Pandemic (10 page)
Authors: Daniel Kalla
"Likewise," Haldane said. "Dr. Wu, I understand your hospital has had the most experience of any facility with this disease."
"Very true, Dr. Haldane," Wu said. "We have treated 146 cases at this hospital. As many as the other hospitals combined."
McLeod rubbed his beard roughly. "How many dead?"
"Twenty-seven." Wu cleared his throat. "I fear that number will rise to thirty by day's end."
"Including Dr. Fung?" McLeod said.
"Yes."
"It would be very helpful for us to hear about your firsthand experience with this virus," Haldane said.
"Certainly." Wu looked down at his desktop. "It began twenty-three days ago. A farmer from the north was sent to us with a high fever and complete respiratory failure. He died within twenty-four hours of arrival. We were concerned about the possibility of the Bird Flu or even SARS."
Haldane frowned. "Did SARS ever reach Jiayuguan?"
"No. Not anywhere in the Gansu Province. Still, we exercised precise pulmonary protocol with our patient. We did not know until the blood tests came back negative for the SARS coronavirus. Soon more patients arrived with the same symptoms. Abrupt onset of high fever followed by respiratory symptoms, pneumonia, often associated with hemoptysis." Wu used the technical term for coughing up blood.
"Followed by respiratory collapse," McLeod said.
Wu shook his head. "Not in all cases, Dr. McLeod. Over half the patients never became short of breath. Just a cough, fever, and severe weakness. Prompt recovery in less than four days in all cases. We believe there are still others who have a subclinical form of the illness and do not require treatment."
"And in those who did become critically ill," Haldane said. "What treatments have been tried?"
Wu sighed. "Everything our infectious disease specialists can think of steroids, ribavirin, acyclovir, amantadine, even the HIV antiviral medications."
"And?"
Wu held up his little hands in a helpless gesture. "We have seen no benefit from any of them. The only intervention that seems to make a difference is the ventilator. The support of the artificial life-support system has helped some patients stay alive long enough to recover." He shrugged. "If the patient lives for four days, then it seems he or she will recover. But our resources are limited. All the ventilators are in use. We have to guess who has the best chance of surviving. And the others ..." His shoulders sagged. He looked down at the table, as if personally responsible for the lack of resources.
"Understandable," McLeod said. "How about the town doctor? How long has he been on the ventilator?"
"This is only Dr. Fung's second day. We will remove the life support in the next few hours." He glanced away in embarrassment. "We need it for one of the others who might have a chance."
Haldane nodded sympathetically. His heart went out to Wu and the rest of the staff, knowing this kind of life-and-death rationing of resources was the worst kind of decision health-care professionals ever had to face. "Dr. Wu, what measures have you instituted to prevent spread within the hospital and beyond?"
Wu stiffened in his chair. "I don't understand what you mean by the question, Dr. Haldane," he snapped. "We have not had any spread away from this hospital."
Haldane was taken aback by the administrator's abrupt defensiveness. "Dr. Wu, we appreciate the excellent work you and your staff have done. What I meant is, can you describe your infection control program?"
Wu nodded, but he still eyed them guardedly. "We implemented the same precautions the hospitals in Beijing used with SARS. In this hospital, we now only accept patients suspected of having the virus. Other patients are diverted elsewhere. All patient care areas in the hospital have negative pressure airflow and filters. The rooms and wards are sealed behind airtight doors. All staff wear bio-hazards suits in patient care areas. So far we have not had a single incident of transmission to a staff member within the hospital."
"I thought Dr. Fung followed the precautions, too," McLeod pointed out.
Wu crossed his arms over his chest. "He was infected at his clinic. He only wore a surgical mask, gown, and gloves. This was proven during the SARS outbreak to be inadequate, especially if the masks were not fitted properly."
Haldane noticed that Wu's attitude had subtly shifted from that of deferential collegiality to bureaucratic wariness. While he didn't understand the reason for it, Haldane realized that they would learn little more from the associate director. He rose from his chair. "Thank you, Dr. Wu. You have been most helpful," he said.
Before rising, McLeod looked at Wu and asked, "Between us, how much does this bug scare you?"
Wu looked away, as if ignoring the question. Finally, he said, "I never saw a patient with SARS, but I believe this virus is worse. I think this is the worst thing to ever strike Gansu."
"Will it stay in Gansu?" Haldane asked.
Wu's eyes narrowed to slits. Then, slowly, he shook his head.
Dr. Ping Wu stood at his window and watched until the car carrying the two WHO physicians pulled out of the driveway. Then he turned down the window shutters, locked his door, and returned to his desk. He left instructions with his administrative assistant that he was not to be disturbed under any circumstances.
He cleared the papers off his desk, cleaned his glasses with his handkerchief, and then folded his hands on the desktop. He sat perfectly still, trying to compose his thoughts before proceeding.
The two WHO doctors had struck Wu as sincere, but he had his doubts. Their questions and innuendoes about the virus spreading from the hospital and beyond Gansu hadn't come out of thin air. Maybe they already knew?
How did it come to this? He tried to retrace the steps in his mind.
For four years of residency at UCLA in the 1970s, he lived below the poverty line, ever the good communist. Never complaining or wanting for the material wealth that was everywhere around him. Returning to China, he continued to live a life of virtual asceticism, forsaking a family of his own to work harder than all his colleagues and subordinates while he watched lazy party officials grow rich from graft and corruption. He practically built the hospital in which he now sat, but when the time came to appoint a director, an underqualified party hack, barely out of his teens, was placed ahead of him. None of it softened Wu's rigid ethical conduct, until his eighty-year-old parents became too frail to live in their own hovel. In order to help them, he needed to supplement his income. So he did what he had to. What he was entitled to do, for all his years of service.
