Cukudeopul looked surprised. “So I need to help my immune system because this virus is mutated.”
“You do. I suggest you enter the Machine in three to five days. Nearer the three. Or even now. I’m hoping people will reach the serious stages at different times. What do you want me to do?”
“Treat as many as you can. Prioritize my security staff and my chief ministers.” Cukudeopul paused. “And their secretaries and main assistants. How many do you think will enter the stage of internal bleeding?”
“It is impossible to predict but the report we have from Torroxell estimated at least twenty-five percent with bleeding, while the reports from Oberterk were a lot worse, with nearer seventy percent. I think we should allow for the latter. With any virus, there should be some who do not get the virus at all. But I am very perturbed to see the whole security shift of the control room has it. One hundred percent. That frightens me. That was another factor in my thinking that this was an assassination attempt. This could have been achieved by ensuring they got a huge dose.”
An hour later there was a conference of all the doctors, Kumenoprix and Cukudeopul. They decided to divide up and quarantine the Base, but people had come and gone and it was near-certain that the virus had got beyond the Base. Kumenoprix said, “I suggest that all who have left the city in the last eight days should quarantine themselves in their own homes. No contact except by electronic means. Plus all those who have had contact with them.” He looked uncomfortable. “Your people are generally not known for doing things for the good of others so I suggest putting these people on state-paid sick leave or the equivalent if they are self-employed, and also delivering food and necessities to them free of charge. If you make it so they get an advantage to declaring themselves at risk and needing quarantine, more will do so.” The others looking unconvinced: he could almost see the mental calculators adding up the cost. “This will be a lot cheaper in the long run, cheaper for your hospitals and it will reduce the risk to your Race. If someone aims to wipe you out they will use this confusion and uncertainty, especially if they know how serious this virus can be. You must get your researchers developing an inoculation. You must also look for complications. Contact Oberterk and find this out. What causes the deaths? Some reports indicate air-exchange complications while others indicate bleeding from the stomach. There are possibly people who die from treatable complications. If so, these may be relatively easy to treat so long as the cure is available.”
“How will we stop people saying they are sick just to get these advantages?” asked one of the accountants.
“Blood tests will be the quickest and cheapest way,” answered Kumenoprix. “I suggest you use them on all who say they may have been exposed. You can’t risk them being right. And a second lot of blood tests before they are allowed out of quarantine. If they develop complications, you must remove them from the house and treat them. People must feel it is in their best interests to report sick or exposed and that they will be well monitored and well treated if they become ill. You also will need those who have had the virus and recovered in order to get information on the course of the illness, and plasma for inoculation.” He looked around and saw the hesitation. They still weren’t getting it! Their medical science was so good they could not contemplate how serious this potentially could be. “I have a very bad feeling about this virus,” he said urgently. “There has not been an epidemic in your Race for hundreds of years, possibly longer, and it is well out of your racial memory. You cannot imagine how serious this could be. I can! I believe this is deliberate! You must think ahead. No one would dare to do this unless they were very certain it will work and that they’ll get away with it. That is frightening.”
He scanned their faces. They still didn’t get it. “Cukudeopul,” he snapped. “You must move now! If this develops into a pandemic, a huge percentage of your Race could be annihilated. You are not equipped for the quantity of sick and dying people that will result. It will take five to six people to care for one seriously ill person who needs intensive care. Your medical facilities, supplies, and medical workers will quickly become overwhelmed. You must order all non-urgent medical treatment to stop and cancel all booked surgery. Treatment should continue only for life-threatening illnesses and then only until the virus hits.
“Your hospitals run at full capacity with the emphasis on financial efficiency. They have no reserve capacity. Normally, they cope with disasters only because there are so many hospitals and therefore just a few people arrive at each hospital. But this will not be enough now. You will quickly see your hospitals overrun. In about four to five days from now at the latest, critically ill people will start to arrive. If the statistics from Oberterk are correct, you will be looking at millions or billions. The hospitals cannot cope, not even with all surgery and all procedures canceled. No chance. We will have to hope the rate of infection can be contained.
