by Jim Shepard
The wards were still packed. Another row of cargo containers had been hauled in out back and the maternity ward had been decommissioned as a mortuary and turned into another isolation room with another HEPA machine flown in from Denmark.
There hadn’t been any fresh food in three days and they’d been living on shipments of Danish army rations. Along with the usual precautions, Danice continually washed her hands with Betadine and used hand sanitizers and tried not to touch her eyes, nose, or mouth. She also tried to spend fewer nights wide awake and obsessing about things she couldn’t do anything about, but that was easier said than done.
The bad news was that Marie Louisa remained too sick to work, but the good news was that otherwise she seemed to have stabilized. Danice visited her often enough in isolation that Marie Louisa joked whenever she saw Danice coming, “Oh, someone needs more advice.” Marie Louisa’s assistant had gotten only marginally better at overcoming her panic and doing her job, and had developed the habit of snatching up her tea mug and disappearing whenever Danice needed something. As Jeannine’s replacement Jerry Sussman had turned out to be amiable and hardworking and smart, but his attempts to demonstrate his language skills in his first few meetings had caused most of the medical staff to exchange glances.
“I guess my Danish is a little rusty,” he’d apologized on his first day.
“I would call it intermittent,” Dr. Hammekin had told him. Hammekin had, with the deaths of Drs. Kristensen and Holm, taken over as head administrator. His English was good and he was cordial to Jerry but he had seemed to stop engaging Danice. It had gotten to the point that when she spoke to him he answered Jerry. She’d finally asked him what his problem was, and it had turned out that Olsen had been one of his prized students and best friends, and that he hadn’t forgiven Danice and Jeannine for having gotten Olsen sick.
Since Jerry was the epi and Danice the MD, she was the one who gave Hammekin a hand every morning with the new arrivals. No one was worried about attending privileges when things got this apocalyptic. But of course it meant a much higher risk factor, as Jeannine pointed out to her on the phone. Danice and Hammekin wore masks and gloves and eye shields and the first day they’d worked together someone had sneezed right in Hammekin’s face. Intake was two long tables next to the front door, and two rows of folding chairs for those waiting. On one an old woman sat with her hands pressed to her belly. Next to her a father kept his arm around a small son, and behind them against the wall was a whole family, with a teenager who seemed to be trying to sleep across three chairs, his head hanging off one side and his feet the other.
Marie Louisa’s assistant briefed Hammekin on how many new beds had opened up and midsentence she switched to Danish and they continued the conversation. It turned out that the family spoke English, so Danice dealt with them at the other end of one of the tables. The teenager roused himself and sat up, raking his hair back and forth with his fingers. They were all sick, and panicked, and she tried to reassure them as much as she could and then asked them to describe their experiences of the illness, and then who had gotten sick first and how, whether they’d had any unusual contact with animals or travelers, whether they’d visited anywhere new. She asked if there was anyone sick who hadn’t come in with them, and the mother said no, but one of the daughters immediately looked down and away, and when Danice said, “Who’s still sick at home?” the daughter said her grandmother.
The mother said a number of their neighbors were concealing their symptoms, too, and the father agreed and said that his uncle had died without even trying to see his nearest relations because he hadn’t wanted to infect them.
Two more families came in, and Danice, with Marie Louisa’s assistant translating, got their information as well, and then she found spots for all three families wedged into the new isolation room, and then had to take a break and wandered outside and around to the back of the hospital and pulled off her mask and eye shield.
The sun was arriving earlier each morning. Inside a picket fence someone had set up a little grill on a table where the rock dropped away with a view of the cove’s icebergs. Out beyond them the battered orange-and-white regional ferry was still running. Seabirds she couldn’t identify sideslipped back and forth over its wake. The narrow bridge over the gorge had the town’s name on its railings in big blue metal letters. Some front loaders carrying more cargo containers were heading up onto it and didn’t even rouse the sleeping dogs they passed on the side of the road. She could smell the brine and marine life and the diesel.
Hammekin had come up behind her and was blowing his cigarette smoke in her direction. His mask was down around his neck like a cravat. Between the church and the old people’s home off to their left, two tiny boys were playing the world’s worst game of badminton over a sagging net while waving off mosquitoes.
Hammekin told her that three more of the hospital volunteers had refused to report and seemed to have made off with a crate of rations as well, like the other workers. Supposedly they’d barricaded themselves in with their supplies.
“What do you call chaos once it’s gone on forever?” he wondered.
“Normal?” Danice suggested.
“You really have to cover your mouth when you cough,” he told her.
“Sorry,” she said. “I thought I had.”
Down below the bridge, the windshields of the fishing boats periodically blinded her with reflected sunlight. “Did Dr. Olsen have an extended family?” she asked.
He didn’t answer. With each wave in the harbor, the boats’ mooring lines slapped the water.
