Mike picked up his version of the National Strategy for Pandemic Influenza and absentmindedly leafed through its pages. The US government’s disaster response ability had been found woefully inadequate following the disaster that Hurricane Katrina left in her wake at the end of August 2005. The National Strategy had been written to ensure three key functions: investment in the technology to detect emerging pandemic influenza, investment in the development of vaccines and anti-viral drugs, and lastly cooperation with local, state and federal government to ensure a seamless network of protection exists for everyone in the country. Mike threw the strategic plan in the wastepaper bin and looked out of his office window towards the flagstaff that stood at the front of the building. There the Stars and Stripes of the US Nation fluttered in the wind. Fifty stars representing the 50 states of the Union. Mike wondered how many of those states would be devastated by this influenza epidemic. On the wall opposite Mike’s desk was a lithograph by Albrecht Dürer that depicted the Four Horsemen of the Apocalypse. The fourth horseman, riding the pale, white, sickly horse, in most English translations of the bible, is thought to represent fear, sickness, and death. The second horseman, riding a red horse, represents pestilence. Pestilence and Death represented by the colour of red and white, the same colours as the stripes of the Union Flag. Perhaps, mused Mike Morrison, the fifty states would soon be united in pestilence and death. H5N1 might well turn out to be the apocalyptic instrument of the second and fourth horseman.
***
Ellen Augustein was well ahead of the pack and had already established plans to contain an outbreak of a contagious disease such as influenza. Ten days after the first reported case, there had been 200 hospitalisations and 13 deaths. Ellen also had reports from the UK, France, Italy, Turkey and Japan of another 11 hospitalisations and 4 deaths. She crossed her fingers and allowed herself to think that they had so far been lucky. However, quite unexpectedly new point sources of infection within the US started to occur, keeping the number of hospitalisations and consequent deaths to steadily rise. By day fourteen the numbers had risen to 250 hospitalisations and 18 deaths. Alarmingly, some of these new sites of infection were establishments that housed large numbers of people. There was also a report of three hospitalisations at Fort Meyer. Ellen had the results back from over thirty viral typing tests, confirming everyone’s worst fears, the virus was a type A, H5N1. By day fifteen they had implemented a movement restriction order in ten different communities, enforced by the military.
By day twenty they had another 14-point source outbreaks, ten of which appeared to have the Milwaukee Greyhound Bus Terminal as a common denominator. As the numbers continued to increase, Ellen moved over twenty-three million doses of anti-viral drugs into the North Eastern states, but it was a drop in the ocean considering how many people actually lived in those areas.
On day twenty-two they had reports that a virus causing the infections in some isolated areas were from an H1N1 sub-type. If this were true, it could be that the current native influenza, an H1N1 New Caledonia virus, was just an opportunist killer. Certainly, the numbers of hospitalisations were not much greater than might be expected from influenza at this time of the year. At USAMRIID Lieutenant Colonel Mike Morrison and his team were conducting gene-sequencing tests on some samples of the H1N1 type virus to confirm that it was the New Caledonia sub-type.
Day thirty saw the number of hospitalisations hit 350 and the deaths reach 34. Now the virus kept popping up all over the North Eastern States, all seemingly new sources of the disease.
Then on day thirty-five came a bombshell from USAMRIID and Mike Morrison’s team, the gene sequence of the H5N1 sub-type was 65% the same as the H5N1 bird flu that had originated in Asia and 35% the same as the 1918 Spanish Flu. The genome of the Spanish Flu had been determined and published in ‘Nature’ in 2005, by Ann Reid, Jeffery Taubenberger, and their colleagues. The only possible conclusion that could be drawn from this data was that the H5N1 infecting the people of the North Eastern States was bio-engineered to ensure that it could be transmitted from person to person by aerosol through sneezing. It confirmed that this outbreak of influenza was part of a biological terrorist weapon.
The conclusion was devastating. Someone had engineered a contagious variant of the H5N1 bird flu with the highly contagious 1918 H1N1 Spanish flu making a synthetic super virus that science had no experience of and the peoples of the world had no immunity against.
Ellen Augustein hoped that epidemiology analysis of the outbreak distribution, and the numbers of victims at each point source, might reveal the principal method of release of the virus. Discovering that would depend on Mike Morrison at USAMRIID and Major Julian Adams, PhD at the Walter Reed Army Institute of Research in Washington D.C.
***
Mike Morrison and Julian Adams were both experts in the epidemiology of bio-terrorism, and with the help of sophisticated computer analysis they would try to determine each point source of the infection. From that, normal investigative techniques by field teams might lead them to the method of release.
