by Jinkang Wang
Xiaoxue was quite uncomfortable, but still answered politely. “No, that must have been someone else. Director Mei just got married. She and her husband are still on their honeymoon.”
Dr. Ma sighed. “What a good person she is, to have funded the orphanage herself. It’s been ten years. I remember before I retired, when she first came to Nanyang to set this place up and raise all of you. It hasn’t been easy.”
After she’d spent enough time on the drip, Xiaoxue walked back on her own. Mother Liu and Mother Chen had decided to let Xiaoxue stay in Director Mei’s new room, even though using the newlyweds’ room as a sick room seemed like an ill omen. They knew Director Mei would think nothing of it.
Mother Liu prepared some chicken soup, and Xiaoxue managed to eat a bowlful before falling asleep. Her temperature was still too high, her whole body ached—especially her head and back—and her limbs were so heavy there seemed nowhere to put them. The two mothers had to take care of thirty-two children alone. Previously, Xiaoxue had practically been half an adult, and without her to help, they were much busier.
Stuck alone in the room, moaning from the high fever, Xiaoxue drowsily looked around her: the “happiness” character on the wall, the pot of flowers on the table (she thought, Don’t forget to water those for Mommy Mei every day), the simple bookshelf, the rack hung with Mommy Mei’s clothes, the pillows that still smelled like her. After thirteen years she’d all but forgotten she was an orphan, but in times of illness, she felt all over again what it meant to be alone. She longed to be like her classmates, able to burrow into their mother’s arms when they were in pain, able to fuss or even have a little tantrum, so their fathers and mothers would coo and try to soothe them. She wept quietly, her tears soaking through the pillowcase.
After two days on the drip, her fever went down a little, but more and more blisters appeared all over her body, even inside her mouth. Another six or seven kids in the orphanage also came down with a fever. Mother Liu panicked, and quickly took Xiaoxue back to see Dr. Ma, who examined her solemnly. Trembling with fear, Mother Liu said, “Dr. Ma, do you think it could be . . . it could be . . . that disease they had in America?”
She couldn’t bring herself to say the word smallpox—even pronouncing it seemed to invite infection. Just think of the tragic scenes in the American infection zone. She shuddered to imagine such a catastrophe taking place here. She and Mother Chen would be fine—they’d both survived cowpox as young girls—but what about the orphans? Dr. Ma had been having doubts of his own. Xiaoxue’s blisters were clustered around her head, which was a symptom of smallpox (whereas chicken pox blisters tended to be on the torso). Yet smallpox blisters ought to be larger and deeper, and usually sunken in the center, like craters, while Xiaoxue’s were smaller and shallow. The two illnesses could be difficult to tell apart at this stage. But smallpox had been eliminated long ago, and he’d not come across a single case in his forty years of being a doctor. Smallpox had even been taken out of all the medical textbooks, a decision that wouldn’t have been taken lightly. The epidemic in America was caused by terrorists, a special case, and on TV it said they detected it early, managing to cut off the infection, and it hadn’t spread any farther. How could it have come all the way to Nanyang, the middle of nowhere . . . Then, with a jolt, he remembered that Director Mei was Chinese American, and quickly asked, “Has your Director Mei been to America recently?”
Mother Liu almost sobbed out loud. She’d already thought of this, but still couldn’t get the words out—it would seem too much like blaming Director Mei. But it wasn’t something that could be kept hidden, and so she wept. “Thirteen, no, fourteen days ago, Director Mei got back from America. She didn’t go to Wuhan, but came straight to the orphanage. But she left the States before the epidemic struck. And she said she wasn’t anywhere near the infected part, Ida-something, and she didn’t look ill . . .”
Dr. Ma felt a sharp stab of regret at his carelessness the day he first saw Xiaoxue—he’d neglected to ask who the patient had come into contact with. Fourteen days, precisely within the incubation period of smallpox. “You said Director Mei wasn’t ill, but that doesn’t mean anything. Some people are naturally immune, but could still be carriers. According to the law, anyone suspecting a smallpox case has to report it to the CDC within six hours. I’m making the call right now.”