“That Kleivan is a magic man,” she finally added. “Where would we be without him?”
“This is a big country for duct tape,” Hammekin told her. “People up here are used to having to make things work however they can.”
One of the badminton boys missed the shuttlecock yet again and fell into the net, pulling it down.
“Maybe we should get Kleivan on the job, in terms of identifying what this thing is,” Danice said.
“Some of us have thought of that,” Hammekin said. It didn’t feel like a joke they were sharing, and while she watched the boy untangle himself from the net, Hammekin turned and went back inside.
The Track of the Invisible Man
Even deciding on which people to quarantine wasn’t that simple, given the banality of the initial symptoms, and the ridiculousness of the squeeze in terms of available space. Information sharing was nonstop from Greenland to Atlanta to Porton Down to WHO headquarters to Rocky Mountain Labs to Fort Detrick to any number of other places, and still no one had much of anything yet, and no one was even sure of that.
Talent and hard work got you a certain distance, but then you still needed luck. But it seemed to Danice and to everybody with whom she consulted all over the world that every third clue introduced a confounder, an element that seemed to drive the investigation off track. And each pattern that was initially found significant devolved into a maddening knot of ambiguities. Whenever Danice thought she’d spotted something, it started to look more like the result of some other factor. You couldn’t go all in on any observation but couldn’t let one go, either. Everyone was working the problem, but people had to be thinking that she was right there, on the ground, where it started: maybe she’d missed something?
Jerry had brought a number of pads of Post-it notes as his way of keeping track of random notions, and they were stuck everywhere around their workstations. There was also in one big plastic bin a knee-high heap of empty Faxe Kondi cans, the only soft drink left in the vending machines. Danice hated the taste of it but kept drinking it anyway.
It felt like every half hour she pushed back from her computer and put her hands over her eyes. It was getting harder and harder, with everything else going on, to just sit in front of it hour after hour, entering data and fielding incoming messages as if she had all the time in
the world. She was tired of doing endless work that was intricate and tedious, and tired of being tired.
She could feel a breeze on her butt. In one of the rooms in which they’d lost three people in a row they’d used so much bleach in the cleanup that when she’d leaned against the table the residue had eaten a hole in her pants.
“It’s all this pressure and feeling like there’s been no progress,” she said to Jerry, by way of explaining having sat there inert for some minutes while he pattered away on his keyboard.
“Welcome to the Epidemic Intelligence Service,” he told her. He reminded her that EIS veterans always claimed that the letters stood for “Everyday I Sit.”
“You know what the definition of investigate is?” he asked. When she shook her head, he answered, “ ‘To flounder.’ ”
“In our case, that’s generous,” she said, unencouraged.
A virus would explain why antibiotics had been no help, and there’d been a number of viruses that had turned up among the infected, but those viruses normally should not have been a problem, or at least not the problem. They looked to be just non-pathogenic passengers. It was possible something overlooked was working synergistically with something else to produce the disease, even if otherwise incapable of producing it on its own, and everybody knew that old viruses could cause new syndromes in new circumstances. It was possible that something was mutating more prolifically or rapidly than anyone might have expected, or that there was some kind of gene swapping going on that they were missing. She remembered something the head of WHO had said a decade or so earlier in a speech, even before COVID, about what happened if you left a burglar in front of a locked door with a sack of random keys and gave him enough time.
The thing didn’t even need to be new. It might be something that had been around forever and had needed only a minimal genomic change to arrange its route past our immune systems.
Jerry reminded her that for years the Eaton agent that had been associated with cold agglutinin-positive pneumonia, a version of cold agglutinin disease, or CAD, had been assumed to be a virus, but then they’d been able to grow it on cell-free artificial media, and it had turned out to be a mycoplasma that was crucially different from other members of its genus.
“So how do you find the invisible man?” Danice wondered aloud. She cracked open another can of Faxe Kondi and looked glumly at what she was about to drink.
Jerry shrugged. “Look in the snow?” he suggested. “Wait for it to rain?”
“And what happens when you can’t wait?” she wanted to know. Earlier that afternoon, Marie Louisa’s fever had started yo-yoing again, and had gotten as high as 105.
He reminded her that the EIS’s symbol was the fouled anchor, for a boat in trouble, crossed with a caduceus. And that the worldwide symbol of the field epidemiologist was a hole in the sole of a shoe.
“Have you noticed how often you tell me stuff I already know?” Danice remarked.
Jerry smiled. “I find that anything that sounds like a dad joke keeps up morale,” he told her.
She was going to give him more grief, but he meant well, and she was too tired even for sarcasm, so she let it go.
She had nightmares that night, and before she’d even settled into her workstation with her coffee the next morning, Jerry reported that now Atlanta, on top of everything else, wanted them to do some public relations work.
