Virus Hunters 3: A Medical Thriller

by Bobby Akart

  Ghosh agreed to turn his car over to Yeshi, and he allowed Babu to take his seat. This gave Harper and Kwon the opportunity to speak with him for an extended period of time as they traveled to Tingri County.

  The conversation was somewhat belabored as the young man had only a basic understanding of conversational English. However, in addition to his native language, Standard Tibetan, he was fluent in Mandarin Chinese. As was Kwon.

  Babu explained in Chinese, “Everyone is in that fine line between life and death when they approach the summit. The climb from the South Face is much easier, but also too crowded. Each year is more dangerous because everyone wants the money.

  “As Tibetans, we are limited to the paltry sums the government allows us for scaling the North Face. This year was especially difficult because poor weather at the start of the climbing season meant there was only a very small window of time to approach the summit. In prior years, with better weather, we were able to stagger our teams. There are always lines, but nothing like what we experienced this year.

  “My friends and I have learned to stay calm on the mountain. We know the most challenging parts of the climb, and we also have learned to conserve our oxygen. Many climbers are doing it for the first time. Between the excitement and inexperience, they run dangerously low on oxygen at the top. However, this accident was different.

  “At the base camp, there was a rumor that two men from Australia were not taking Everest seriously. They seemed more interested in socializing with women than preparing themselves for the climb. They were not part of my group, so I stayed out of it. I simply advised my climbers to avoid their drinking and late-night activities.

  “Anyway, as the day grew near for the climb, another rumor circulated that influenza or a cold was circulating through the camp. Again, I kept close tabs on my climbing group and monitored their health.

  “I hope you understand, I could lose my life if one of my climbers passes out or loses their balance. It is just as important to me that they remain fully prepared for the climb, just as I am. Sadly, not all Sherpas are this conscientious.”

  With each point made, Babu would pause and allow Kwon to translate what he said to Harper. Kwon also asked the young man questions and relayed the answers to Harper as well.

  “On the day of the accident, my group was third in line to the summit. There are parts of the climb where I can look ahead and see the progress of the other groups. Nearing the Chinese Ladder is one of those times. I noticed there was a delay at the top of the ladder. I was puzzled because every climber was properly clipped to the safety rope, and none appeared to be trying to reverse course.

  “I paused my group and passed the word down the line to rest. I was glad I made that decision. You see, when the queue builds like that, there is great danger to us all. The path is too narrow for the more experienced climbers to unclip and pass the slower ones. If someone loses oxygen or needs medical attention, there is no room to drag a body backwards, and it is unlikely the other climbers would give way. They are in their own survival state of mind.

  “I do not know what happened on that final climb to the summit because I could not see the start of the accident. I have spoken to the Sherpa who avoided dying with some of his climbers. He told me the two men, both Australians, had become very ill and were unable to hold their balance. One fell, snapped the rope, causing a chain reaction of people losing their footing.

  “The first man who collapsed slid backward and over the cliff toward the top of the Chinese Ladder. He was the one evacuated by the military team. The other man, his friend, fell farther down the mountain, dropping as far as the Kangshung Face would allow. Many thousands of feet.” Kangshung Face, translated as East Face, is one of the Chinese sides of Mount Everest. It can be accessed from a remote valley near the side of the mountain closest to the Tibet border.

  Kwon interrupted him. “If he fell that far down, how do you know where his body is?”

  “Ghosh can help, as can I. There are many vertical, overhanging rock buttresses jutting out from Kangshung Face. The body could be seen from above because of its outer jacket in the white snow. Unless an avalanche swept it farther down the East Face, it will still be lying there.”

  “Let me ask again. This is an enormous mountain. How can you both be sure where the body is located?”

  The young Sherpa chuckled. “It is big, but it is ours. Since we were able to walk as young children, our fathers took us on every route from top to bottom and side to side. Just as their fathers had done with them.”

  Kwon explained to Harper, but before he finished, Yeshi interrupted them by raising his phone into the air. He’d received a text message.

