The Perfect Pathogen

by Mark Atkisson

  When a train goes through a tunnel and it gets dark, you don’t throw away the ticket and jump off. You sit still and trust the engineer.”

  CHAPTER 18

  Sarah, Ben and Katie entered the conference room ready for the DVC with the Secretary of HHS, National Security Advisor, the Director of the CDC, and a host of other supporting characters. When they fired up the screen, they could see the members from the other organizations around their respective tables. This should be an interesting discussion, thought Katie.

  At 10:00 a.m. sharp, the Secretary started the discussion.

  “Thank you for joining in on this DVC today. Allow me to start with a brief overview. I have been in touch with the WHO and our partners around the world. There are over 260 teams of scientists working on this problem, but no one has come up with anything concrete yet. The death toll worldwide is approaching five million deaths per day. In the U.S we are going to breach the 150,000 deaths per day mark soon which will likely outstrip the capability of our infrastructure. We have contacted each State Health Department and recommended they establish mass grave sites in the vicinity of all major metropolitan areas. Plans are in place to assist with handling the dead, if need be. In some of the more populous states, the governors have activated the National Guard to help with the problem. Only a few of the far right and far left press organizations are sounding the panic alarm, even though the term Epigeddon has taken hold and is now used daily in the mainstream press. In other parts of the world there are varying responses. In the more authoritarian countries, the people are starting to riot, believing that the government is holding back bad news. In countries with more democratic governments, the response is more like here. There is a wait and see attitude. But we all know, the patience of the people only lasts for a short time and as the number of deaths continue to mount, we will be approaching a tipping point. So with that as an introduction, what do you have?”

  The CDC Director in Atlanta, Bob Gleeson, answered first. “We have six teams working across the country in conjunction with the task force which has been formed out of Johns Hopkins University. We still have not been able to determine the cause. The characteristics are common among all of the victims. It is almost like a premature aging that is causing the deaths. We have never seen anything like this in the past. The pathogen is neither a virus nor a bacteria, so our normal protocols for detection and treatment are not working. All cultures are negative. Biopsy results are inconsistent. We have conducted antibody serology testing, PCR, culturing for every infectious agent known to man, spectroscopy, Western blots, and prion testing. We are branching out in creative ways at different sites, but to date there has been no success. I know my colleagues in DC are working on a different angle, as was discussed yesterday, and maybe with additional insight provided by their research we will be able to move in the correct direction. In summary, the prognosis so far is grave.”

  “Thank you for your report, Bob,” said the Secretary. “Allow me now to let Dr. Lin explain what her team has.”

  “Madame Secretary,” Sarah started, “We have been looking closely at trying to determine how to define the spread of the disease, the potential gestation period of the pathogen, as well as to determine the cause of death of the victims. I will let Dr. Shah and Dr. McMann explain their theories regarding the disease. Ben.”

  “Good morning ladies and gentlemen,” said Ben. “I found it interesting to hear what the Director said regarding premature aging. I haven’t actually used that term, but it does fit, based on what Dr. White and the Johns Hopkins team and I have discussed. What we believe is happening is that this pathogen, which we are now calling SDX or symptomatic disease unknown, for lack of a better term, is causing the internal organs of its victims to age at accelerated rates. We don’t know how fast the process is or when it starts or if it follows the trajectory of a hyperbolic curve approaching infinity, but what we do know is that when people show signs, as evidenced by a stroke or heart attack, they don’t recover. All of the evidence we have seen from autopsies over the last four days supports this assumption. The internal organs of the victims appear much older than the victim themselves. As to the question of when it starts, I think this varies based on the health condition of the individual and the normal life span of the person, based on their environment and or lifestyle. For example, if someone was 40 years old with a life expectancy of 80, and they were a carrier of SDX, then if the disease was active in their system we could expect they would age at an accelerated rate. Currently, we don’t know the gestation periods of SDX and we don’t know how fast acceleration is. My colleague, Dr. McMann is working to try and determine this and I will let her discuss what her hypotheses are.”

  “Thank you, Ben,” said the Secretary. “Katie, I want to thank you for the interesting work you have done so far. Please explain your theory as to why you think your blood test analysis can predict the presence of SDX and please elaborate more on Ben’s comments regarding gestation period.”

  “Certainly, Madam Secretary,” said Katie, swallowing her fear. “As most of you know, I have been analyzing the blood results from thousands of victims. We are measuring over one hundred and fifty different blood levels, most of which are not measured in routine physicals. What I have determined is that there are six key markers that I believe are indicative of someone who is infected with SDX. They are listed in my report. After running the samples through an algorithm I had previously developed to predict longevity, I can now say with 99% certainty that all the victims of the pandemic have had abnormal readings for these six unique blood tests. I theorized that if the victims of SDX had the elevated levels, shouldn’t the levels also be elevated in anyone who is a carrier of SDX? So, I took the liberty of having my blood tested, since I had worked closely with the Chief of Statistics for Aging, Herb Burns, who died Monday of this disease. When I received the results, I found that all six levels were high in my blood, and that the levels fell in the middle of the range of what the victims have exhibited. Based on this information, I recommended expanded live tests and I expect to receive the first live test batch results today around noon. I will be looking at this information to determine if the live test batch candidates are positive for SDX. My theory is that they will all be positive and let me explain why.”