“Now, where will it hit first? It depends on where this outbreak started from. Probably the spaceports. You must cancel all leave, bring trained staff out of retirement and off maternity leave. You must retrain staff and train new staff. Also recruit from other Races. Quickly! As many as you can get! Other Races will be safer to care for sick Keulfyd, and there should be no cross-infection from carelessness. You will be able to have wards with no Hazmat precautions which will make the medical care easier, cheaper and more efficient. Use Keulfyd staff to care for other Races and those with other illnesses. Maintain quarantine and keep all unnecessary Keulfyd out of the hospitals including relatives. You also need your medical laboratory staff to be of other Races so they will not be at risk from the blood drawing or testing.”
Cukudeopul glared at Kumenoprix, annoyed at his impudence. Kumenoprix gazed back with a determined expression Cukudeopul recognized. But Cukudeopul knew Kumenoprix was one very smart Okme, even for Okme whose medical science was (Cukudeopul admitted to himself), even better than Keulfyd. He said thoughtfully, “It seems mild so far but I remember what the outbreaks were been like. I was in them! This was one of those bad illnesses that sometimes mutated naturally and after killing a lot of people one year it could roar back even worse the next year. We had eleven planets of our own and a large population on seven other planets. This gave a lot of scope for viruses like this that were prone to mutate. There could be different mutations on more than one planet at the same time and almost unrestricted movement between those planets. It was common for illness to be concealed due to the potential for a large financial loss and also the inconvenience. Sometimes it wasn’t thought to be really important and millions died as a result. Oh yes, I remember. Quarantine was very difficult and expensive. And it often didn’t work. It required co-operation and we are not the most altruistic of Races. We are not known for co-operation either.
“Immunity one year didn’t always mean total immunity the next year but it generally helped. But over time, immunity built up and I have had this virus more than once, I think. The mutations were usually small and insignificant. But I remember bad years. Those who had it and survived might get the new strains but were not as sick. It was only those who didn’t usually get it and caught it in a year that it was bad. They often died. But if you lived, you were not left chronically ill. You generally recovered completely.” So, he thought cold-bloodedly, the population needs to be helped and the survivors will not remain a burden on the rest.
Cukudeopul turned to Sikleffidisk. “Do what he says. Draw up a plan between you. Do it today and bring it to me. Go.”
Sikleffidisk and Kumenoprix sat down with their dictators next to their printers. Kumenoprix was first off the mark. “We need the Emergency Fund activated and paid out to each hospital in accordance with how many patients they can treat. We need to instruct them to stockpile all supplies needed. They will need Hazmat. They will need huge amounts of blood test kits. You will need to get the Kinandier Lab to devise a blood test, a fast-prick test. Give them infected volunteers. If they are well paid, that will encourage
quick participation. The hospitals need to recruit other Races so that Keulfyd staff treat foreign Races and vice versa. They need to set up quarantine wards and guard them. We all know that Keulfyd who think they are important consider inconvenient laws do not apply to them. This opinion needs to be dealt with,” Kumenoprix said grimly, thinking of the times he’d had to deal with arrogance that was to the point of blind, crass stupidity. Bacteria and viruses did not discriminate according to social standing but to resistance, exposure, susceptibility, age, state of health, fitness, lifestyle, timely treatment, and lastly but often crucially, determination to live. That was one time stubbornness could literally be a lifesaver. And Keulfyd had liberal quantities of stubbornness.