“Well, to be fair, I think it’s more important than I just made it sound,” he said, when he saw her face.
It turned out that the president had authorized with a special directive the forming of an Epidemic Emergency Interagency Working Group, with representatives from the CDC, the NIH, the DOD, and the State Department, with liaisons to WHO and UN Disaster Relief, and that that entire brain trust had gotten together and had produced as one of its first initiatives the notion that they needed all hands on deck to get on the same page in terms of the information that was going out.
Governments had their hands full directing their first responders and working to support their health care organizations and tracking exposures, but in most countries the nonmedical effects of the outbreak were draining a greater and greater proportion of resources as well, and many of those effects were being driven by the kind of misinformation they could do more to combat. There needed to be more widespread compliance with the medical recommendations being issued, and the Interagency Working Group was proposing as a first step what it called an “Information Inoculation” to combat the increasing impression that official sources were not to be trusted.
“Well, what do they want us to do about it?” Danice wanted to know.
“Read it yourself,” Jerry said, his hand out to the computer screen.
The bottom line was that the government was certain it needed to do better at getting its messages across clearly and credibly, and that media professionals who had been recruited from the private sector would soon be in touch as to how the CDC’s team in Ililussat could contribute to any number of public information materials—from Instagram posts to tweets to YouTube videos to Wikipedia pages to podcasts—targeted for various demographics. As the country’s representatives in the place where most people assumed this whole thing had started, they were uniquely situated when it came to the battle for attention and claims of authority.
“Podcasts?” Danice exclaimed.
“I think what they want are just a few things from us that they can spread around social media,” Jerry ventured. “I’m not sure what we can say that would reassure anybody, but they’d clearly like us to give it a shot.”
“Do they think we’re not overwhelmed here?” Danice asked. “In terms of time?”
“When we get a minute,” Jerry said. “If we get a minute.”
“I’m going to go see what’s happening with intake,” she told him. “Then I’ll be back.”
“Top-down messaging has stopped working,” he added as she got her things together. “People are saying that agency heads are serving their own agendas. Apparently the hope is that heroic grunts like you and me in the front lines will be seen differently.”
“I can’t hear you,” she said, once she was out in the hall.
“And there were a few countries that went way too long denying their outbreaks,” he called after her. “So everybody’s dealing with that blowback as well.”
This Is Normal
She was hunting up some Zofran for a ten-year-old who’d thrown up all over the intake table when Jerry texted her a document headed “SOME IDEAS FOR THE MEDIA PEOPLE” and the heading annoyed her so much she stepped outside, but Hammekin and some other medical staffers were having a confab and eyed her, so she ducked back inside and through the closest door, which led her down a flight of concrete steps to the basement.
A few people were coming and going fetching things, but otherwise it was much quieter. The hallway was lit by only a few buzzing ceiling bulbs, and was nose to nose with rolling carts and bins. Her phone buzzed, and it was her mother calling again, and she thought why not, at this point, and answered it.
Her mother when Danice answered always said her name like she was startled to find her on the other end of the line.
“She’s all right,” her mother said to someone else, probably Danice’s brother.
“Is Danny there? How’s he doing? How are you guys?” Danice asked.
“How’re you?” her mother asked. Danny in the background said, “She’s all right?” and her mother snapped “What did I just say?”
Danice took a breath and rode out the surreality of her mother’s voice in this context. “I’m fine. Knock wood,” she said. “So everybody’s good, Ma?” she asked again.
“We’re all fine,” her mother said. “Your brother thought it was the end of the world that you weren’t answering.”
“It’s
been crazy here,” Danice said.
“I can imagine,” her mother said. “Hold on,” she told Danice’s brother. “He’s so excited to talk to you,” she explained. She liked to think of herself as someone who saw the best in him even when he disappointed everyone else.
“How’s Grandma?” Danice asked.
“They’re going to have to beat her to death with a stick,” her mother said. “Last time I talked to her she said she hoped you weren’t working on anything dangerous.”
Danice chuckled.
“I’ll put your brother on in a minute,” her mother said. “So is anybody there making any progress?”
She told her mother that their joke now was that pretty much whatever they were asked, their answer was always “We don’t know, but we’re working on it.”
“Well, I predict you’re going to end up being the big hero in all of this,” her mother said.
“I certainly prefer that to what I’ve been predicting,” Danice said.
“Well, you tend to think the worst,” her mother said.
“I think that’s you you’re thinking of,” Danice told her.
“Okay, well, here’s your brother. Take care,” her mother said.
“Hey hey,” her brother said. “You’re good?”
“I’m good. And Ma says everybody there is good,” Danice said.
“Well,” Danny said. “Mrs. Calzolaio died.”
The Calzolaios had been their lifelong neighbors. “Ma said everybody there was good,” Danice protested.