  Suddenly, there was a combination of gasps, whispered discussions, and people shifting in their seats, in the other conference rooms. There were looks of grave concern all around. Katie definitely had their attention.

  The National Security Advisor, Jim Redman, interrupted, “That is a pretty bold statement, Dr. McMann. What you are saying is that we are all going to die, it is just a matter of time.”

  Katie glanced at Sarah and Sarah nodded. Katie continued, “Mr. Redman that would be correct, assuming all are positive and that we don’t find the cause and a remedy.”

  “This is just a bunch of bullshit speculation. You don’t have any hard data to back up your claim,” said Jim in a noticeably louder voice now.

  “Now let’s all just settle down a little bit,” said the Secretary, firmly taking control. “I have asked for this briefing and I want to hear what Katie has to say. She could be wrong, but if she isn’t, I want it all on the table so we can start to consider contingencies. Katie, please continue.”

  “As I said, I will receive a total of thirty-seven samples around noon today. I will analyze the data and provide the results to Sarah as soon as possible. I expect this will take about two hours after receiving the results. Let me explain my position as to why I think they will all be positive.

  “I have been analyzing blood data from Centenarians for over seven years. I modified the algorithm I used for this longevity project to analyze the SDX data. Four of the six blood tests I have identified as markers for SDX were used in my longevity study. I have started a cursory analysis of the four tests on my Centenarian population and what I found set off alarm bells. Approximately five years ago, the levels of these four blood tests star
ted to increase in my test group. This was noted during the longevity project, but little attention was paid to this because it was hypothesized that these levels went up as a normal part of the aging process or they were accepted “normal” like elevated HDL or chloride.”

  Katie continued, “In retrospect, when you look across the age range prior to five years ago, this is not true. What I do know from a sampling from different areas around the world is that all of the Centenarian population in my test data have elevated levels. What I expect to find is that the levels increased in some areas of the world sooner than in other areas. As of this morning, more than two thirds of the 3,300 people we were tracking have succumbed to this illness and they all had elevated levels before they died. Six or seven years ago, that was not the case,” she said. “Those that died seven years ago had normal levels for all four tests.”

  “That explains part of the puzzle, how about the gestation period?” asked the Secretary.

  Katie took a deep breath and said, “That is a little harder to determine. Over the next day and a half, I plan on going through the longevity data from the last seven years to see if I can determine where the levels of the coinciding blood tests started to increase first. Then I will follow the trail to see if we can determine where it spread and how quickly. The third part of the analysis is to look at those who died and when their levels started to increase to see if a conclusion regarding gestation period can be drawn.”

  “That sounds like a lot a work for one person. Is someone assisting you?” said the Secretary.

  “Yes, Dr. Shah and his team will be assisting me.”

  “Yes, Madame Secretary,” said Ben joining in. “As part of the data analysis, we will be trying to come up with a determination regarding life expectancy for someone who is a carrier of SDX. I believe that the data Katie has can provide a window into this problem. Again, the key is, how fast is the premature aging process? I did some back of the envelope calculations and I expect it could be as much as one-hundred times the normal aging process, which would mean that someone who is 40 with a life expectancy of 80 would have about six months to live, or better stated, six months for us to find a cure.”

  “Well, I am looking forward to the results of your analysis. I have another news conference today at four this afternoon. It doesn’t look like I have any concrete progress to report. For those of you involved in the strategy meeting, there will be another DVC at 1 p.m. Does anybody have anything else?” said the Secretary.

  “Yes,” said Jim. “I want to remind everyone that what we have discussed here is classified and that it is not to be shared outside this room. All press contacts will be made through the Secretary and her office in consultation with the White House.”

  Everyone nodded and the DVC ended.

  “You handled that well Katie,” said Sarah. “I don’t know what got into Jim.”

  “I have a feeling he is one of 37 samples in the live batch and he didn’t want to be confronted with his mortality,” said Katie.

  “I hope that isn’t an indication of how people will react when this finally gets out,” said Ben.

  “If it gets out,” said Sarah.

  “Ben, I need to talk to Sarah privately if you don’t mind,” said Katie.

  “No problem, I will just wait outside and then we can meet to discuss how to coordinate the analysis of the longevity data.”

  “What is it Katie?” ask Sarah with a look of concern.

  “I took the liberty of having my family tested for SDX. I’m sorry, but I needed to know. I didn’t want to infect them if they weren’t already infected,” said Katie.

  Sarah’s look of concern turned to a look of disappointment.

  “Please don’t do any more unauthorized tests, Katie. If you feel strongly that something needs to be done, come to me first and we can discuss it. At any rate, now we will have more live tests results, including you and your family. I sure do hope you are wrong about everyone being positive for SDX.”