Mei Xiaoxue stared blankly at Mother Liu, muttering, “What did Grandpa Ma say? Small . . . pox?”
Mother Liu could no longer hold back her tears, but hugged Xiaoxue tightly and wept.
Dr. Ma’s phone call put a national operation in motion. At the Municipal Health and Anti-Infection Unit (a sister organization of the CDC), Xiao, from the Epidemic Department, picked up the phone, and with a start, her eyes wide, turned and called, “Department Head, smallpox!”
Department Head Yang Jicun felt his mouth go dry—the catastrophe he’d been worrying about for days had really arrived. He’d heard about the outbreak in America, and although the official line was that all transmission routes were successfully closed off, he’d instinctively mistrusted this. With transport so highly developed these days, so many people went back and forth between China and America that it would hardly be possible to completely cut off all these corridors. That was the unfortunate thing about biological warfare: as long as one person slipped through the net, the entire barrier became useless. A single spark could ignite a forest fire.
Yang Jicun was thirty-two, a PhD accomplished in the field of epidemiology, and knew better than his colleagues what they were facing. Over thousands of years, smallpox had caused more destruction to human civilization than any other contagion, including the Black Death. In Egypt, the mummy of Ramses V, from 1200 BC, showed traces of smallpox. Records from the sixth century BC in India mentioned smallpox. The virus was now classified as Level Four, the most dangerous tier. In ancient times, China, Persia, and Turkey all experimented with using the scabs or pus of victims as a preventative inoculation, but it was risky. In 1796, the Englishman Edward Jenner produced an inoculation, after which smallpox infections gradually diminished until, in October 1977, the final case took place in Somalia. It was the greatest victory in the war of human beings against pathogens.
The question was whether the victory was too complete. Most people, including the older generation who’d been inoculated, would have lost their immunity. For historical reasons, the Han Chinese had a stronger natural resistance to smallpox, but after several decades of the smallpox vacuum, the resistance of the Han Chinese would also have begun retreating back to zero. If the evil spirit of smallpox was really once again descending on Cathay, they would find it hard to cope with a large-scale outbreak: China’s anti-epidemic infrastructure was nowhere near as effective as America’s, though at least, after the American incident, they had quickly bought a million doses of vaccine from Europe. There was no effective treatment for smallpox apart from the vaccine, which had to be applied within four to six days after infection to work. The government had focused on infectious-disease prevention in recent years, with good policies and funding—for instance, you could be tested for AIDS inside Nanyang. The problem was that this focus hadn’t included smallpox! After all, smallpox had already been eliminated!
An earth-shaking catastrophe. During the Jin dynasty, Ge Hong recorded in A Handbook of Prescriptions for Emergencies that smallpox “was acquired during the Jianwu era from invading barbarians in Nanyang, and is also called the barbarian pox.” The Jianwu era mentioned in the book was probably during the Yuan emperor’s reign in the Eastern Jin—approximately AD 495. So Nanyang was already a site of smallpox infection over fifteen hundred years ago. Could history be repeating itself?
He grabbed the phone from Xiao. Fortunately, after the 9/12 incident in America, he’d reviewed all the literature about smallpox diagnoses, and at least felt a little more confident in his knowledge. The new textbooks no longer contained a smallpox chapter, and he’d had to go back to the 1979 edition of Epidemiology S
tudies, edited by Di Guanyi. Dr. Ma described the symptoms once again, and they did sound like smallpox. Department Head Yang asked, “Have you tried pricking the blisters? If you stick a needle in a blister, whether or not it deflates is the main difference between chicken pox and smallpox.”
An awkward pause. “Ah, I forgot that one. Let me try it now—ah, I don’t remember which it is: Smallpox blisters don’t collapse?”
“That’s right.”
Rustling noises. “I stuck a needle in and the blister didn’t collapse. It’s smallpox!”
“All right. Keep the patient isolated. I’ll send someone at once to take a sample, and we’ll run some lab tests to be sure.”
