In view of the events described above, Homeland Security and the Centers for Disease Control have recommended an intense and aggressive worldwide vaccination program. Unfortunately, there are not yet sufficient quantities of either the live—and somewhat dangerous—vaccination based on cowpox, or the protein-based, non-living vaccination based on the live virus. At present, plans are to vaccinate exposed persons and isolate them in order to protect the unvaccinated remainder of the population. CDC and the government do confirm that they’re in the midst of gearing up industrial programs to produce more of both of the vaccines in quantity.
CDC has confirmed that neither of the vaccines have been proven to prevent the new version of smallpox. However, it is presumed that the terrorists confirmed that the live virus does prevent the disease as they have been distributing it amongst Islamic groups that they wished to protect. Experts believe that the protein-based vaccine “should work” and is safer than the live virus, especially for those whose general health or immune system is weakened. It’ll be used preferentially in those types of individuals.
It is important to note that the actions of the Islam Akbar splinter group do not by any means represent the thoughts, beliefs, or intentions of any but that one very small and radical minority of Islam…
Abe entered the room and looked around for LaQua Kelso. He saw her near the far corner, having an apparently heated discussion with one of the older staff. He made his way over, wondering what this argument was about. As he arrived, she was saying, “… the antibodies it generates in both rats and mice bind to the smallpox virus.”
Abe now recognized she was talking to Norm Atwater, one of CDC’s highly respected vaccine experts. Atwater said, “The fact that it binds in vitro doesn’t mean that it’s going to stop the virus in vivo.”
LaQua rolled her eyes, “We don’t know that vaccination with the live virus is going to protect people either!”
“No, but we can assume that the terrorists tested it and that it does!”
“Dr. Atwater,” she said exasperatedly, “we’re growing the live virus as fast as we can. We’ve sent it out to every facility that can grow it, and they’re growing as much of it as they can as well. We’ve essentially taken over every facility that we believe can grow the virus and we have them working full time. But we’re in the midst of a crisis here! We don’t have enough! We need something that we can mass manufacture, the way we can produce the antigen using CFPS. Facilities that can make a protein seldom overlap with facilities that can grow the virus and even if they do, the two processes don’t use the same equipment. We’re not making less of the live viral vaccine in order to make more of the antigen!”
Atwater turned to Abe for support, “This antigen… she’s basing it on a sequence provided by that damned Gordito website. The site’s only been up a few months. It’s completely unproven and no one even knows who it is! Yet we’re basing a nationwide vaccination program on it?!”
LaQua said, “Gordita. I don’t know how you can say it’s unproven. Multiple investigators have vetted her protein folding results!”
“Her results? Do you know something about this person?”
Kelso shook her head, “Let’s just say I have a feeling.” She winked, “Call it a woman’s intuition if you want.” Her smile vanished, “The fact remains that a lot of people have tested the site and it’s right almost every time.”
Atwater shook his head, “There’s been multiple tests of Gordito’s ability to predict protein folding, yes. There have not been multiple tests of its ability to predict viral antigens…”
Abe interrupted, “Norm, do you have an antigen we can use instead?”
Norm gave him a wide-eyed look, “No, we’ve just started working on it! You should know this isn’t something that can be turned out overnight on demand!”
Abe put a hand on his shoulder, “But, Norm, we need results yesterday… Which, I must point out, Gordito gave us. Nothing about this keeps you from continuing to work on producing an inactivated viral vaccine, or your own form of antigen vaccine. If the Gordito vaccine fails to work we’ll be ecstatic to have whatever you come up with waiting in the wings, but the fact that you’re working on it doesn’t keep us from manufacturing the Gordito version and hoping that it does work. Because, Norm, I can guarantee your vaccine’s too late. Hell, the Gordito vaccine’s too late. Thousands, and probably millions of people are gonna die and you, my friend, should be in your lab working on your own vaccine rather than standing here hassling Dr. Kelso.”
Atwater looked to Abe, frustration all over his face, but then his shoulders suddenly sagged and he turned, “You’re right. I’ll get back to work so we’ll be ready when Gordito gets egg all over his face.”
Abe turned to Kelso who was watching Atwater walk away with fury in her eyes. “LaQua,” Abe said softly, “try to remember that he’s on our team, trying in his own way to do the very best he can. In times like these you’ve got to expect people to have strong feelings.”
LaQua rolled her eyes, “All right, ‘Mr. Reasonable.’ I’m just gonna tell myself he’s not disrespecting me as a African-American woman.”
“Nope,” Abe said, “just disrespecting you for trusting one of those damn newfangled websites.” He gave an exaggerated roll of his own eyes and sighed, “These young people today, always looking for the easy way out…”
Chapter Nine
Dallas, Texas—Tom Milner, the Dallas UPS driver who dropped a package mailed from Islam Akbar’s viral production site and was admitted to hospital three days ago with a pustular eruption has died of fulminant smallpox. In an alarming note, his illness did not respond to several antiviral agents which had been proven to work against ordinary smallpox. This has led to the concern that modified smallpox also contains changes that makes it resistant to antiviral medications. His wife and two young children had also been isolated at the hospital and have now developed similar pustular lesions. Vaccination of personnel at the hospital and all of the Milner’s contacts is well underway…
All across the nation people are staying home from work. This problem is at its worst in healthcare facilities where workers rightly feel that their risk of contracting modified smallpox is higher than at any other form of employment. CDC is apparently sending vaccines to healthcare institutions first since the people there work on the very front line of our defense from this terrorist attack.
