“That’s right,” said Hodis. “There were the two cases and then the drug-resistant strains disappeared as mysteriously as they’d appeared. Our plague is very different.”
Susan’s phone dinged, and she glanced down at it, feeling tenser than she would have liked. “Ezra’s texting me from the hospital.”
“You better go help him, then. I imagine things are pretty busy there.”
“Probably. Will you be here the rest of the day?”
“Yes, most likely. I’ve got a lot of work to do.”
Susan turned and made her way to the door.
“Susan?”
She stopped, her hand on the knob. “Yes, Tom?”
“Be careful over there.”
“Of course,” she said.
Eighteen
Susan found Ezra watching TV with several other staffers in the ICU. Video of looters brazenly walking out of stores flickered on the screen, canned goods and other foodstuffs spilling out of their arms.
Ezra glanced up when Susan arrived. “Would you get a load of this?” He shook his head in disbelief. “People are just flipping out. At least they’ve got the shooting under control.”
“For now,” said a male ICU nurse.
“Why are they stealing food?” asked Susan.
“Why do you think? It’s not like the McDonald’s on the corner is open. In fact, everything is closed, including our cafeteria downstairs, unless you call coffee and water ‘open.’”
“The DDR is closed?”
“Yeah, I know you miss the haute cuisine, but you’ve got to have workers and a food supply, and we don’t have either this morning. There’s coffee, though, because there is apparently enough coffee and nondairy creamer in the building to last until Armageddon.”
Susan didn’t reply to that. There was no use engaging Ezra on any subject that involved food. “Why aren’t you down in Triage?”
“I’ll treat them when they bring them to me. There’s enough residents and nurses down there to manage the crowds.”
Susan squashed down the immediate cynicism that Ezra’s words elicited. She wondered why Ezra even went into Infectious Disease if he was so resistant to seeing patients, but then she realized that the dangers of epidemic plague had probably never factored into his specialty selection. Most likely, he had chosen Infectious Disease to treat celebrity HIV patients and other well-heeled clientele.
The male nurse returned from the front desk. “OK, guys. Gotta get. We’re getting our very own plague victim right here in this very room.”
“What are they doing with all the ventilators we saw yesterday?” Susan asked as she and Ezra walked away.
“Reopening one of the wards on the twelfth floor. It’ll be a makeshift ICU. Which is good,” he said, gesturing at the room they had just left, “because that was our last ICU bed in the hospital.”
Susan was surprised. County had more than 100 ICU beds. Of course, not all of them were filled with plague patients, but the fact that the system was already taxed with only fifty or so cases in the entire city seemed a harbinger of bad things to come. “How many are plague beds?”
“Probably about twenty-five right now, but the good thing is, turnover is high.” He grinned ghoulishly.
“My god, Ezra!”
Ezra moved his hands in a “settle down” gesture. “All right, all right. I keep forgetting I’m working with the morally pure and idealistic Dr. Barry. No more jokes.”
They walked in awkward silence for a moment before Susan asked in a low voice, “Did you see Andy?”
“Nah, didn’t seem like much point. You know how that’s going to end.”
Susan couldn’t take it anymore. “I’m going to the triage station,” she snapped, before doing an about face and heading back to the elevators.
The triage station was worse than Ezra had described. There were more than fifty patients there, Susan guessed, and the waiting area was crammed with people. A figure in a bunny suit and respirator hood stood at the door, handing out masks to all arriving patients. Susan wasn’t sure if the bunny suit covered a man or a woman, a medical provider or a security guard.
“Susan!”
Susan turned to find Sanders in full personal protective equipment behind her. Only his eyes were visible above the respirator. “Sanders, is that you?”
The skin around his eyes crinkled. “Don’t you recognize the reckless good looks?”
Susan peered at him doubtfully. “No,” she said.
They both laughed. “You’d better get a full bunny suit if you’re going to help. Public Health’s orders. I’d get a face shield, too. A lot of them are coughing up little plague bombs.”
“Can you catch plague through eye exposure?”
“I don’t know,” said Sanders. “But I’m not looking to find out.” He grabbed her arm and drew her over to a filing cabinet in the doctors’ charting room. He opened the top drawer and pulled out her protective equipment. “The word from the top is to conserve these. The supply is limited, and we don’t know when we’ll get resupply.”
She quickly pulled on the bunny suit and slipped the face shield over her N95. While he checked her for exposed skin, she thought back to the night they had responded to the code blue for the lung transplant patient on ridaravine. They had both worn respirators that night, too. Could that have been only two weeks ago?
“C’mon, let’s go,” he said. They left the small office and walked back into Room 1050, the section of the emergency department that normally served as an urgent care clinic. Now, each room was occupied by a coughing patient. Some lay on the exam tables, and some still sat, each waiting to be seen by one of the doctors.
“We’re not at full triage, yet,” said Sanders, handing her a clipboard. “But we’re heading there. Here’s a chart for that room.” He pointed to the patient room farthest in the corner.
She turned to go, but Sanders stopped her. “Susan?”
“Yeah?”
His eyes looked suddenly tired, worry lines visible in his skin. “I’m glad you’re here. A lot of staff didn’t show up.”