Yang Jicun then asked about the source of the infection, and as he listened he began imagining the outline of the infection zone. The orphanage was fine, that was a relatively easy area to seal off. The problem was that kids from the orphanage had been to school, so there were an elementary and a middle school to deal with, which then affected their classmates, teachers, everyone’s families, and suddenly the circle was a lot bigger. They’d probably have to quarantine the entire town. That was still possible. The most terrifying thing was the first carrier who’d come back from America, Mei Yin, was currently with her husband on their honeymoon. They’d set out ten days ago. Where might they have gone in those ten days? How many people had they been in contact with? How many would they meet after this?
He tried hard to remain calm, but the scenario before him was utterly terrifying. He couldn’t stop waves of darkness from falling in front of his eyes. Hanging up, he immediately reported to Unit Head Lin and Secretary Chen, and then set out with Xiao to collect the specimens in person. Lin and Chen decided to first call Deputy Mayor Jin, who was in charge of Culture and Public Health. Once they were connected, Lin hurriedly explained the situation, and said, “We’ve only just learned about this infection, so it’s not verified yet. I just wanted to give you a heads-up, seeing as you’ve just come into the post and might not be familiar with the situation. Ever since the smallpox outbreak in America, the Anti-Infection Unit has been prepared to take preventative measures here. This will be difficult, but we will deal with it. The biggest problem is the original carrier, the benefactor of the orphanage, who’s presently on her honeymoon.”
Jin’s grim smile was almost audible on the phone. “That’s Mei Yin, I know her. She’s a famous virologist herself. Have you been in touch with her? You should isolate the two of them right away.”
“Yes. I’ll call her immediately.”
“Forget it, I’ll call her myself. I have her cell number.”
Deputy Mayor Jin hung up, his face dark as he sat, sunk in thought. Destiny must really love him. He suddenly recalled a month previous, when he’d made a special trip to inspect Mei Yin’s facility. He’d been worried at the time that the workshops might contain some secret that might damage him professionally. Maybe that was some sixth sense warning him of today’s disaster? And now look, while his original fears hadn’t yet been realized, the source of the catastrophe was still Mei Yin.
When she answered the phone, he heard a lot of background noise, and her cheerful voice. “Jin? What’s up?—Hey, Jingshuan, close the windows, the wind’s too loud.” Most of the noise cut out. “Jin, are you in such a hurry to celebrate with us? Don’t worry, we haven’t forgotten. We’re hurrying back now from Jiuzhaigou, should be back in two days at the most. The scenery in the highlands is breathtaking! Mighty and desolate. We’re floating above a sea of clouds right now . . . Hey, Jin, if there’s anything to say you’d better tell me quick, my phone’s almost out of juice. I left both our chargers in the hotel the day before.”
She sounded carefree; love had made her younger. Listening to her light, happy voice, Jin Mingcheng almost couldn’t bear it. The contrast was too stark—all-consuming tragedy on one side, bliss on the other—especially when you thought how joyous she must have been, all the while spreading the virus on her journey. He quickly explained the situation, and she exclaimed, “Smallpox? That’s not possible. When I left America, the outbreak had just started, and I was with my adoptive father the whole time, I barely saw anyone else. My God . . .”
A few moments of silence, during which he heard her murmuring something to her husband. When she picked up again, she was back to her habitual calm and efficiency. Unhurriedly, she said, “I remember now, I might indeed be a carrier. The one social activity I took part in while I was there was an independent forum. There was a man called Zia Baj who gave a bloodthirsty speech, and he mentioned that three of his Native American friends would be embarking on a tour of remembrance. It was these clues that made me call Homeland Security and report a biological attack. Now it seems my report was incomplete. Zia Baj must have infected the attendees with smallpox.”
Jin Mingcheng’s heart sank. Hearing this, he had no doubt about the nature of this disaster. “Oh, I see.”
“Jin, we’ll drive through the night to get back as soon as we can.”
Jin was silent a moment. “It might be better to get to the nearest big city, and admit yourselves to the isolation ward. I’m afraid that along the way . . .”
“Don’t worry, from now on we’ll keep the windows and doors tightly shut, and won’t go near anyone until we reach the quarantine zone. That’ll be safer than stopping in any city. As for the people we’ve already come into contact with”—a pause, then in a low voice—“I can only pray to God for help.”
