The Rationing

by Charles Wheelan

“So here’s what I’m thinking,” I began. “The places where people are getting sick from Capellaviridae are the places where there have been intensive efforts to get rid of the North American dust mite.”

  “Right.”

  “And Capellaviridae is also prone to turn virulent when people move away from a region where dust mites are endemic to one where they are not.”

  “Yes.”

  “That’s odd, right?” I asked. Jenna nodded and I continued. “If you strip away everything else we think we know, that’s the bit that feels strangest. The dust mite is the vector, but for some reason once you are carrying Capellaviridae, you are better off if there are still dust mites around.”

  “It could be just some kind of statistical aberration,” Jenna offered.

  “Maybe,” I said skeptically, my voice trailing off as ideas bounced around. “Okay, there are three crazy things about lurking viruses that we can’t explain.”

  “And they are?”

  “First, the virus infects humans for no particular reason. Humans don’t spread it, so there is no obvious advantage to the virus from infecting humans.”

  “Okay.”

  “Second, the virus is benign most of the time, then suddenly virulent, for no obvious reason.”

  “Right. And third?”

  “The virus is somehow more likely to be benign when the vector—the dust mite—is still present.”

  “None of it makes any sense,” Jenna said.

  “Maybe they make sense together,” I suggested. “That’s the Huke final exam question: How do these things make sense together?”

  Jenna laughed. “Except we never got the required reading.”

  “Then we’ll just have to figure it out,” I said.

  We began tossing around ideas and theories. Eventually the time drew near for the President’s statement.

  “Shall I stream it?” I asked.

  60.

  THE COMMUNICATIONS DIRECTOR HAD ISSUED SPECIFIC instructions to the traveling press corps: a handful of print reporters were to stay on board Air Force One; the cameras were to be on the tarmac, presumably because the President would be making his statement from the stairs of the plane, or on the tarmac. The print reporters balked at being told to stay on the plane. The Home Depot Media correspondent demanded to get off. “You can do whatever you want,” the Communications Director told him. “But if you get off the plane, you’re not getting back on. Anything the President says will be piped back here in the cabin, so you’ll hear it in real time. Trust me on this one.” By and large the press corps did trust him, something he had earned over time. The Communications Director could parry and obfuscate with the best of them, but he was never overtly dishonest. He had been a political reporter and an international correspondent for nearly twenty years, mostly television, before the President had tapped him to cross to the “dark side.” Reporters were always skeptical of paid flacks, but at least the Communications Director was a former member of their guild.

  The television cameras were lined up on the tarmac, awaiting the President’s appearance. The front door to Air Force One remained closed. There was no staircase in place. “Why isn’t the front door open?” a CNN cameraman asked a low-level staffer who’d been left behind on the tarmac with the cranky reporters.

  “There will be a statement in ten minutes,” the staffer answered. Shortly after that, the staircase at the rear of the plane was wheeled away and the door was closed.

  “You better not screw us on this,” the CNN cameraman growled. The other members of the press were growing similarly concerned.

  “Just make sure you’re recording,” the staffer said loud enough for all the camera crews arrayed on the tarmac to hear. “I promise you will get what you want.” There was a whir as the engines on Air Force One came to life and the plane began to move forward. On board, the Captain instructed the passengers to fasten their seat belts. The press corps began texting and calling one another frantically, trying to assess what was happening. What about the President’s statement? A Reuters reporter on the tarmac threw his headphones to the ground in fury, screaming about the perfidy of the Communications Director, the President, the pilot, and everyone else associated with this dirty trick.

  “I promise you that if you stand here and pay attention, you’re going to get the story,” the staffer said calmly. He was convincing enough that most of the reporters turned their attention back to Air Force One, which was taxiing steadily away from them.

  “I’ve got plenty of stock footage of Air Force One taking off,” the CNN cameraman said angrily. “Now how the hell am I supposed to get back to Washington?” The staffer ignored the chorus of complaints. When Air Force One reached the end of the runway, the plane turned slowly, preparing to take off past the reporters into a gentle breeze. The camera crews focused on the plane, trying to make the best of what little they were being offered. The 747 accelerated steadily, the front wheels leaving the ground right as the plane passed the press corps arrayed on the tarmac. Seconds later, Air Force One was aloft.

  “Whooptie-fucking-doo,” a Home Depot Media camerawoman yelled.

  “Don’t stop filming,” the staffer said. Once again, something about his tone was convincing. The camera operators focused on the plane as it ascended away from the airport. Roughly ten seconds later, Air Force One banked sharply and began a slow 180-degree turn back toward the airport. The plane, still flying relatively low, passed over the assembled press corps, who stared at the hulking jet in confusion. As the plane flew overhead, ostentatiously low, an AP reporter suddenly grasped what was happening. “Which way is west?” she yelled to no one in particular. “Which way is west!”