To date no single point source of infection had been identified, the spread of the disease did not fit the normal parameters of an intentional release of a contagion apparent in a bio-terrorist attack. Using the sophisticated algorithms of the epidemiological computer program at USAMRIID they had confirmed over twenty-four different point sources where the contagion had been released. The initial incubation period observed in the first victims to contract the disease confirmed that the virus had been released in large quantities. In one case, the lady working at the Mercy Medical Centre in Oshkosh, Juanita Martinez Rivera, had died just a day after being infected. However, the subsequent spread of the disease from person to person had a much longer incubation period. This could mean that the virulence of the two combined influenza virus types was not as high as it could be. Perhaps the virus had been damaged by the methods of storage or release chosen by the terrorists. Mike Morrison and Julian Adams hoped beyond hope that this was the case.
The next stage in the epidemiological investigation was to send field teams out to discover the circumstances of the original contagion release. Mike and Julian quickly organised the field teams and sent them out to the places of employment and homes of the victims, whom they had established beyond reasonable doubt were at the original point sources of release. They also organised information collation systems and teams that would sift through all the data collected by the field teams. In the interim these people were organised into groups that would brainstorm the possible scenarios of how this bio-terrorist contagion was released.
***
By day thirty-six the number of hospitalisations in the United States had risen to 531 and the number of deaths to 63. People all across the North Eastern States of America were staying away from work. The number of people travelling by public transport had diminished to only 3% of normal capacity. Events where people would normally gather were cancelled, theatres and cinemas around the country were closed. Those people and areas of infection that were quarantined were feeling the hardship of their isolation. Essential services were slowly buckling under the pressure of absenteeism of their staff. The military had already been co-opted to assist in the management of these services. Military personnel were now asked to assist outside the quarantine areas in services that were in danger of collapse.
Although the human cost, – the number of people infected and the number of dead – was not extraordinary, the economic cost to the nation was staggering. Already estimated to have cost billions of dollars, the US was struggling to maintain normal international trade and travel as a number of countries closed their borders to U.S. citizens.
By day thirty-six the number of hospitalisations outside the US had risen to 57 and the number of deaths to 21. People all around the globe started to wear facemasks and to voluntarily restrict their own movements. A state of emergency had been declared in the UK, France, Italy, Turkey and Japan as their borders were sealed to genera
l trade and travel.
Contrary to Lieutenant Colonel Mike Morrison’s prediction, there was little evidence to suggest that this pandemic would become apocalyptic in human terms, but in economic terms it was already a catastrophe.
26. Point Sources of Contagion
The USAMRIID computer analysed the data from the incident reports collected from across the U.S. and isolated four definite point sources of contagion: Ripon College, the La Rabida Children's Hospital in Chicago, the Alexander Nursing Home in Salisbury, and the Mercy Medical Centre in Oshkosh. There was also another as-yet unconfirmed source, the Milwaukee Greyhound Bus Terminal in Wisconsin. Lieutenant Colonel Mike Morrison sent five teams to the probable sources of infection with instructions to get statements from all the influenza victims who were still alive and coherent, and statements from the relatives of those victims who had died. The questionnaire seemed very mundane but in reality, even the simplest of questions might reveal details of the initial release of the virus.
While the teams at USAMRIID and the CDC worked tirelessly round the clock, the entire country was groaning under the burden of movement restrictions and quarantine procedures. Without military assistance much of the infrastructure in the North Eastern States of America would have broken down. Every member of the public wore facemasks and avoided activities where there might be groups of people. Everyone waited, morbidly anticipating those first deadly symptoms that would indicate that they too had contracted the disease. Many did fall victim to the bio-terrorists’ influenza variant, while countless others contracted the endemic Type A influenza viruses, the 1999 H1N1, “New Caledonia,” or the 2004 H3N2 “California.” Even though the public were informed that there would be nearly 17000 hospitalisations and 3000 deaths from the endemic flu strains across the US every month, everyone thought the worst, that they had contracted the “big one” and were about to die.
General practitioners and hospital staff were struggling with the public demand for flu vaccinations, even though these would do nothing to prevent them contracting the bio-terrorist variant of the disease. The whole country was suffering from the panic buying of general foodstuffs, water, and homeopathic influenza medicines. People queued outside supermarkets and like locusts striped the shelves of produce; rice, bread, tins and fought over bottled water and toilet paper. People were literally dying as a direct result of such panic; pedestrians being run over as they rushed blindly into the path of oncoming cars to get that last bottle of water or that last can of fruit. One shopper was stabbed in the face when she took the last loaf of bread from a supermarket shelf in Miami. There were shootings too. One in a New Orleans hospital occurred when the parents of a black child suffering from the measles, were shot by another patient, who had been waiting for two hours for a flu vaccination, aggrieved that the boy had been bumped up the queue ahead of him.