Senator Gerald Munro of Tennessee has accused the Surgeon General of malfeasance for allowing dissemination of information about the bioterrorism epidemic to the general public and thus eliciting panic. He says, “It's akin to having shouted fire in a crowded theater.So far more people in this great country have died from panicked responses to the news of this supposed bioterrorism threat than have died from the disease in question…” Senator Munro is certainly correct, as the UPS driver in Dallas Texas is the only person to die of modified smallpox so far, but it is highly unlikely he will remain the only one. Although this reporter certainly hopes that Senator Munro’s observation remains correct, that seems decidedly improbable.
UPS, USPS, Fed-Ex and other major shippers have been cooperating with the government in tracking down shipments made from the Dallas site where the terrorists were growing up the virus. Homeland Security reports that they believe they have tracked down over ninety percent of the shipments and sequestered them. A minority of shipments had already been delivered. Homeland security, the FBI, and the police here in the United States as well as similar organizations in other countries are working on trying to find the people to whom the shipments were delivered and retrieve the packages. This is certainly good news, but it seems unlikely that all of the packages will be located…
The CDC is recommending a layered approach to the containment of any viral release episodes. A primary layer will involve cordoning off the immediate area where the exposure occurred, to include all persons who may have been exposed. A secondary layer will surround the primary layer and will include peopl
e, buildings, and vehicles which are not thought to have been exposed. This secondary layer will be at least one kilometer wide surrounding the primary layer. At least initially, they recommend that all highways, trains, waterways, and airports in and out of the involved cities be closed until it’s certain that the exposure has been adequately contained. President Stockton has issued a directive that the police, the military, and the National Guard be assigned responsibility for maintaining the cordons and closing down the means of transportation. In a prepared statement she said, “In this crisis of unprecedented dimension, extraordinary means must be used to prevent dissemination of this disease in order to give the Centers for Disease Control sufficient time to vaccinate every single citizen of the United States.” It’s rumored that she has threatened to shut down every highway, every train, and every airfield in the United States if the virus gets out of control…
Protests have already erupted against the “grievous abridgment of personal freedom” represented by Stockton’s mandatory containment and immunization programs but the protests have been limited in scope and there is little doubt that the vast majority of the population agrees with their necessity.
Dallas has become the first city to be isolated under the CDC’s layered containment guidelines.…
In alarming news, children who’d been given free firecrackers by a man in Buffalo New York set them off in the streets last night. The firecrackers were quickly noticed to be generating puffs of white powder. Preliminary investigation of unexploded firecrackers have found them to be filled with viral particles. As yet the virus has not been confirmed to be the bioterrorism version of smallpox, but of course all suspicions are pointing in that direction. Homeland security and the CDC have initiated the layered containment and vaccination program in Buffalo, making it the second city in the United States to be subjected to the draconian policy. There have been reports of children being given such firecrackers in Durban, South Africa, Budapest, Hungary, Mumbai, India and Busan, South Korea. However, it is not clear yet whether they contained powder and, if so, whether the powder was viral in nature. Those countries are apparently undertaking various isolation programs of their own, but it is unknown how successful they will be. Also unknown is the status of their own vaccination programs and whether the United States or other countries in the developed world will be willing to share any of the limited quantities of vaccine they may have with countries that are not fortunate to have a healthcare industry capable of manufacturing their own vaccines…
LaQua Kelso’s AI said, “You have a call from Gordito.”
She put up a hand, cutting off the person who was talking to her, and said, “I’ll take it… Hello, Gordito?”
“Yes ma’am,” the synthetic voice said. “I wanted to offer a suggestion that you release the live vaccination virus through the ports that were confiscated in Dallas. That way you could begin to immunize the same populations that Islam Akbar had intended to attack.”
LaQua’s eyes widened at the audacity of such a proposal. She said haltingly, “I agree that… such a policy might be the best… strategy for dealing with this crisis. But there’s no way we’d be allowed to undertake such an airborne immunization program without the permission of the people who were unknowingly being administered the vaccine. It’d never get past the legal people.”
“But… you could save millions of lives!” Gordito protested with an almost childlike frustration.
LaQua wondered whether Gordito was actually just some lonely soul with a computer. An immature genius, perhaps living in his mother’s basement, seeing solutions to problems that no one else could, but completely unaware of the basic realities of modern social contracts. “I agree completely. If it were up to me, I’d do it, but it’s not. Sorry.”
“But…” Gordito said. Even through the flat affect of the voice synthesizer LaQua got the impression that a tantrum was impending. Then, suddenly Gordito continued in a completely reasonable tone, “Okay. If you can’t, you can’t. I wanted to tell you that the website has another gene sequence for you that improves synthesis rates of the antigen vaccine approximately ten-fold. That’s assuming you’re using CFPS?”
