by Alex Ryan
When she finally reached the level-five landing, an orderly dressed in PPE identical to her own greeted her. In his left hand, he held a garden-variety, hand-pump, ten-liter plastic bug sprayer filled with an aqueous solution of chlorine dioxide. In his right hand, he held the sprayer wand. He gestured for her to step into a blue plastic tub filled to a depth of three centimeters with the same disinfectant. As a biocide, chlorine dioxide outperformed chlorinated water. It was extremely effective against a wide range of pathogenic microbes—killing viruses, bacteria, protozoa, and toxic molds within seconds—which was why she had stipulated its use here. The unspoken truth was that she had no idea what they were dealing with here, and she wasn’t taking any chances.
She stepped into the plastic tub, positioned her feet shoulder-width apart, and held her arms out from her sides. Because level five was a clean zone, disinfection was mandatory prior to admittance. The carefully orchestrated decontamination ritual was critical to safeguarding not only her but everyone in the clean zone she was about to enter.
“Ready,” she said, looking up at the orderly through her fogged goggles.
On that cue, the decontamination man methodically misted her from head to toe with biocide. When he stopped spraying, she rotated so that her back was to him. After finishing, he simply said, “Clear.”
She rotated and stepped out of the plastic tub and onto an absorbent pad. Next to the pad sat a second blue sterilization tub, an oversized laundry hamper, and a trash receptacle marked with a biohazard sign. First, she removed her goggles and gently—so as not to make a splash—deposited them in the tub where a dozen other pairs of goggles and boots were soaking. Next, she held out her hands to the orderly for him to remove the tape sealing the cuffs of her rubber gloves to the sleeves of her suit. Once the tape was stripped off, he removed her gloves and placed them into the waste receptacle, leaving her inner pair of purple nitrile gloves untouched. After that, she stepped out of her rubber boots and waited while the orderly gently deposited them into the blue tub for soaking. Finally, she let him strip off her coveralls and dispose of them in a trash receptacle.
“Ready,” she said.
“Clear,” he replied and opened the heavy steel fire door with his gloved hand.
She stepped out of the stairwell and onto an oversized absorbent pad taped to the linoleum tile floor just inside the level-five corridor. She waited until the door closed behind her before removing her mask and tossing it into another prestaged biowaste receptacle. She then slipped on a pair of sterile foot covers and disposed of her nitrile gloves.
Decontamination ritual complete.
Absent her blue suit, the cool, dry, air-conditioned atmosphere of level five sent a chill careening across her sweat-soaked skin. Her damp, thin cotton scrubs offered no insulation, and gooseflesh stood up on her forearms and the nape of her neck. She shuddered involuntarily and headed toward a stack of fresh, dry hand towels, neatly folded, staged on a chair against the opposite wall. Towel in hand, she set off down the hall, wiping the sweat from her face and neck. When she reached the middle of the corridor, she stopped outside a pair of double doors labeled Gastrointestinal Department. Within an hour of her arrival, she and Commander Zhang had commandeered the space, and it had served as the Tactical Operations and Communications Center for their multidisciplinary task force ever since.
She tossed the towel into a laundry hamper and pulled open the door to the TOCC.
“Dr. Chen,” Commander Zhang said, walking to greet her the instant the door opened.
“Commander Zhang,” she said, nodding cordially.
“You’re shivering,” he said, noting how she was hugging her chest. “Sergeant Tan, get Dr. Chen a jacket.”
“Sir,” acknowledged the young, fit Snow Leopard soldier standing beside Zhang.
“Thank you, Commander, but that is not necessary.”
“Of course it is,” he said with a smile. “You are the last person on this task force I can afford catching a cold.”
Before she could protest further, Sergeant Tan returned with a SLCU tactical jacket and draped it over her shoulders. The coarse, black material swallowed her tiny torso. Under its weight, she felt small and fragile. It was the same jacket that Commander Zhang wore, with the same embroidered patches on the left shoulder. The unit patch had a blue background and a golden border. In the center, a growling snow leopard was depicted over a map of China, framed by golden laurel, and resting above a pair of machine guns crossed at the barrel. Above the Snow Leopard patch, an embroidered Chinese flag was stitched—bright, bold, and red. Together, the two patches were dramatic and stark, contrasting both each other and the solid-black fabric onto which they were sewn.
“Thank you,” she said at last, shifting her attention to the sergeant.
The junior soldier nodded at her and wordlessly returned to Zhang’s side.
“How do you like it?” Zhang said, the crook of his mouth turning up at one corner.
“It is . . .” She hesitated. “A very handsome jacket.” Then, with a smile, she added, “But maybe a little big for me.”
“There are no female commandos in our unit,” he said. “But when we come out of this crisis as heroes, I will mail you an insignia patch—so you will always remember your time with the Snow Leopards in Kizilsu.”
“I would like that,” she said, with as much earnestness as she could muster. “Very much.”
