind of this hypothesis … you realize we’re already teetering on the brink of World War III here, don’t you? That kind of speculation would push most of Asia over the edge and us likely into nuclear conflict. Japan had nothing to do with this outbreak but North Korea has been waiting for a justifiable reason to attack them and now look at what has happened. It was their warning to the entire world. Fuck with us and we’ll nuke your ass. And on a larger scale, it doesn’t matter who’s at fault if this was engineered, Ruth. There will be enough blow-back to go around and the US will be attacked next. Probably from multiple directions. Please tell me you have a theory for how this strain originated naturally. It doesn’t have to be true … but it just has to be believable.”
An electric shock rippled through Ruth as though she’d licked a 9-volt battery. She’d anticipated a strong response to this news but not this prediction of all-out war. The Shepherd’s geopolitical scope and concerns were an order of magnitude greater than hers. She was so worried about the virus the potential for war hadn’t even registered on her radar. Taking a moment to collect her wits, Ruth responded with a newfound appreciation for the immense pressure this man, her mentor, was really under.
“Well sir, it would be a first, but humans could have infected an avian species with H1N1. If the birds were already infected with another more deadly strain and didn’t die from it, then it’s possible the strains could share genetic information. Those birds would then become immune carriers of the new hybrid, potentially zoonic, disease. Meaning it could travel between both species. And this virus would have receptors for H1N1 and could lie dormant until the victim received the key. In this case, a simple flu infection could set it off.”
“That was very technical, Ruth …”
“Sorry, sir. I should have slowed down to explain it in simpler terms,” Ruth said out of breath.
“No, you didn’t let me finish. That theory sounded both plausible and technical making it difficult for most laypersons, including the press, to refute. Especially if it came directly from the CDC. Say perhaps the Deputy Director.”
Ruth’s spider senses continued to tingle.
“Have you been able to identify the killer strain?” Shepard asked quickly shifting gears before she could protest what he was insinuating. He knew Ruth would resist making a public declaration before proving it out and he didn’t have time to wait for that. A clear example of the differences between government leaders and scientists. Sometimes you needed a leap in faith more than you needed facts.
“We performed molecular tests on samples taken from a few victims and isolated markers for H5N1 … the avian flu. Our bodies don’t respond well to this strain and approximately 60% of those infected with it since 1997 have died. It is so lethal they had to destroy billions of birds in Asia to stop it in the late ’90s.”
She was getting close to the conclusion he needed her to reach. Time to push a bit harder.
“That fits what we’re seeing with Blue doesn’t it? There are a bunch of birds out there infecting us with this dormant but very deadly strain of the avian flu. Would destroying the poultry population in the US stop it in its tracks?”
“Unfortunately, no. I wish it really was that simple but we don’t know which species is responsible as there haven’t been any reports of unusual bird deaths. But they may be just carriers of the disease. We’ll have to conduct more tests to identify potential target species and prove out this theory.”
“No, we need to announce something to the public to ease their fears and more importantly we need to do something before the death toll rises and things escalate with Asian aggressors. So what do we do Ruth? What's your recommendation?”
He couldn't see her body language but could almost sense it through the digital signals bouncing off the cell towers, off satellites, and back to earth, as she paused for what she'd say next.
“May I speak candidly?”
“No Ruth, I'd rather you blow smoke up my ass to save my feelings. Of course, you can speak candidly.”
“I know we're all trying to find the truth here but what I'm thinking is going to be controversial … so I'm a little hesitant to share the theory.” Another nervou
s pause and clearing of her throat. “Many in the press have been reporting the return of the Spanish flu. But the presence of the H5N1 strain tells us, well, I believe we are dealing with an even deadlier virus.”
“Deadlier than the Spanish Flu? Are you serious?”
“The symptoms and the accelerated death rates are similar to the Spanish strain which was based on H1N1 hence the likely conclusion most have jumped to. However, though it infected 30% of the world’s population only 10 to 20% of those turned fatal. But this H5N1 strain lying dormant has an even higher fatality rate.”
“Holy shit Ruth. Didn't up to 50 million die from the Spanish flu at the end of World War I? If this is deadlier, what's our worst-case scenario here?”
“Depends on how it’s being transmitted. But we’re facing a fatality rate of nearly 100%. Mr. Vice President, if Blue spreads or mutates to person-to-person transmission … billions could die.”
“Jesus Christ, Ruth, you want me to tell the President, and the rest of the world, well that we’re facing the impending apocalypse?”
“I certainly don’t propose we say anything of the sort. At least until we have more facts and know-how to combat it.”
“We don’t have time for more facts, especially if what you’re saying is correct. We’ve got to get in front of this. The world is looking for the US to take the lead here. If the Russians, or Chinese, or heaven forbid the North Koreas, come to this same conclusion … society will break down immediately. We have to take action right now to guard against the worst-case scenario. You said two viruses may be involved, don’t we have vaccines for them?”