***
Henry Govens had now received a total of five aerosol cans with accompanying letters from disgruntled customers, complaining about the spray mechanism becoming blocked. If he got five, then there were more than a hundred times that many of which customers, for one reason or another, had not bothered to return them. Sometimes they would return them to the shop where they bought the cans from and get a replacement or their money back; which then left the store owner to claim the cost back from C & W Cooper. Five complaints made by customers direct to the company at the Meadowvale plant in Silver Ridge, meant that there were hundreds of customers who would not buy the Meadowsweet air fresheners again. The company prided itself on the quality of their product and the loss of even a single customer was a matter the company took very seriously. The five that Henry had received would be compensated at five times the cost of the product because C & W Cooper cared. If there needed to be a product recall it would send tremors right through the market and the valued reputation of C & W Cooper would be adversely affected, so such complaints were taken very seriously.
When Henry examined the returned cans, he saw that they all had some kind of yellow, waxy material blocking the nozzle. He scraped some off with a pencil and sniffed it. It was odourless. He then squeezed some of it in his fingers. It looked like some kind of wax, though Henry had never seen anything like this in the complaints department before. Changing the nozzle had no effect, so the fault must be in the pressure release valve inside the top of the can. That meant the cans would have to go to Viktor Czerny, in the research and development lab. Henry could send them by internal messenger, in which case they would be there within twenty minutes, but Henry fancied one of the receptionists at the lab.
“Ahh…Melonie, I think I’m in love with you,” said Henry to himself.
“Henry, are you talking to yourself again? If you don’t ask her out soon, you’ll go blind.”
It was Alistair Webster, his assistant mocking him again.
“Oh, shut it Alistair, I don’t make fun of you and Isabel. Besides it’s you who wears the glasses, not me.”
“You’re obviously not getting enough are you, you poor sod”
“Well, I’ve got to go over there with these things,” said Henry, indicating the five cans of Lavender Meadowsweet air freshener on his desk. “I’ll try and pop the question and see where it gets me.”
“Pop the question? You want to bed her, not wed her, you daft bugger.”
“You know what I mean. I’ll tell you what happens when I get back.”
“Here, you’ll need this,” said Alistair, tossing him a small aerosol.
Henry deftly caught the can then briefly, glanced at it before replying. “I don’t need “Fresh Breath” do I?”
“Well, you never know your luck; you could end up with her in a clinch over the lab reception desk. You have to be quick these days, you know.”
“When I get it together with Melonie it’ll be after a romantic candle-lit dinner and a few glasses of wine.”
Henry gathered the five cans of Meadowsweet and left the office for his rendezvous with ‘lurv’. Move over Barry White, I’m coming through, thought Henry as he trotted down the corridor to the lifts.
***
Captain Phillip James’ original degree from Caltech, the California Institute of Technology in Pasadena, California, was in environmental biology. In the US Army, at USAMRIID, he was a molecular biologist. However, he was often co-opted into the field teams that were sent all over the country to investigate the epidemiology of some disease, just in case it turned out to be a bio-terrorist attack. Phillip didn’t mind being away from home, on an expense account, meeting and interviewing all sorts of interesting folk in the pursuit of truth; but his wife Val did. Phillip was a tall, 1.85 metre, tri-athlete, with blonde hair and green eyes, who many women found handsome in a rugged sort of way. Val, who had become a little dumpy after her second child, doubted, just a little bit, that Phil would remain faithful to her when he was away, facing temptation. She needn’t have worried though, her husband was devoted to her and the two children, even though there was lots of temptation for the weak Phil was staunchly loyal. Other colleagues though were not like Phillip, his assistant, Staff Sergeant Robert Carter, was always after some woman when they went away. He would come back to the motel with them, as bold as you like and then boast about his conquests over breakfast. Carter always said that his wife Sally knew he was “playing the field” and that they had a sort of open marriage, but that wasn’t what Val had told him. Sally Carter and Val were best buddies and often confided in each other, so much so that Phil was often given the third degree about Robert’s behaviour when he got home. Phil had to bite his lip sometimes to remain neutral, the last thing he wanted was conflict with a colleague. Phillip always wondered if the same thing was going on in the Carter household, probing questions about his own behaviour on the field trips. He always wondered what Robert said on such occasions, he didn’t really trust the guy that much.
“Where are you going this time, Dad?” asked his 12 years-old son Rory.
“Wisconsin. Do you know where tha
t is son?”
“Yes sir, that’s where the flu is, isn’t it?”
“It sure is. How do you know about the flu young man?”
“My teacher, Miss Strickland told us. We’ve had a lot of lessons about the flu and how not to catch it. She said that it has killed a lot of people. You’re not going to catch it are you Dad?”
“No son, I’ll make sure I don’t so don’t worry about that. You look after Mum and Mary-Anne while I’m away, you hear that soldier?”
“Yes sir, Captain James.” Rory stood to attention and gave Phil a copybook salute.
“Yes, be careful love, we need you back safe and sound. Don’t take any risks, will you?” It was Val, standing in the doorway.
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