  The camera operators looked to the staffer, who pointed toward Air Force One as it flew away from them. “That way is west.”

  “Holy fuck!” the CNN cameraman yelled. “He’s flying west! He’s flying west!” As the cameras focused on Air Force One, the plane climbed steeply, the roar of the engines drowning out the yells of the reporters capturing the moment.

  On board Air Force One, the Captain made his now-famous announcement, “Ladies and gentlemen, please make yourselves comfortable. We will be touching down in Canberra, Australia, in approximately ten hours.” The effect was electric as reporters scrambled to report what was happening. In Washington, where I was watching all of this on my phone from a bench on the Capitol Mall, it was opening day for the Washington Nationals, who were playing the Atlanta Braves. There were two outs in the bottom of the third inning (the Nationals at bat), when the game was halted temporarily. The home plate umpire signaled a pause; the Braves pitcher stepped off the mound, perplexed.

  The stadium’s PA system boomed to life with the familiar voice of the Nationals’ home announcer: “Ladies and gentlemen, please excuse this interruption.” There was a scattering of boos as fans protested the break in the action. “We have just been informed that three minutes ago the President of the United States took off from Honolulu . . .” The announcer paused slightly for dramatic effect, after which he articulated each word slowly and forcefully. “Air Force One is currently westbound, headed for Canberra, Australia.” There was a short silence as the crowd processed what they had been told, and then a sustained, visceral cheer. In a gesture that has now become synonymous with the moment, the Braves pitcher turned slowly toward center field and pointed at the American flag.

  In Seattle, where hundreds of people had gathered outside the hospital where Cecelia Dodds now lay in intensive care, a murmur went through the crowd. Most had not gathered in protest, but rather to honor her life and acknowledge her sacrifice. Still, when the news of Air Force One’s westward departure spread quickly through the crowd, there were cries of shock. “He just pulled the plug on her!” someone yelled. That was not an accurate description of what had happened—but it was not wholly inaccurate, either. Time was running out: for Cecelia Dodds and for thousands of others.

  We have no information on the reaction in Beij
ing, but one can easily infer that President Xing had seen enough westerns to know what had just happened to him.

  PART 7

  OKAY, NOW WHAT?

  61.

  I FELT THE SAME IRRATIONAL SURGE OF NATIONAL PRIDE AS everyone else, only mine was mingled with dread. I watched video clips on my phone of Cecelia Dodd’s family leaving the hospital after a visit. Cecelia’s daughter and her husband walked out with their twin daughters, no more than three or four years old. Each little girl was clinging happily to a large stuffed animal, as if it had been just another visit to see Grandma. The look on their parents’ faces, the puffy eyes and the tear-stained cheeks, told a different story. Neither Cecelia Dodds nor her family ever commented publicly on the political drama unfolding around them, but that night her daughter did stop to address a cluster of reporters. She had one arm draped over each daughter. “I want her to see them grow up,” she said. “My mother deserves that.” Whether she meant it or not, the message was clear to me: A lot of people are going to miss a lot of graduations and weddings.

  If the China offer was really off the table, our best hope was to make more progress on the virus side. The NIH fatality projections were bouncing all over the place. The last time the President had spoken to the nation about Capellaviridae, he had suggested we could weather the Outbreak without any incremental deaths. That was an optimistic statement at the time; as I sat there on a bench looking out on the Capitol Mall, it was impossible. The Atlanta Braves pitcher was not likely to point at the flag when people started dying in Atlanta hospitals from diseases that should have been easily treatable.

  The President had no long-term plan. He later admitted as much. The flight to Canberra was an impulsive political gesture. He could have declined the Chinese offer from Washington. The other signatory nations of the South China Sea Agreement were all comfortable postponing the signing ceremony. There was no logical reason for the President to order Air Force One to make that low, flamboyant loop over the runway before accelerating “west.” The President’s critics on the far left were merciless, blasting everything from his jingoism to the wasted fuel. They were right—and utterly wrong. True, there was no reason to fly Air Force One across the Pacific. What that misses, however, is how the President was constructing an edifice of political support for whatever he would have to do next, even without a political party to depend on. The Senate Majority Leader, a dependable ally to begin with, was complicit in the decision to fly to Canberra and was now even more firmly bound to the President.