Sikleffidisk made the occasional suggestion but had the good sense to mainly listen. Kumenoprix was a lot brighter than her, she knew. And she liked him a lot. They got on well. Sometimes she even understood some of his genetic research. A skilled doctor, she also was what Keulfyd called a jumper: with what was normally insufficient data for others, she could mentally leap ahead and accurately. It was a mix of knowledge, good instincts and a brain that worked fast and made connections others didn’t normally make. A brilliant diagnostician, she had earned her place as Chief Medical Officer. But she was also in her job because she intuitively leapt ahead also in seeing implications, trends, consequences, and dangers. Epidemiology was one of her specialties and her type of thinking was invaluable. On the math, she was ahead of Kumenoprix and she didn’t need a calculator. She had one hard-wired in as one teacher had told her parents.
“This planet has one hospital bed per ninety-five thousand people on average,” she said. “Only ten thousand of those are critical care or could be converted to critical care. With this virus, most of those entering the bleeding stage will be critical care. That doesn’t count the Okme centers. We may need to use them but that will initially be unpopular.” She sat and thought. The state paid for the Okme to put through Machine loads of babies every day in every city. That fixed the worst of those with severe birth defects, and fixed them very cheaply in comparison to what lifelong care would cost. It reduced the chronically ill, the deformed and those who would have had intellectual handicaps. But that still left many who needed hospitals. Only one bed per ninety-five thousand. That was so inadequate as to be laughable, if it wasn’t so tragic, she thought. And she had a husband, three children and one grand-daughter.
“Kumenoprix, could we use the Okme to replace some of the critical-care beds?”
“I’m going to try that with the essential staff here. Symptomatic care. It will buy time. Whether it will affect the outcome or just delay it, I don’t know. But I’ll try.”
She nodded. That was the question. Would the treatment of the worst symptoms allow the body time to develop immunity to fight the virus?
It took them only an hour to brainstorm it all and get back to Cukudeopul. He looked over the print out of the report and handed it back to her. “Implement it,” he said. “Kumenoprix, I think you are going to tell me I need to go back into the machine and then start more medication.”
“Yes.”
“Overnight. I will sleep in it.”
Kumenoprix breathed a sigh of relief. Cukudeopul was not going to be difficult. The Machine was soon going to be used flat out and he had only one. He had never anticipated needing another because he knew this one literally inside and out. He could service it, operate it, reprogram it, and maintain it. He thought he could probably build one too.
Chapter Eighteen
Three weeks after the decrees, Cukudeopul called for a report from Kumenoprix and Sikleffidisk. “Once the decrees were published, opinions on the threat and responses varied. However, most resistance disappeared when the emergency funds reached the hospital accountants and the medical committees found out the funds were there,” Sikleffidisk said wryly. “Most hospitals appeared to see this as a bonanza rather than the threat we were stressing. Most quickly worked out how to advantage their hospital and their budget. One such was the large teaching hospital, Dimarindoss.”
“Where is that?”
“On the other side of the planet. No reported cases until a week ago. The medical committee ordered everything on the list they were told to get. They initially reported that all non-essential surgical and other procedures were being canceled and the patient population had started to reduce. As ordered, the Checkers were reprogrammed and switched on. The entrances were reduced. All incoming patients are required to go through the Checkers and have the finger-prick test. Relatives and visitors are banned. All non-essential personnel are banned. All incoming Keulfyd staff are given the blood-prick test at the start of every duty. Millions of blood testers have been delivered, free, to every hospital as you ordered. Dimarindoss reports it is ready and prepared. It is an example of a hospital which obeyed directives and had the advantage of seeing what happened in other hospitals before the plague cases arrived at its own doors.
“Other hospitals were not so lucky or well prepared. Kisjidomell Hospital, less than fifty miles from here, did not cancel surgery immediately as they were told to. Last week they were overrun with highly infectious patients, left sitting with other patients who were not infected until they had spent time in the company of the sick, coughing, dying ones beside them. It now has infectious patients and staff spread throughout the hospital. It isn’t the only one in this situation but I believe it is the worst. They appeared to have ignored all the directives and are evasive as to what they did with the emergency funds. It is a disaster. What do you want us to do?”