Jin thought about it, and decided she was right, it was probably safer this way. “All right, let’s do that, come back as quickly as you can, but drive safely. Be careful! I mean it! I don’t mean to jinx you, but if there were an accident, with a whole load of rescue workers, that really would be the end.”
“We’ll be careful. We’ll take turns driving.”
“If this case is verified as smallpox, we’ll immediately declare an epidemic and seal off the quarantine zone.”
“We’ll head straight into the sealed area, and stay there till the epidemic is over. The children need me. Don’t worry about us, we haven’t shown any symptoms yet, so we must have some resistance.”
“When you get back, will General Manager Sun also stay in the quarantine zone?”
“That’s the only way. We’ve been together for so much time, he’s definitely a carrier too. But don’t worry, he can manage the business over the phone.”
“Fine. Thank you, on behalf of the children.”
In a small voice, she asked, “What are you thanking me for? If only . . .” But she didn’t finish.
After hanging up, Jin Mingcheng told his secretary to hold all calls and visitors; he needed to calm down and think about the situation. The town’s anti-infection measures were comparatively strong, and the most worrying factor was the ten-day journey of Mei Yin and her husband, who’d turned this infection from a point to a line. Hopefully it hadn’t expanded farther, into two dimensions! Still, he had confidence. After all, China had already been through the SARS crisis, when they’d had no previous knowledge to draw from and the initial stages were much more confused, but they’d quickly found a sense of order. Through that outbreak, they’d gained precious experience.
Suddenly, he thought of another problem: Mei Yin had said they wouldn’t go near anyone on their way back, but they’d have to pass through toll booths and gas stations, and at the very least would need to hand over cash. He’d have to warn them, and try to come up with a plan. When he called, there was no answer, just a well-modulated robotic voice: “Sorry, the cell phone you are trying to call is switched off.” They surely wouldn’t have turned off their phones at a time like this, which meant their batteries were dead, just when it was most urgent to get hold of them. Deputy Mayor Jin kicked himself: When he gave Mei Yin that Lifan, why hadn’t he thought to have it fitted with a car phone?
He could get in touch with them through one of the toll booths, but this method could only be used after news of the outbreak was public. No
w, all he could do was wait for the Anti-Infection Unit—Yang and the rest—to come up with a result.
Yang Jicun took some samples of pus from the blisters on Patient One, Mei Xiaoxue, then scraped some skin cells from the blisters, swabbed her throat, and took some blood. Back in the CDC’s lab, he dyed the pus-smeared slides and blister cell samples using the Bazin method, and studied them beneath an oil-immersion microscope. Holding his breath, he slowly adjusted the lens until the virus came into focus, brick-shaped rather than the icosahedral form of chicken pox. The virus was arranged in a chain, in pairs or clusters. A textbook image of the smallpox pathogen. He yielded his place to Unit Head Lin, standing beside him, who looked through the microscope and silently nodded.
Of course, the proper course of action would be to cultivate the virus, then run some serological and fluorescence antibody tests. But the former would take too much time, requiring four days to run; the latter required costly immune blood-serum or fluorescent antibodies, neither of which the Nanyang CDC had in stock. They were prepared to send the specimens to the national CDC for these tests, but before that they would need to inform Deputy Mayor Jin. According to the epidemic rapid-response rules, any diagnosis of a high fever with a suspected Category A disease (smallpox had been removed from the Category A list by now, but only because it had been “eliminated”) ought to set this apparatus in motion, let alone now, with confirmed lab tests.
Unit Chief Lin immediately phoned Deputy Mayor Jin, who was at that moment in a meeting with the Health and Infection Department, the Animal Infection Department, the Traffic Department, Public Security, the Civil Affairs Department, the Citizens’ Militia commander, various major hospitals . . . In short, any organization under his jurisdiction that had anything to do with responding to this epidemic had been summoned. Only the Armed Police was absent, as they didn’t come under his command. The meeting had been going on for three hours now, and he’d already announced that a Category A infection had been discovered in Nanyang, which could mean the plague, anthrax, cholera, or smallpox, and he wanted to get everyone together right away to decide how to set their defenses in motion. His bearing was stern—even though everyone believed this was just an exercise, they took it seriously and managed to agree on a plan.