“Um, we are, but how do you know that improves efficiency ten-fold?”
“Well, it does in my CFPS set up. Because the protein’s pretty small, this modification just makes a long chain of identical antigen molecules that separate at low pH.”
LaQua blinked a couple of times as she tried to picture a chain of the antigen proteins, each connected to the one before it with some pH sensitive molecule. She wasn’t sure that synthesis of one large chain the molecule would be faster than a number of small ones. “You have a CFPS set up?”
“Yeah, I’ve made up quite a bit of the antigen vaccine. If I sent it to you, would CDC be able to use it?”
“Sure,” LaQua said, trying to picture how she’d get it tested to be sure it was safe and efficacious, but not wanting to turn away any vaccine that might help people in this crisis. If he only delivered a couple of hundred doses, it might not be worth testing it. But if he had thousands of doses… “Aren’t you worried that we’ll figure out who you are from the shipping records?”
“Um, I’ll have to work that out. When I do, I’ll have it delivered to your attention, okay?”
“Okay.”
***
When Zage came in to dinner he said, “Mom, I’d… or, I should say Gordito, would like to deliver some vaccine to the CDC. Can you think of a way to do that without revealing Gordito’s identity?”
She turned and rested her chin on her hand as she fixed him with a musing gaze. After about thirty seconds of examining his features, she said, “You would, huh?”
He nodded, a serious expression on his face.
“And you think they’re just going to accept a vaccine from an unknown entity, no questions asked?”
“Well, no. I’d hope they’d do some testing. Ensure its sterility and confirm that it binds to the appropriate antibodies etcetera before they put it to use.”
“And you don’t think they could better utilize their time making more of their own vaccine than testing whatever you deliver?”
He tilted his head, “The main limitation to vaccine manufacturing’s the availability of protein synthesis equipment. I’m sure they’re using all of their own equipment at capacity as well as farming it out to commercial establishments. I’ve recently sent them a modified gene sequence for the antigen that should improve their production efficiency significantly, but I still think it’d well be worth their time to do a little testing on the stuff I send them.”
“Oh yeah,” she said thoughtfully, “you have several million doses, right?”
“It’s almost up to 40 million now. I improved the efficiency several days ago. I’ve just been confirming that the new product’s as good as the original.” He said quietly, “That’d be enough to treat the 27 million people in Durban, Budapest, Mumbai, and Busan. Otherwise, I think they’re all going to die because I don’t think anyone’s going to feel they have vaccine to spare… Then they’ll spread it to the rest of the world.”
“Do you want to deliver it to those locations directly?”
“I don’t think they’ll take it from us. I think it’s got to go through CDC.”
She stared at him for a minute, then shook her head. “Where in the heck are you keeping 40 million doses? They’re, what, half a cc each? That it be 20,000 liters! I’m pretty sure you don’t have a tanker truck hidden away somewhere in the basement.”
He gave her a surprised look, “Vaccines are often administered in half cc injections. But each injection only contains about fifteen micrograms of the protein. That means that enough of the freeze-dried protein to make up 40 million doses only weighs about 600 grams.”
Ell snorted, “Well, I suppose it’s probably worthwhile doing the testing for 40 million doses. We’d be delivering it to the CDC in Atlanta?”
Zage nodded, “Care of Dr. LaQua Kels
o. I’ve told her it’s coming. I thought about delivering it to her home, but I’m worried she might be sleeping over at the center during the crisis, so I’m thinking we should deliver it to the main entrance with her name on it.”
“You picture somebody just walking up to the desk there and handing over a big bag full of white powder, saying, ‘special delivery for Dr. Kelso’?”
“Yeah, I thought that might be a problem so I’ve got it vacuum sealed in a nontransparent black plastic bag with a label carefully describing what it is.” He gave her an almost beseeching look, “Could one of the security guys deliver it?”
Ell pursed her lips, trying hard to suppress a hysterical desire to laugh at what her five-year-old son had wrought. 40 million doses! “I’ll talk to them. How big is it?”
“Just a minute,” he said, jumping out of his chair and trotting into the living room. A moment later, he came back with a black plastic object about the size of a small loaf of bread and set it on the table next to her. She hefted it and thought it weighed a little more than a pound.
***
Alice suddenly sat up, drawing Rick and Zage’s attention. Rick said, “What’s up?”
Alice said, “I was just checking the Gordito site. It’s published the DNA sequence and methodology for making the smallpox antigens! Claims it’s the same vaccine the CDC’s manufacturing!”
Rick frowned, “How’d Gordito get it?”
Alice lifted an eyebrow, “I’ll bet Gordito gave them the sequence.”
Rick looked surprised for a second, then apparently accepted her thesis, “How’s it manufactured?”
“Cell free protein synthesis.”
Rick’s eyes turned towards their CFPS set up, “We could be making it here?”
Zage said, “I noticed the recipe on the Gordito website last night. The site says it’s putting it up in view of the vaccine shortage. The idea’s that anyone with the right equipment can start making vaccine.”
Bioterror! (an Ell Donsaii story #14) Page 22