“Maybe it’s the traffic.”
“Maybe.” He sounded doubtful. “Anyway, thanks for coming in.”
She smiled a small smile, barely enough to lift the skin around her eyes. “No problem,” she said.
And then the two of them split up, each heading off to a separate exam room and the dying person inside.
The latest projections—the ones they called the “nightmare projections” or “worst case scenario predictions”—were grimmer than Harry Kincade had expected. He brooded over them as he drove to USAMRIID headquarters at Fort Detrick, Maryland.
35,000 dead in Reno. 75,000 in Sacramento. And an incredible 120,000 in Los Angeles. These were the numbers that USAMRIID’s PULSE program had spit out earlier after Jim Heger had input the latest data from the quarantined cities.
Kincade took one hand off the wheel and rubbed his forehead. His head had begun to ache, a dull throbbing sensation that slowed his thinking. He took a deep breath and dialed Heger’s number.
The Chief of USAMRIID’s Disease Assessment Division answered on the first ring.
“Harry, it’s in Japan,” Heger blurted out.
“What?”
“The plague is in Japan. The Japanese have their first confirmed case, some business traveler just returning from Los Angeles.”
A pit formed in Harry’s stomach. The plague was spreading. Although several of the government’s mathematical models showed that plague would spread despite shutting down West Coast cities, he’d hoped that with sufficient speed and ruthlessness, the California and Nevada quarantines would at least slow down the disease.
Rage, powerful and hot, surged through him. And they worried about coronavirus, he thought. Well, they’d get their fucking pandemic after all. Goddamn the media! Goddamn them all!
“Harry, are you still there?”
“Jim, I told you, I’m on my way.”
/> Nineteen
Ezra Pilpak was hungry. God, was he hungry. He pulled open the small refrigerator in the Infectious Disease office, looked inside and found nothing, then crossed over to the desk to check the bottom drawers again. Nothing.
Where was Susan? She’d called an hour earlier to report the triage station was full but still orderly, and that she’d come up so they could round on the inpatients. But she hadn’t shown yet, and Ezra would be damned if he was going down to the triage station to find her.
Fucking Susan. A regular paragon of the Hippocratic Oath. Oh, how she irritated him with her noble must-take-care-of-the-poor-downtrodden-sick attitude!
He found an ancient-looking piece of gum in the department secretary’s desk, popped it in his mouth, and chewed miserably.
He wanted to go to Catalina, to take his parents’ boat and leave. When the dumb quarantine was over, to hell with the fellowship program, he’d take the boat and go.
She finally called at a little after two. “I’m still in triage,” she said. “Half the staff didn’t show up, and the numbers are picking up.”
“Let the medicine residents take care of it. We need to round on the inpatients.”
“OK, OK.” She sounded annoyed. “Let me take care of this last patient. The nurse is drawing blood. It’s a real plague case, I think. I just need to enter the admit orders.”
He shifted irritably. “Hurry up. I’ve been waiting over an hour.”
“If you’re in such a big hurry to see me, you could always come down here and help.”
“No way.”
“Then quit whining,” she snapped. “I’ll be up in fifteen minutes.” She hung up the phone.
Susan felt harassed. Almost as harassed as the nurse who came rushing out of the exam room, where Susan’s patient lay miserably huddled beneath a wad of blankets.
“Here’s the blood,” the nurse said, thrusting two culture bottles and several other blood tubes into Susan’s hands. “I didn’t know what you wanted, so I just drew everything.”
Susan raised her eyebrows. “Where’s the paperwork?”
The nurse gave her a disgusted look. “Can’t you fill it out? I’ve got four other rooms where I’ve got to draw blood. There’s no one drawing blood here today but me, so if you wouldn’t mind, it would help a lot if you filled out your own paperwork.” She pulled a little round tube of rolled up lab requisitions out of the back pocket of her bunny suit and shoved these into Susan’s hands before stomping off.
Which left Susan standing there with several blood tubes clutched against her chest, two blood culture bottles in one hand, and the lab requisitions in the other. Despite herself, Susan felt a little stung by the woman’s angry response. She told herself that everyone was stressed out, that they were short of personnel, that things might be like this for a little while until the situation was better under control. But nonetheless, she heaved a little sigh as she dumped the blood tubes and culture bottles on the desk in the center of the room and sat down to fill out the forms. She’d be even later now. Ezra would be irate.
One of the other residents materialized at her side. “We need your patient room,” he said. “When are you going to get that guy out of there?”
“I called transport twenty minutes ago,” she said, her eyes still on the computer screen where she was entering expedited admit orders. “They should be here any minute now to take him upstairs.”
“Good,” said the resident. “Because there’s a frickin’ hundred people out there in the waiting room now.”
Susan looked up, surprised. “A hundred?”
“At least. There are more people lined up outside, I hear.” The resident shook a harried head. “I can’t believe they all have plague. This has got to be mass hypochondria.”
“I hope so. Oh hey, look who’s here.” Two bunny-suited orderlies arrived with a gurney. Susan helped the two men load her patient onto the stretcher, and then, when the room was at last empty, she turned back to clear the exam table.