  “Stay calm. We are going to have company.”

  Chapter Five

  CDC Headquarters

  Atlanta, Georgia

  The Centers for Disease Control and Prevention, like any other government agency, had a hierarchy. Being aware of turf wars and backstabbing was a part of the job, and Dr. Berger Reitherman understood how to play the game. He didn’t like it, but his survival instincts had served him well since arriving in Atlanta.

  From the moment Harper had left for Beijing, he kept in contact with her husband, Congressman Joe Mills. He’d promised to give Joe updates on Harper’s progress as information came into him. Thus far, there had been complete radio silence, and he was growing increasingly uneasy.

  Truthfully, he missed his days as a program manager within the infectious disease group at DARPA, the Defense Advanced Research Projects Agency. The comradery there resembled a unit of the military rather than highly educated stuffed suits looking to climb the government’s equivalent of the corporate ladder of success. At DARPA, problem-solving through unconventional methods was the norm, an outside-the-box way of thinking that wasn’t appreciated as much at the CDC.

  So it came as no surprise to Dr. Reitherman when his superiors lost their collective minds after they learned he’d sent Harper to China on her undercover mission to locate patient zero. The revelation came purely by accident. Four days after the Chinese sent the epidemiologists from Europe into the Great Khingan Mountains in the northernmost region of Inner Mongolia to search for diseased yaks, Dr. Reitherman’s counterpart overseeing the U.S. contingent from the CDC in Beijing gained approval to send Dr. Eloise Blasingame as part of a second expedition. Only, he learned from the CIA station chief in Beijing that she was ineligible to travel because her credentials had been loaned to Harper.

  Within hours, Dr. Reitherman had been called to the woodshed. He argued that the decision to send Harper to the Far East was not only necessary but within his authority. Further, he appropriately made the case for handling such an important matter on a need-to-know basis. One mistake, one slip of the tongue, could’ve compromised Harper and Kwon.

  He was threatened with future discipline and warned against withholding any information regarding Harper’s activities. He was also shadowed by his boss, who seemed to make an extraordinary number of visits to his department throughout the day.

  When Dr. Elizabeth Becker notified him first thing that morning that she’d received autopsy results and specimens from Las Vegas courtesy of Dr. Wolfgang Boychuck, the medical examiner, his spirits lifted. He decided to get his hands dirty, figuratively speaking.

  “Okay, Elizabeth, are you ready to do this?” he asked as he approached Becker, who was studying Dr. Boychuck’s notes in the dressing area of the biosafety level 4 laboratory.

  “Are you sure about this, sir?” she asked politely. “This is kinda grunt work, if you know what I mean.”

  He did, but he didn’t care. He was ready for a change of pace, and he thought it might be good for his soul to conduct a little research therapy. The serene environs of a BSL-4 was just what he needed at the moment. Besides, his boss couldn’t come around to check on him when he was suited up and tucked away in the sterile confines of the submarine-like space.

  In separate areas, they dressed in positive-pressu
re suits made of a material resistant to the virucidal chemical showers required to destroy any deadly pathogens that had attached to it in the lab. It also had to be sufficiently mobile for them to work. The suit was equipped with an in-line HEPA filtration system connected to a breathing air system using the same kind of quick connections available to astronauts aboard the International Space Station in the event of an emergency.

  In order for scientists and epidemiologists to safely study the most dangerous biological agents, laboratories were created with certain levels of biocontainment precautions established. The lowest safety level was a BSL-1. The highest was the BSL-4, where most of the CDC epidemiologists performed their work.

  True BSL-4 facilities were extremely rare. There were only eleven countries in the world with BSL-4 facilities until years ago when the one in the Central African nation of Gabon had been destroyed by terrorists.

  To enter the BSL-4, Becker and Dr. Reitherman passed through two stainless-steel doors into an airlocked chamber. They were able to feel the air pressure change in both spaces through an automated system that ensured high-pressure air in the airlocked chamber flowed into the low-pressure laboratory, effectively preventing any airborne pathogens from escaping.