Cukudeopul thought for a minute then ordered, “The whole of the committee of the hospital is to go, themselves, into the wards to sort out the problem. I am ordering a ‘standstill.’ Every ward is to be sealed and every Keulfyd tested. All infected are to be masked and isolated with the other infected. How extensive is the problem? Has it extended out into the city?”
“It must have. Patients who had entered the hospital included those booked for surgery, accident cases, people who had come in for tests or treatments and left, those with illnesses, and expectant mothers. Many now are probably fatally ill.”
“And most will be unidentified,” added Kumenoprix softly. “Worst of all, that includes new mothers and babies and the children’s ward, plus all who have entered these wards. They receive huge numbers of visitors, all of whom should not have had access. The problem is enormous, the cost in lives is going to be horrendous.”
“And the hospital’s legal liability will cripple it. Publicize this. Let all know the penalty for disobeying my orders. What were they thinking? They were told three weeks ago and to implement these orders promptly.”
As Cukudeopul left, Kumenoprix said softly, “When accountants run hospitals, this is the result.”
Sikleffidisk left to carry out his orders while Kumenoprix went back wearily to check his Machine and top it up. Normally, a Machine was never left untended but he’d had no choice but to risk it. By this time Cukudeopul had, for a second time, been put in the Healing Machine overnight. So had seven of the eight of the original security shift infected, including the Chief. The eighth appeared to be recovering and his organs were not bleeding to any significant degree. His blood pressure was low but steady and his other observations indicated his body was winning, or at least not losing. But his antibody count was negligible.
Kumenoprix checked the latest statistics. So far, of the approximately six and a half thousand Keulfyd in this part of the city, about half appeared to have the virus. Only one hundred and twenty-seven had died. And it was a mere nineteen days after the first cases had been positively identified. Probably twenty-four days since the virus had been, he thought, deliberately introduced. The scatter of first case outbreaks on the same day indicated it had been liberally seeded in a variety of public venues including all the main transport areas, shopping areas, food distribution outlets, and learning institutions. The latter indicated a Race that did not value children
, which was a significant indicator for Kumenoprix. He was exhausted. He was now treating sixteen people a day by jamming two in at the same time, top to tail. He slept beside the Machine. It alerted when it ran out of something or needed attention. He treated Cukudeopul the first night, then one person every few hours, then started doubling them up as the numbers of those reaching the stage of bleeding started to rise rapidly.
On Day 18 he reported to Sikleffidisk, “Yesterday I found traces of antibodies in the blood of the security man who is appearing to recover. This morning, the concentration was enough that I could take some plasma off him. I replaced it from an uninfected source, and that gives me 500 ml of plasma. What is your priority?”
“What do you advise?” she asked.
“That’s enough for fifty doses for those in the first stage. Use it for them. Treble the dose is required for those in the final stage and it doesn’t always work.”
“Don’t waste it. Take what you can from him and keep me informed.”
Four days later he reported to her, “I have now treated two hundred and fifty who are now possibly safe. But some have reacted badly to the raw foreign plasma and three died, but I expect less than two percent to be so unlucky on average. There has been no time for testing or trials. I need another few hundred to recover. Cukudeopul remains well and his antibody count is starting to rise as well. How are the hospitals coping?”
“Sadly there were many hospitals whose administrators did not listen,” she answered. “The lessons were learned fast and those that had not paid attention started to do so. But for so many it is now too late. Available staff are all working elsewhere, supplies are exhausted, equipment has run out and the hospitals are over-full. Some simply closed their admissions unit. This was against their contracts and they will be heavily fined. But I personally cannot criticize this. It gave them the time and the ability to implement the changes they had been told to put in place. It allowed them to get the hospital under control and safe procedures installed, starting with installing a Checker at all entrances. It would have been better if they had done this originally but they did get their hospitals safe and functioning.
Alien Backlash Page 17