Susan felt a sharp prick on her middle finger as she soon as she swept up the blankets and paper table cover. For a confused moment, she thought she’d been stung by a bee. She dropped the paper and cloth wad back on the bed and carefully unwound it. In the center, she found the blood draw kit, its micro red tubing terminating in a bloody, unsheathed needle.
When Ezra found Susan, she was frantically scrubbing her finger with betadine. She stood at the sink at the side of the room, scrubbing, scrubbing, as though she might be able, with enough fervor, to scrub the bacteria out.
“Susan, for god’s sake, you’re pathetic. I’ve been waiting—” He stopped mid-sentence when he saw what she was doing. She looked up, her eyes a little wild, her chest rising and falling rapidly. She didn’t speak.
“What happened?” he asked.
The words tumbled out in an agonized rush. “A needle. A blood draw needle. The nurse forgot it on the bed. I went to clean the bed. I didn’t see it there. I—” She thrust her finger back under running water, watching as the betadine cleared, and then held it up before her face, scrutinizing it fiercely.
Ezra twisted around to look. The bubble of blood was unmistakable, crimson against the pale whiteness of her skin, a small drop that grew and dripped.
“Oh, Susan—” Ezra said, his voice low and filled with horrible pity.
She stared back at him, speechless.
Twenty
George Mack stood in the War Room at the County Department of Health and felt a moment’s elation, which he tried to suppress. The video was good, and Hayden was a star.
Mack watched the live shot at Reno’s main post office, where mail truck after mail truck left the enclosed yard, heading out onto the streets of Reno, their back ends filled with mail and a more precious cargo—100,000 masks.
It was television at its best. Hayden stood in front of the building, his face partially obscured by a respirator, talking with another masked man, who wore the blue and gray uniform of the US Postal Service.
The man said, “We want to send a strong message to the people of Reno that business will continue as usual for the United States Postal Service. Our mail carriers are coming to your homes with your mail and a supply of masks for each family member to wear—”
Mack shook his head, disbelieving. “Where’d they get this guy? He’s a fucking cowboy.”
“He’s great!” said Nesbitt.
The two men watched the TV screen, riveted. Hayden turned back to the camera. “Local health authorities are taking this epidemic extremely seriously. As the race to find a cure for the disease continues, officials are emphasizing protective measures for citizens, such as staying at home, washing your hands frequently, and—” He pointed to the mask on his face, “wearing these whenever going outside or if there is a sick person in your household.”
Hayden turned back to the postal worker, whom Mack now recognized as Reno’s postmaster, an old Gulf War vet like Mack. “Are you worried, sir, about your workers being exposed to the plague?”
“Of course,” said the postmaster. “Each of our mail carriers has received emergency training on how to protect themselves from disease. They’ll be wearing protective clothing, similar to health care workers. You know as well as I do, Mr. Hayden, that we must all work together to stop this disease, and with coordinated effort, I am sure the good people of Reno will prevail.”
Mack shook his head, but he couldn’t help the small smile that formed on his lips. “Who knew the postal service had such balls?”
They watched as Hayden held up a box of masks and the camera zoomed in on its contents. Nesbitt looked over at Mack, his face suddenly serious. “It was a great idea, George.”
Mack shrugged, his eyes not leaving the television set. The small smile was gone from his face. “We’ve got one-hundred thousand masks going out today, but there are over five-hundred thousand people in the metro area. This is only the beginning, Nesbitt.” Mack reached for the pack of cigarettes in hi
s breast pocket, his expression grave. “It’s going to be a rocky road ahead.”
Susan knew she didn’t have much time. Maybe three days, if she was lucky. Funny how conscious of time you became once you knew there was so little left. She looked at her watch, at the seconds quickly passing, the end of her life happening before her eyes.
She hustled across Zonal Avenue. In her mind’s eye, she could see the Yersinia pestis bacteria swimming through her blood stream to her lymph nodes and lungs, where they would multiply and erupt, spilling in murderous numbers into her blood.
But maybe she would be lucky. Maybe she would lose her mind first, because she had seen that, the delirium that overtook the plague victims, making them thrash about wildly before they ultimately sank into the apathetic coma of approaching death. Yes, delirium would be best, maybe God’s way of sparing her, so that she didn’t have to see the blotches grow together, to see her fingers turn black as she hacked her last moments away, the life smothered out of her.
She pulled back the glass door to the Stauffer Medical Research Building lobby, and then, keeping her head down, made her way to the elevator.
She found Hodis sitting in his office, his position unchanged from earlier. He looked up, surprised. “Hi, Susan. Why aren’t you at the hospital?”
“I got a needle stick,” she said.
Hodis jerked, as though she’d stabbed him.
“I don’t think I’m infectious yet—”
He grabbed her hand. “You’re sure it was plague? Did you go to employee health?”
“Why?” her voice cracked. “What on earth can they do for me now?”
He didn’t answer.
“I wanted to say goodbye.”
He shook his head, adamant. “Don’t. You’re not sick yet. Go home. Go into quarantine. Call employee health. You know what to do.”
DRYP Trilogy | Book 1 | DRYP [The Final Pandemic] Page 17