Pandemic

by Robin Cook

  As a consequence, Jack was sound asleep when Laurie’s mobile phone rang at 5:15 in the morning. Laurie was the night person, not Jack, but because she was a deep sleeper in the morning, she didn’t stir. Although she had mocked people in the past who kept their phones close to them at night, now that she was the chief medical examiner, she always had hers hearby. Yet Jack always had to give her a couple nudges to bring her to a stage that she heard the phone’s rather quiet ringtone. She’d chosen a tone called Illuminate that Jack was always trying to get her to change. It was a bit too pleasant. After the second gentle shoulder shake, she finally answered, and Jack buried his head under his pillow to try to screen out her conversation with the hope of possibly getting another half hour of sleep.

  “Really?” Laurie questioned loud enough that Jack thought it capable of waking up JJ’s gerbil a floor below. He could feel her sit up, partially pulling the covers off Jack’s naked body. Instantly, any chance of him going back to sleep vanished. “Yes, of course,” Laurie added at a more reasonable decibel level but with unmistakable urgency. “I understand and will see that it is implemented immediately.”

  Removing the pillow from his head, Jack looked at Laurie. She was rapidly scrolling through her contacts. “What’s up?” he asked, but Laurie ignored him. In the half-light, with her moderately long mop of hair in disarray and her eyes thrown open to their fullest, she looked like a madwoman. A second later, having found what she was looking for, she placed a call. “Who are you calling?” Jack asked, but she still ignored him, even after he repeated his question.

  “Paul, it’s Laurie. Sorry to wake you so early, but I just got a call from the duty supervisor at the Department of Health, who’d gotten a call from the city’s Emergency Operations Center. We are to initiate immediately the OCME Pandemic Influenza Surge Plan. No, it’s not an exercise. It’s the real thing. So get out your copy of the protocol. I’ll be in the office as soon as I can, but since you’re closer, make sure that the mortuary tents that will go in the parking lot next to 421 are retrieved from storage. And then start the process of dispatching the refrigerated body collection trailers to all the city hospitals. I’ll see you as soon as I can.”

  The next thing Jack knew, Laurie leaped out of bed and dashed into the bathroom. She was so preoccupied it was as if he wasn’t there, despite his calling out her name. He’d never seen her so animated in the morning. As long as he had known her, she’d been the antithesis of a morning person. Normally she dragged around with heavy-lidded eyes and a shuffling gait until she had a coffee.

  Throwing back the covers, Jack followed her into the bathroom. Laurie was already in the shower and partially obscured by steam. The room was chilly, and she took showers hotter than Jack could stand.

  Jack cracked the glass door to the shower and yelled over the sound of the water to ask her what was going on, although he had a pretty good idea from hearing her side of the conversation with Paul Plodget, the deputy chief medical examiner.

  “New York City Emergency Management initiated the NYC Pandemic Influenza Preparedness and Response Plan that Bloomberg spearheaded in 2006.”

  “My God!” Jack exclaimed. “Do you know what caused them to do so?”

  “The duty supervisor didn’t know,” Laurie said as she rapidly soaped herself. “It’s not surprising. I’m assuming it had been a Case Load Hazard Trigger Point coming from city hospitals, which was set up a few years ago as an early-warning mechanism. My guess would be that there was a flood of really sick people yesterday and last night. It certainly wasn’t from us at OCME. I would have heard for sure if there had been a surge of influenza deaths last night. My worry is that’s what we’re going to be seeing today.”

  “The timing is a bit ironic,” Jack shouted. “I’ve been worrying about such a situation because of the two subway deaths. And now to have it happen . . . weird! I hope to God it’s not a rash of cases like the two subway deaths.”

  “Let me finish showering!” Laurie yelled back.

  Jack quickly shaved, and after Laurie got out of the shower, he got in. Ten minutes later they were both down in the kitchen to have a quick bite on the run.

  “Should I turn on the TV?” Jack questioned.

  “Don’t bother,” Laurie said. “We don’t have time. Besides, let’s not subject ourselves to media misinformation. We’ll hear the true details soon enough.”