This seemed to please the Snow Leopard Commander, because he smiled broadly at her. She knew Zhang found her attractive. It was obvious from the way he treated her. Boys and men had been pining for her affection since her fourteenth year. She had been blessed with a symmetrical and profoundly feminine face, with a petite nose, wide almond eyes, and shapely lips. In adolescence, she had come to understand that her beauty was a powerful asset when properly and demurely showcased. As she matured, she learned how to leverage her beauty to open doors and engender lasting but unrequited professional affections. The key was to entice, not tease. Allure, but not seduce. Men despised a cocktease but would wield sword and shield for a maiden. Commander Zhang was no exception. He was only doing what came naturally for men like him—subconsciously falling into the archetype that suited his ego. Should she ask, he would gladly become her champion.
Major Li, from Regiment 54423 of the People’s Liberation Army, however, was another story altogether.
She leaned left to glance past Zhang into the TOCC behind him. “Is Major Li here?” she asked.
“No,” Zhang said, his voice deepening. “Major Li has not returned from the laboratory.”
“Hmm,” she said. “I would have expected him to have the test results by now.”
Zhang nodded pensively, then asked, “How are the patients doing?”
“Not good,” she said, shaking her head. “Not good at all.”
During her time in Liberia, she began to detach herself from the gruesome, heartbreaking patient interactions that she, and every other Ebola worker, had to face on a daily basis. Pain, suffering, and death were everywhere and unavoidable, so she learned to compartmentalize her feelings, her empathy, her fear. To function in the face of great adversity and risk, a doctor must become . . . clinical.
“How bad is it?” he asked.
“Seventy percent mortality, and we are losing more every hour. With the type of progression I’m seeing, I would not be surprised if the mortality rate reaches ninety percent or more.”
“Is that normal for Ebola?”
“I don’t believe we’re dealing with Ebola.”
Zhang took a step back. “If not Ebola, then what?”
“I don’t know,” she said, and then felt her pulse quicken as she added, “Something worse.”
Chapter 6
Quarantine zone, level four
Artux People’s Hospital
Nick stretched his back and felt the overwhelming urge to start pacing again. He was not a jumpy guy by nature, but with the toxic, nervous energy coursing throug
h his veins, he couldn’t sit still. Lying in the short, uncomfortable Chinese hospital bed was unbearable. He simply could not relax.
So he paced like a caged animal.
Since the androgynous bubble-suit doctor and his or her two guards had locked the three of them in this room, they had been poked, prodded, and kept completely in the dark. Meals and water were being provided, but the hospital rations were not substantial enough to quell his rumbling belly. Taming hunger on a SEAL mission was an entirely different beast than in quarantine. On a mission, even in the desert, there was sensory nourishment for the mind to help offset bodily hunger. In here, in this horrible, gray-and-white, windowless room, with its linoleum tile floor and fiberboard drop ceiling, there was nothing to see, nothing to smell, nothing to hear. The room reminded him of a treatment bay. Rolling beds with metal side rails had been brought in for them to sleep on, but they did not have chairs. Their room was separated from a half-dozen similar rooms by folding glass partitions that had been pulled closed. He could count three other rooms with quarantine patients inside, one of them packed with at least ten people, including three small children. Nick guessed they were kept together in groups based on how and when they had been exposed. Whatever the hell this disease was, Nick was now certain that Batur was not the only victim.
He glanced up at the television suspended from the ceiling, where men in Western suits were yelling at each other behind an oversized desk. The volume was on mute, and he could not read the Chinese subtitles. He did not recognize the show, but it looked like some variant of the wildly popular CSI series.
Ironic, he thought.
“I don’t feel sick,” said Yvette, her voice small and sure.
He looked over at her. Sometime during the past six hours, she had drifted into an eerie and unsettling state of calm. This was the fourth time she had made this comment.
“You don’t look sick,” he said, realizing this was the fourth time he made the same reply. He did not like seeing her with this new, creepy Stepford Wife tranquility. In fact, he liked her better when she was teetering on panic. At least then he could satiate his instinct to comfort and protect her. Her hysteria had given him something to focus on besides questioning whether his lips and eyelids felt like they were beginning to swell.
“How long has it been?” she asked, smiling at him.
“Almost two days, I guess.”
“If we were going to get it, don’t you think we would be sick by now?”
He desperately wanted to point out that he had no friggin’ idea. Without knowing the time from Batur’s initial exposure to the point when his face exploded with edema and he began bleeding from the eyes, it was impossible to make predictions about the disease’s incubation period. In Nick’s mind, two days “symptom-free” was no guarantee they were out of the woods. But he heard soft hope in Yvette’s voice and decided to keep these thoughts to himself.
“Definitely,” he said. “I think we’re good.”
He looked past Yvette at the body lying motionless in the bed beside her. Bai was staring so intensely at the ceiling that, for a moment, Nick thought the man was sleeping with his eyes open. Yesterday, the hospital had allowed Bai to call his family. He had not been permitted to tell them where he was or any details of his detainment, but he had been allowed to say he was okay. Since making that call, Bai had not said a word.
“How long do you think until they let us leave?” Yvette asked.
“Soon,” Nick said, and he winked. “You ready for that beer I promised?”
Yvette shook her head, her lips tight.