It had begun harmlessly enough. He accepted small gratuities for providing priority access to diagnostic services like lab tests or X-rays for people who might have otherwise waited months. In that first year, the money barely covered the expense of the homecare worker he hired to help his parents. From there, his services expanded. For a larger fee, he would move people to the top of elective surgical waiting lists. Soon surgeons began to pay for more operating time to work on their own "private" patients. For a substantial fee, Wu would even "doctor" disability and other pension applications.
When he first heard Lee's offer in exchange for allowing two "relatives" to visit a dying infected patient, he balked at the idea. But the black marketer offered more than Wu had ever seen before. In spite of huge misgivings, Wu could not resist. The moment he laid eyes on the foreigners, he knew they were not honest in their intentions. He tried to convince himself that they were just reporters, capitalizing on a sensational story and that they needed privacy to capture the virus's victims on film but in his heart he never believed that. He knew something more sinister was at work.
When hours after their visit, a nurse discovered that the dying patient had puncture marks over his jugular vein, Wu managed to cover it up. However, he could lie to himself no longer. They had stolen the man's blood and with it the virus. And he had facilitated the theft.
Wu had long since quelled the stirrings of self-recrimination about his acts of petty corruption. It was understandable, even expected to some degree, within the system he lived. But his life had been dedicated to the practice of medicine. Never before had his profiteering been undertaken at the patients' expense. His role, inadvertent as it was, in disseminating the virus beyond Gansu was beyond rationalization. Or forgiveness. And in the week since the men had stolen the virus, he barely slept at night.
Satisfied his thoughts were in order, he put his glasses back on, reached for the computer keyboard, and began to type. He addressed the e-mail to his immediate superior, the hospital's young director, Dr. Kai Huang.
Dr. Huang,I am writing to inform you of a critical breach in hospital security that occurred seven days ago.I accepted money from a man, Kwok Lee, whom I know to be a black marketer. In return for the bribe, I arranged for Mr. Lee and two of his accomplices to see one of the afflicted patients. Mr. Lee claimed the two men were relatives of the dying man, but I knew differently as they appeared to be of Malaysian or Indonesian descent. I assumed they were reporters, but I did not dwell on their identity or intentions.They spent five unsupervised minutes with the patient The patient died an hour after the men left. While preparing the body, one of the nurses discovered recent puncture marks over the left jugular vein. No medical procedures had been performed at that site. My only possible conclusion is that the men withdrew vials of venous blood.From our experience, we know that body fluid of infected patients is highly contagious. Since he was suffering from overwhelming sepsis, this patient's blood would have had a particularly high concentration of the virus.I have no knowledge of how they mean to use this infected blood, but I can only assume that it involves criminal intent. And I cannot exclude the possibility of terrorism or the use of the virus as a weapon.Yours,
Ping Wu
Wu reread the e-mail, satisfied. He intentionally left out any attempt to minimize his role or justify his actions. He did not owe them that. Without hesitating, he tapped the "send" button. As soon as the e-mail left his screen, he felt a weight lift off his shoulders. He had done his part to warn others.
He reached down and opened the same desk drawer where he had twice deposited those dirty envelopes that had ruined his life and, possibly, countless others. The money was gone, but he pulled out the two bottles from the drawer. One was a popular Chinese wine, the other a pill bottle containing one hundred tablets of a major sedative.
He popped the lid off the pill bottle. Bringing the hard plastic to his lips, he tasted the bitter-salty flavor as he stuffed as many pills as would fit into his mouth. He choked them down with a gulp of wine. He had another sip of wine, but the medicinal taste lingered. He took a deep breath, and then swallowed the rest of the tablets.
CHAPTER 8
CIA HEADQUARTERS LANGLEY, VIRGINIAIt was an ominous name: "Carnivore". The software system electronically spies on e-mails from across the globe, trying to sniff out criminal activity and threats to U.S. national security. Among the several hundred million screened that day, Dr. Ping Wu's final e-mail piqued Carnivore's interest because it contained the words "terrorist" and "virus". After translating it into passable though grammatically questionable English. Carnivore graded the e-mail as "moderately suspicious", meaning it required review by human eyes.
As did 68,435 other e-mails sent the same day.
The overburdened CIA staffers who ran Carnivore were forever falling behind in their attempt to find the needle in an electronic haystack. Eavesdropping on the entire world was a challenge that the CIA had yet to master. Another "backlog debulking" loomed in the near future. The term was classic CIA-speak--a euphemism for a random, massive hard drive purge of all but the most suspicious of the unread e-mail backlog. The espionage world's equivalent of Russian roulette.
Even if Wu's e-mail wasn't destined to be lost in the "backlog debulking," no one at Langley would have a chance to review it for a minimum of seven days.
HARGEYSA SOMALIAA southern breeze stirred up flakes from the dirt road. It carried with it the faint smell of food that drifted in from the cooking fire of the militia posted a half mile down the road.
Hazzir Kabaal and Abdul Sabri stood out front of the laboratory complex in the windy but warm dusk. Minutes earlier they had said prayers together with mats almost touching. Neither had spoken a word since.
Kabaal had a knack for reading people, which helped explain his unfettered success in the cutthroat world of print media. But after four days spent in Sabri's company, Kabaal still read nothing behind the man's pale eyes and placid expression. From that alone, Kabaal realized that Sabri was a man to be reckoned with. Having witnessed the dispassionate and unhesitating manner in which Sabri executed the Malaysian--one of their own men--Kabaal knew he had chosen well.
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