  While Jack rushed to make coffee, Laurie called the night medical-legal investigator, Janice Jaeger. She used speakerphone.

  “Has there been a flood of influenza deaths?” Laurie asked, just to be sure. After she’d told Jack the trigger didn’t come from the OCME, she wanted to be certain.

  “There haven’t been any,” Janice assured her. “It’s been a busy night, but no influenza deaths. Mostly overdoses but also a couple accidents and one homicide.”

  “Well, there’s going to be a surge of influenza deaths if NYC Emergency Management is correct,” Laurie said. “They’ve declared a Pandemic Influenza Emergency. So be sure to let Bart know the moment he arrives. Better still, try to get him on his mobile. Also call the mortuary techs and give them notice. Tell them I want everybody to be wearing personal protection gear, including N95 HEPA masks, with any presumed cases.”

  “Should I tell anyone else?”

  “Yes. Call the duty ME and give the same message. We are probably looking at working twenty-four/seven for the foreseeable future. I’ll be in my office in about a half hour.”

  After finishing her call, Laurie tossed down the coffee she had diluted with a dollop of fat-free milk. “It seems awfully early for an influenza outbreak to start,” she said. “It’s usually not until late December or early January.”

  “I agree,” Jack said while quickly peeling a banana. “It must be a strain completely out of the ordinary, like the bird flu everyone has been worried about becoming transmissible from person to person instead of just from poultry to humans. That would be really bad. What would be the best-case scenario is that it’s an influenza strain that this year’s flu vaccine covers. Then the city could do a massive vaccination program to take care of it.”

  “Wouldn’t that be lucky,” Laurie said. “That could make all the difference in the world. But coming on this early makes me think it’s got to be something out of the ordinary, as you said. Maybe it’s something like SARS or MERS. Whatever it is, the prospect is really scary. I don’t think there are nearly enough ventilators available citywide. Some scenarios have predicted up to a thousand hospital admissions a day in this kind of scenario. As you know, everybody in city government has been terrified of this happening for years. It’s why there have been so many exercises and drills. Ever since I have been in the front office I’ve been concerned that all the Emergency Management people have been whipped up into a frenzy anticipating this.”

  “I understand,” Jack said. “Should I call us a car?”

  “By all means,” Laurie said. “Are you coming with me?”

  “I will.” Jack took his phone out and opened a ride-hailing app. “The weather is hardly bike-riding weather, even for me.” The wind was driving raindrops against the kitchen window hard enough to sound like rice. It was one of those particularly ugly November mornings.

  “What are you people doing up so early?” Dorothy asked as she suddenly appeared, coming up the stairs. She was in her robe as usual. She was wearing what looked to Jack like a shower hat covering curlers in her hair.

  “There has been a sudden, serious outbreak of influenza,” Laurie said. “Apparently, it is a very dangerous strain. We have to get to work to prepare for”—Laurie paused, trying to think how best to complete her sentence—“for being busy.”

  “That’s awful,” Dorothy said, immediately understanding, despite Laurie’s sanitized choice of words. “Especially since you have two young children to think of. For the life of me I don’t understand why you didn
’t listen to me when I pleaded with you not to become a medical examiner. You could have been a pediatrician or a surgeon like your father.”

  Laurie rolled her eyes for Jack’s benefit out of her mother’s line of sight. “I’m going to wake Caitlin and tell her to keep the children home until we know more about what is going on with this influenza situation,” she said, ignoring the irritatingly recurrent comment.

  Jack finished summoning a car and slipped his smartphone into his pocket. He eyed Dorothy warily. He wished Sheldon had appeared with her. Despite Jack’s initial misgivings, Sheldon was turning out to be a helpful moderating influence.

  To Jack’s relief, Laurie reappeared almost immediately. “Shall we go?” she asked him.

  “By all means.”

  Downstairs, they each got umbrellas and then waited in the foyer until a car appeared and slowed. When it then stopped in the middle of the street abreast of their building, Laurie and Jack ran out into the rain and piled into it. It was a black Toyota Camry.