“When we are allowed to leave, I will go straight to the airport in Kashi to find a flight home.” She looked up at him, and to Nick she suddenly seemed younger. “My mother will be worried,” she said, and a tear rolled down her cheek.
He had no reply. The girl probably should go home to her parents. As far as his plans when he “got out,” he had not given the matter any thought until now. Given the choice, his preference would be to finish the project. He felt the same about the mission now as he did before, if not stronger. But if Chinese government suspended or cancelled the project, then he would have no choice but to go home to Texas. His mother would certainly welcome him with open arms, but he wasn’t ready to go home yet. His work here felt unfinished, and he didn’t want to walk away from the NGO life. He didn’t want to walk away from China.
The glass doors opened and a nurse walked in carrying meal trays stacked three high. The woman was dressed in blue coveralls, complete with mask, gloves, and goggles, but she was not wearing a space suit.
That has to be good, he thought. Right?
Bai sat up, and Nick wondered if he was thinking the same thing.
“She’s not in a pressure suit anymore!” Yvette noted.
“Ask her if there is any news,” he told Bai excitedly.
Bai chattered with the woman a moment. Then he nodded to her as she set down the trays and left.
“Well?” Yvette asked before Bai could even take a breath.
“I don’t know,” he said. “She says the soldiers took the pressure suits, and they were told by the CDC doctor to use these suits now. I asked her if she knows our test results, and she said she does not know.”
Nick nodded, not sure if this was good news or not.
“Someone will come to talk to us soon, she says,” Bai added after a beat.
Nick grabbed the three trays and handed them out to the others.
“Celebratory dinner, anyone?” he asked, setting his tray on his bed.
“I think it’s lunch time,” Yvette said.
“Close enough,” Nick said as he sat down on the corner of his bed, his Chinese-sized green scrubs lifting to his knees. He raised a cup of juice to Bai, who tried to smile for the first time since they had arrived. “To not being sick.”
“To getting out of here,” Yvette added.
Bai nodded but did not raise his own cup. “I just want to see my family again.”
Chapter 7
TOCC, fifth floor
Artux People’s Hospital
Dazhong hated supposition, but during her career at the CDC, she’d learned that men like Commander Zhang hated being kept in the dark even more. Their working relationship would go smoother if she shared what she knew, as she came to know it, even if her working conclusions later turned out erroneous. Based on the patients she’d observed and treated so far, her medical instincts told her this was not an Ebola outbreak. Her reasoning for this had a textbook component and was also based on her intimate familiarity with the disease from her time in Liberia. Zhang was a counterterrorism operative, not an epidemiologist, and so much of what she wanted to tell him would fall well outside his area of expertise. Yet during the short time they’d worked together, she’d recognized that Zhang possessed a shrewd and logical mind. If she dumbed down the discussion, she might risk offending him. She decided to talk to him as a peer and put the burden of asking for clarification on his shoulders.
Zhang stared at her, his lips still parted in surprise at the bombshell news she’d dropped on him seconds ago.
“Initially, I thought this could be Ebola because the late-stage presentation of this infection is similar to Ebola,” she said, restarting the conversation. “Diarrhea, chest and abdominal pain, bleeding from the eyes, nose, and rectum, and pronounced edema are all present. But the disease progression is too fast, the tissue damage looks different, and the incubation period is not consistent with what we know about Ebola.”
“What do you mean by that last point?” he asked.
“Ebola has a variable incubation period, anywhere from two to twenty-one days. We’ve admitted sixty-two infected patients who all presented symptoms within the past twenty-four hours. What is the likelihood that all of these people were exposed to Ebola in Kizilsu Prefecture and all fell ill at the same exact time?”
“Are you saying this may not be a naturally occurring outbreak?”
She nodded
. “The consistency of disease progression across this initial wave of victims points to a bioterrorism event.”
Zhang’s expression darkened. “What bioweapon are we dealing with here?”
“Unfortunately, I can’t tell you what it is, but I can tell you what it’s not.”
“Okay.”
“It’s not smallpox, anthrax, or plague, which are the three most probable agents that a terrorist would select. Smallpox victims present with a progressive skin rash that follows a predictable pattern: flat, red spots that become raised bumps, which turn into fluid-filled blisters, and then morph into pustules. The skin lesions we’re seeing bear no resemblance.”
“What about anthrax and plague?” Zhang asked.
“The only forms of anthrax and plague that kill this rapidly are the inhalation variants, and we are not seeing pulmonary pneumonia, hemoptysis, or shock induced by respiratory collapse. I’ve taken chest x-rays of multiple patients, and the images do not support respiratory infection as the cause of death.”
“If it’s not Ebola, not smallpox, not anthrax, and not plague, what else could it be?”
“This is really a conversation we should be having in conference with Major Li,” Dazhong said, her irritation growing by the second. She shrugged off the oversized tactical jacket and handed it back to Sergeant Tan. “I think it’s time we go see him.”
“Agreed,” said Zhang, and he headed for the door.
She trotted after him, down the corridor to the south stairwell. The door was guarded by one of Zhang’s men, who stepped aside as his Commander approached.
“Any unauthorized entry attempts?” Zhang asked.
“No sir.”
“Very well,” he said, pushing open the door.