  “Me too, but I don’t think I am,” said Katie convincingly.

  Sarah opened the door to the conference room and said, “Ben you can come in now, we are finished.” Then she headed for her office.

  Ben said, “That seemed pretty intense. Anything to do with the current situation?”

  “Well, yes,” said Katie. “I had to tell Sarah that I tested my family.”

  “You did what?” he exclaimed.

  “I had my family come up to the office to meet me for dinner and while they were there I took them into the lab to have their blood drawn. They think they are helping me with my research, and they are. If they are positive, then that helps us with the next logical step in our thinking.”

  “You never cease to amaze me,” said Ben. “So how do you want to work the coordination of the data analysis?”

  “I thought I would analyze the data by region and then send you the information. At that point you could see if you can determine a pattern. So, what you will get is the level for each individual in the particular region and whether they were dead or alive as of last Friday. If they died prior to that time you will also get the date and, where possible, the time of death. I will provide you the test data by region for all of the subjects, highlighting when the four marker blood tests started to rise and when the individual died, if they are not still alive. Hopefully, based on this information, you can make a judgment as to whether the individual died of SDX or something else,” said Katie.

  “Sounds like a plan. When do you expect I will receive the first data packet?” asked Ben.

  “Probably around 5 p.m. today. I have ten regions and I expect it will take me at least an hour per region. I also have to look at the live batch results and then I should receive my family’s test results around three this afternoon. I will try and get you at least five of the regions today. If you come up with anything in the meantime, let me know.” said Katie.

  They both agreed that this would work and they parted ways. Katie had a lot of work ahead of her but now at least there was a plan and she knew that without a plan there would be no result, except death. Meanwhile, she needed a Diet Coke.

  Chapter 19

  Resident physicians at Johns Hopkins adored Dr. Stephanie Metcalf. In a paradoxical way, Dr. Metcalf was affectionately known as “Grumpy,” for her mild mood slumps in early morning rounds before her first coffee kicked in. She was therefore always the recipient of a ritual cup of “Grumpybucks” -- a Mocha Frappuccino to be exact -- from one of her Residents as daily rounds at the Medical Center began. The Residents even kept a “Grumpybucks Call Roster” and woe be it to the one who forgot to get the coffee!

  Dr. Metcalf was a renowned hematologist once nominated for the Nobel Prize for Medicine for her ground-breaking work with hemoglobin analysis. Now late in her seventh decade of a rich life, she remained as sharp and energetic as ever, leading Dr. White’s team tasked with covering the western hemisphere. But Grumpy had suddenly fallen ill the day prior, and Dr. White and the entire team were worried about her.

  With each passing day in the face of the daunting task before him, Dr. White refused to lose hope in finding the pathogen behind this unseen enemy, an elusive foe one of his brightest fellowship students repeatedly termed the perfect pathogen -- a student nick-named Sneezy for his seminal and precocious work on the pathology of allergens and the immune system.

  As a scientist, Dr. White knew this perfect pathogen was out there somewhere to be found, all he needed was time to find it. Yet in his stolen, restorative niche moments each day, like when driving his new Audi A6 to and from work, he could not help wondering if this might be the end of the human species. Never had science confronted such a phenomenon like this and his gut was asking him -- no, his scientific mind was telling him, given the speed of the disease’s course -- humanity could be facing a mass extinction event.

  Many scientists had been suspecting an extinction event could eventually impact the human species, just as it had already happen
ed to so many individual species in the modern age and before: the Dodo Bird; the Passenger Pigeon; the Eastern Cougar; the Javan Tiger; the Carolina Parakeet; Cro-Magnon man; the wooly mammoth. Some experts had suggested the major threat would come from an evolving human disease brought on by climate or environmental change, and not by rising tides or wide-spread drought.

  Ensconced in the new car smell he enjoyed so much, Dr. White wondered aloud to himself: Measured in geologic time, had the Holocene extinction, known also as the Sixth Extinction, now come to visit the human race?

  CHAPTER 20

  Katie returned to her office around noon and Beth was there collating the data regarding the longevity study into regions. “I don’t know what I would do without Beth,” thought Katie.

  “Hi Beth, how is everything going?” asked Katie.

  “Pretty good. I am just about done separating all the data files by region and then you’ll be able to access the database for each person based on their group.”

  “That’s fantastic,” said Katie. “I do have a favor to ask of you. Starting on Monday, I will start working out of the main office, so I need you to supervise the operations here. This should only last until we come up with a solution to remedy the illness caused by SDX. Can you do this for me?”

  “Sure. What is SDX?” asked Beth.

  “Oh, I’m sorry. That is the name the Johns Hopkins Team has given to whatever is causing the deaths among the elderly. It stands for symptomatic disease unknown.”

  “Well, I guess it is easier than saying, that disease or bug, or whatever,” Beth chuckled. “…and yes, I will be happy to run the place while you are downtown. I expect most of the action will be taking place down there anyway, don’t you think?”

  “Probably, but I may need access to some of the hard copy files on occasion, so it will be good to have you here since you know where everything is.”