  Once inside, they were immediately immersed in sterile surroundings. The walls had a glistening sheen from the many layers of epoxy compound creating a continuous seal across every surface. Light fixtures and electrical outlets were housed in airtight boxes and lathered in protective epoxy to prevent pathogens from escaping through the wall penetrations. Even the electrical wiring was stripped of insulation and coated with the epoxy.

  “It’s been a while since I entered your domain, Becker,” quipped Dr. Reitherman as he dutifully followed the young epidemiologist. “The precautionary measures taken never cease to amaze me.”

  “These boogers don’t mess around. Sometimes it’s hard to fathom a deadly bacterium or virus that are many millions times smaller than what our eyes can see. All it takes is one to escape and we’ve got a pandemic on our hands.”

  “Well, I’m glad to see the results of your work firsthand. You know, Dr. Randolph speaks very highly of you.”

  Becker motioned for Dr. Reitherman to follow her deeper into the BSL-4 toward a series of microscopes. “She has to.”

  “Um, why’s that?”

  “Blackmail, sir. I know things.”

  Dr. Reitherman slowed his pace and dropped behind Becker. She sensed he was stopping, so she slowly swung around.

  “Sir, I’m just kidding. Seriously.”

  “Okay, sorry, Elizabeth. It’s been a rough couple of days.”

  She motioned for him to stand at a microscope adjacent to her workstation. She pressed her protective helmet up to the bug-eye-shaped eyepiece of the microscope and studied the sample provided by Dr. Boychuck.

  “I heard. Word has been going around that you’re in the doghouse.”

  “Really?” he asked.

  “Yes, sir. It’s a small office, sort of. Anyway, sending Dr. Randolph was the right thing to do, and we all support you.”

  Becker couldn’t see Dr. Reitherman’s broad smile. Neither Becker nor the other epidemiologists under his command at the CDC could save his job if Harper’s undercover mission went public, but it was good to know his team approved of his decision.

  “Okay, Elizabeth, show me what you’ve got.”

  Chapter Six

  CDC Headquarters

  Atlanta, Georgia

  “The best way to start is for you to take a look at this killer, and as you do, I’m going to explain what we’ve found,” said Becker as she pointed toward the microscope in front of Dr. Reitherman. He leaned in to get a view of the virus.

  “Looks familiar,” he mumbled as he studied the virus particles.

  “A decade ago, the whole world saw images of COVID-19 under an electron microscope. When the world experienced the SARS outbreak in ’03, it didn’t have a meaningful impact on the U.S., so the media didn’t cover it as much as the pandemic of 2020.”

  “Well, this guy certainly has the distinctive crown indicative of a SARS-associated coronavirus. But there is something about these proteins that seems different from COVID-19.”

  “Very good, Dr. Reitherman,” said Becker, who was clearly enjoying the opportunity to interact with the capo di tutti, the Italian term for boss of bosses often used in discussion of Mafia crime families. It was another of her pet names for Dr. Reitherman that she would never say to his face for fear he might take offense. “Those crowns, or proteins, live on the surface of the virus and determine which cells it can infect. Do you notice how they are varied in size and shape?”

  “Yes,” he replied without taking his eyes away from the microscope. “Yes, they are ill-defined compared to what we observed of SARS-CoV-2 or even its predecessor, SARS-CoV-1.”

  “Exactly. Would a rose by another name smell as sweet? In other words, they are similar in that the target receptor is ACE2. Our novel virus particle is in the same family, and it also targets the ACE2 receptor.”

  Dr. Reitherman stood and studied the other microscope, which provided him a view of COVID-19. The crown was more defined and crisp. He stood again to address Becker.

  “Okay, I see the difference, but I sense there’s more.”