  As they pulled away from the curb, Jack made it a point to glance out the car’s back window. Although he wasn’t totally surprised, a black Suburban that had been parked up near Central Park West pulled out behind them and followed at a distance. Facing forward, Jack wondered if the driver or drivers were Asian, and if they were, which group they might represent: the group that possibly wished him harm or the group that had seemingly protected him. Although he didn’t know if he was guilty of wishful thinking, he had a sense it was the latter.

  “I’m going to try to call the health commissioner,” Laurie said.

  “Good idea,” Jack responded. As Laurie made her call, Jack again twisted around. As he expected, he could still see a black Suburban following at a distance.

  30

  THURSDAY, 5:48 A.M.

  From the backseat of the Toyota, both Jack and Laurie were appalled by the size of the crowd gathered in front of the OCME, and the line of TV trucks parked along the curb with their antennae extended. Jack tried to get the driver to go straight and stay on 30th Street so that he and Laurie could be dropped off at the receiving bay instead of the front door, but it was too late. The man had not understood the command and was already in the middle of the turn onto First Avenue.

  With no room to stop in front of their destination because of the TV vehicles and the milling people, the driver was forced to pull ahead. As they passed the aged OCME building, it was clear to both Jack and Laurie that the throng were all journalists, a situation both had witnessed before, but not with quite so many people.

  “My God,” Jack commented as they passed. “What a horde. I’ve never seen anything like it.”

  “I’m not surprised,” Laurie said. “The Pandemic Influenza Preparedness and Response Plan calls for an immediate information release to the Health Alert Network, and that’s at least fifteen thousand subscribers. I’m telling you, as soon as the plan was initiated, all government agencies of the city, state, and federal government as well as most media outlets would have learned of it. I know because part of my indoctrination in becoming chief was to get up to speed by practically memorizing the OCME Pandemic Influenza Surge Plan, which is also automatically activated. It’s our responsibility to coordinate with all the involved agencies. I’ve participated in several exercises and drills already in the short time I’ve been chief.”

  “All city agencies?” Jack asked. He swung around to keep the mob in view. He was wondering how difficult it was going to be to push through them to get to the OCME’s front door. The only positive aspect was that at least the rain had temporarily stopped.

  “All the important agencies from an emergency-management point of view,” Laurie said. “Department of Health, Greater New York Hospital Association, fire department with EMS, police department, and of course Emergency Management. There’s been so much coordination and so much planning and so much worry. It’s why I didn’t want to give anyone a heads-up when you were worried about the first subway death. A heads-up alone could have caused what we’re seeing now. The whole system was like a tightly wound-up spring.”

  As soon as he could, the Uber driver pulled over to the curb, which was practically in front of the NYU Langone Medical Center. Jack and Laurie piled out to hurry south. Just beyond the entrance to the medical center’s parking garage, they started to encounter the reporters, who were acting like a swarm of bees. The two medical examiners managed to get about halfway to the OCME front door before someone recognized Laurie. From the press briefings that she’d occasionally held in response to particularly newsworthy cases, Laurie was gradually becoming a known commodity.

  “Dr. Montgomery,” one of the reporters called out. “Can we have a statement about the pandemic?”

  News of the presence of the chief medical examiner spread through the crowd like wildfire. Suddenly both Jack and Laurie were surrounded by pushy reporters, many with microphones or smartphones, all competing with one another to get theirs as close as possible to Laurie’s face. Jack literally had to push several electronic devices out of the way. It was amazing how obnoxious reporters could be when competing for a scoop, almost as bad as paparazzi.

  “I’m sorry, but I have no comment,” Laurie called out over the crowd. “I will be briefed as soon as I get into my office and will schedule a news conference about the OCME’s role in the current situation. It will be held within the hour in the auditorium at the OCME building, 421 First Avenue, not here at 520. Now please let us pass!”

  Jack began acting as a point man to get Laurie through the crowd, at times yelling at insistent, pushy reporters with their microphones or cameras to give way. The going was slow.

  “Please!” Laurie shouted from behind Jack. “Let us through! As I said, you’ll have my statement within the hour. Before then, you people should be at Emergency Management out in Brooklyn or at the Department of Health, because they are calling the shots, most likely through the Department of Health’s Incident Command System.”