  “Yes, sir,” said Becker. “The difference has to do with the nucleocapsid proteins. Both CoV-1 and CoV-2 had an abundance of N proteins. This new virus particle does not. As you know, the N protein of coronavirus binds to viral ribonucleic acids that led to the herd immunity achieved after the 2021 flu season. After the first wave, we were able to determine that the N proteins in COVID-19 contributed to the potent immunity after patients contracted the disease.”

  “Where are you going with this, Dr. Becker?” he asked.

  “Well, it appears, at least for some patients, that the N protein of this particle has the ability to neutralize the immune response of the host. Basically, it acts as an antagonist to the action of interferon gamma proteins, resulting in a cytokine storm.” Cytokines were a category of small proteins making up a body’s immune system. These molecules mediate and regulate immunity and inflammation in the body.

  “A cytokine storm?” he asked.

  “Yes, sir. Basically, this virus particle antagonizes the body into a deranged immune response. The blood samples of the deceased patients we’ve studied indicates their veins were teeming with high levels of these immune system proteins.”

  “The body is overreacting and attacks its own cells and tissues rather than fighting off the real predator. H1N1 was similar.”

  “Yes, sir. That’s correct. In the victims, I would characterize the size of the cytokine storm as gale force and unstoppable. The virus appears to be capable of copying itself very quickly once it infects a cell. That places an inordinate amount of stress on the body. As the cell senses there is something foreign, its immediate response is to kill itself.”

  “It’s a protective mechanism,” interjected Dr. Reitherman.

  “Based on the autopsies we’ve studied, you have many cells doing this at the same time. However, like most respiratory diseases, the lungs are the first to go. As the tissue breaks down, the walls of the lungs’ air sacs become leaky and fill with fluid. The natural result is pneumonia and the patient’s blood is starved of oxygen.”

  Dr. Reitherman wandered away from Becker and stared aimlessly at the thick glass windows lining the BSL-4. CDC staff members traveled in both directions along the long corridor at a hurried pace. It was all hands on deck.

  “Why are some of these patients subjected to the cytokine storm and others are not?”

  Becker joined his side. “Before she left, Dr. Randolph set me on this course of research. Here’s what I’ve learned from the autopsies, the blood samples and the patient histories. Unlike COVID-19, which primarily affected the elderly and those with a predisposition to respiratory illness, this novel virus tends to feed on young adults who appear to be the p
icture of health.”

  “Why is that?”

  “I’m still trying to put together a pattern.”

  “Tell me what you need. More resources. I can pull personnel from another branch. Name it.”

  Berger shook her head before she responded, “Sir, it’s simple. In order to model the progress of the disease and define all of its traits, we need patient zero. It’s up to Dr. Randolph.”

  Chapter Seven

  Gangga, Tingri County, Tibet

  Babu slowed the street racer to avoid unwanted attention from the oncoming vehicles. The first Shaanxi six-by-six troop carrier rounded a bend in the highway. As it lumbered past, half a dozen members of the PLA who were huddled under the olive drab green canvas top peered through the rear opening. Seconds later, an identical truck approached. Followed by another.

  “They are sending everyone, it appears,” said Babu. “This outpost is small compared to the Lhasa Airport base. I believe they are planning a house-to-house search.”

  “They will be looking in the wrong place,” Kwon commented dryly.

  The last of five trucks passed, and Babu picked up the pace to catch up with the lead vehicles. Thirty minutes later, they were entering the small township of Gangga in Tingri County, Tibet. The Himalayan village, population 523, used to be an important trading post where Sherpas from Nepal would bring rice, grains and iron to exchange for Tibetan wool, livestock, and salt. Over time the Nepalese Sherpas took up residency, and a few of the Sherpas accompanying Harper were of Nepalese descent.

  In the region, the Sherpas didn’t look at one another as being from China or Nepal. They were Himalayans who’d been caught up in political struggles in the regions for many centuries. The inhabitants of this desolate, challenging part of the planet looked at each other as one people. Their loyalties were to each other, regardless of the nationality imposed upon them.