  After Laurie’s short but informative impromptu speech, the reporters opened up a path for her. But then someone shouted out to ask whether Jack was Dr. Jack Stapleton. Surprised by hearing his name, Jack stopped and tried to see who had asked.

  “Over here!” someone shouted.

  Jack saw a man wearing a New York Yankees baseball hat and waving his hand, about three rows back. “Are you Jack Stapleton?” he repeated. He didn’t have to shout as loudly on this occasion, as the other journalists in the immediate area all fell silent.

  “Yes, I am Jack Stapleton. Why do you ask?”

  The pause in the crowd’s murmuring vanished as everyone recommenced talking at once. Laurie was suddenly ignored as people pressed in on Jack, thrusting their electronic devices into his face. Now there was even more frenzy than before, as reporters battled with one another to get close. The questions came fast and furious, such as whether he had autopsied more than two victims, whether there was a specific diagnosis of this rapidly fatal subway disease, what exactly were the symptoms, was it a strain of influenza, how did it spread, was there any cure, should people leave New York if they could, and how did being on the subway cause it?

  Jack stiffened. Suddenly it occurred to him that this whole hysteria and panic was possibly related to the two subway deaths, meaning that Laurie’s fear of them stimulating a false alarm had come to pass. How or why, Jack had no idea.

  In a mild panic himself, he turned and looked for Laurie. Now that she was being relatively ignored, she had skirted Jack and had made considerable forward progress. She was nearing the front entrance of 520, silhouetted against the building’s blue-glazed brick façade.

  Redirecting his attention to a woman reporter in front of him, Jack asked, “Why are people talking about the subway?” He had to shout to be heard.

  “You don’t know?” the reporter asked.

  “Oh, come on, Dr. Stapleton,” another r
eporter yelled. “Don’t play dumb with us.”

  “Haven’t you seen the Daily News?” the woman reporter questioned.

  “I haven’t,” Jack admitted. Suddenly, one of the reporters shoved a copy of the tabloid into Jack’s face. Its full-page headline read: SUBWAY PANDEMIC. It was surcharged over an image of an NYC subway car head-on. In slightly smaller print was: KILLS INDISCRIMINATELY. In even smaller print along the bottom was: A wildly contagious pandemic as bad as the 1918 flu explodes in NYC subways on the R and D lines. Jack snatched the paper and folded back the front page to read the first line of the obviously lurid article: Anonymous, highly qualified, inside source from the Office of the Chief Medical Examiner confirms that senior NYC medical examiner Dr. Jack Stapleton has declared the city is facing a remarkably lethal pandemic of an as-yet-unknown virus that kills within an hour of first symptoms and will be possibly worse than the 1918 pandemic flu epidemic that killed 100 million people.

  Thunderstruck, Jack crunched up the paper in his fist and held it in the air. He yelled out for everyone to hear: “Listen up! This article is untrue. I have not made such a declaration. There is no subway pandemic. Not yet!”

  “What the hell does ‘not yet’ mean?” one of the reporters yelled disdainfully.

  “Coverup,” another yelled. “Come on, come clean!”

  “How long will the subways be shut down?” another shouted.

  “What about the schools?” another reporter yelled. “When will they reopen?”

  “Listen!” Jack shouted in response to the rush of questions. “Dr. Montgomery already said she will be giving a news briefing at 421 First Avenue within the hour. I’m sure she’ll address all these issues then and explain that this is most likely one big, unfortunate mistake.”

  From the response his outburst evoked, Jack could tell the crowd was in no mood to believe him or even listen. There was a sense of true panic in the air that was almost palpable. He was aware it was common knowledge among journalists and other informed people that health scientists all over the world had been fearing the appearance of a new, deadly global pandemic. It wasn’t whether there would be such an outbreak but rather when, and there was a profusion of bad viral actors on the horizon capable of wreaking havoc, from bird flu to Ebola, or even something entirely new, like the World Health Organization’s mysteriously labeled Disease X. In a very real sense, Jack knew that although everyone present had been panicked by the erroneous Daily News headline, probably no one had been surprised.