  Meanwhile, the Speaker of the House was continuing her self-immolation. As soon as the U.S.-China Friendship Agreement became public, her comment that we should “take seriously” what the Chinese have to offer was played over and over again, juxtaposed against the most egregious and the pettiest of the Chinese demands. This was totally unfair, of course, as the Speaker had made her comments before the terms of the agreement were known. No one seemed to care about the finer points of context in this case, however. The Speaker’s ascent had been built on self-interest, calculation, and power; those who crossed her over the years found themselves stripped of committee assignments or facing a well-financed primary opponent. Unlike the Senate Majority Leader, she had no deep pool of goodwill to draw upon during a rough patch. Machiavelli may have written that it is better to be feared than loved—the Speaker was definitely feared and unloved by the House rank and file—but that assumes one can hang on to power. Machiavelli did not live through the early 1990s when Eastern Europe Communist despots were toppled and citizens rushed through the streets knocking over their statues. (The leaders themselves typically fared worse than the statues.) The Speaker was no East European dictator, but the larger point still holds. Her power had been kicked from beneath her, at least temporarily. Meanwhile, the President’s support had surged to over 90 percent after the Air Force One show; most House members (never that popular) rushed to pledge their public support to the White House.

  So yes, when Leonard Creelman went on This Week and pointed out that the President had used seventy thousand gallons of jet fuel (“an abhorrent carbon footprint”) just so he could “impress people eating hot dogs at baseball games,” he was absolutely correct. It is also true that a solid majority of Americans felt a powerful urge to punch Leonard Creelman in the face. (Even 53 percent of self-described progressives “supported” or “strongly supported” the President during the Outbreak, up from less than 20 percent during most of his tenure.) Meanwhile, the Tea Party, normally eager to lambaste the President for every nickel of public money he spent (that jet fuel is not free), was eager to have yet one more reason to blame China for America’s problems.

  It is crucial to recognize two things. First, in just a matter of hours, the President had fortified his political position and gained the support of most Americans for whatever he would do next. Second, he had no idea what he was going to do next.

  62.

  THE PRESS WAS ALWAYS A STEP AHEAD OF THE PUBLIC, AT least the print reporters were. While the video of Air Force One doing a loop over the Honolulu base and accelerating west was played repeatedly on tablets, and watches and eyeglasses, the more enterprising reporters grasped what must inevitably come next: we were going to run out of Dormigen. The NIH projections had never been public, but any reasonably intelligent person could connect the dots. We had a shortage of Dormigen; the Chinese offer was off the table; at some point “the constraint would become binding,” as the scientists like to say. And then what? The media was aware that the White House had “a number” with regard to likely deaths, and enterprising reporters redoubled their efforts to get it. As usual, the Internet was awash with bogus projections and reports.

  On board Air Force One, the President basked briefly in the glow of his dramatic takeoff before confronting the same reality I was contemplating on the park bench. What now? The Dormigen supply across the country had finally been secured, though it was still uncertain where the stolen drugs would end up. As the President flew toward Canberra, the NIH projections were showing a range of likely fatalities from forty thousand to a hundred thousand. There was no full-blown Dormigen rationing in place yet. In theory, everyone who really needed the drug was still getting it, but the protocols for prescribing Dormigen had been tightened sharply to help make the existing stock go further: no prescriptions when another antibiotic might work; no prescriptions for non-fatal infections likely to heal on their own; no prescriptions for secondary infections among terminal patients; and so on. The video communications equipment on board Air Force One had been repaired during the long stop in Honolulu. (This was one small factor in the President’s decision to fly toward Australia; he was now as well equipped on the plane as he would have been in the Oval Office.) The Communications Director was urging the President to make another address to the nation, seizing on his surge in popularity to prepare the country for the possibility of fatalities. The President was noncommittal, presumably still hoping that those of us in the scientific community would pull an antidote out of a hat.

  In fact, the first preventable fatalities had already happened. While all eyes were on a weakening Cecelia Dodds, other people were dying. An eighty-three-year-old man had been admitted to a hospital in Tucson with a severe case of pneumonia. He would normally have been prescribed Dormigen on admittance, but with the new protocols in place the emergency room physician prescribed a traditional antibiotic as a first line of treatment instead. The man’s condition worsened almost immediately and he died before he could be switched to Dormigen. In Atlanta, a much younger man, African-American, died in an emergency room after being denied Dormigen when he arrived unconscious in an ambulance. His mother gave a tearful press conference in which she alleged that her son had been denied the lifesaving drug because he was a young black male. The controversial civil rights leader Latisha Andrews rushed to Atlanta, where she planned to organize a protest against “Dormigen discrimination,” but before she had even landed at the airport it was widely publi
cized that the young man had suffered a massive stroke, not any kind of infection, and would not have benefited from Dormigen.

  And then there was Larry Rowen, the smarmy Los Angeles nurse who inadvertently set in motion a massive law enforcement dragnet that would recover over twenty thousand doses of stolen Dormigen. Rowen was an aspiring actor who had moved to Los Angeles ten years earlier from Moline, Illinois, hoping to capitalize on his nursing background by getting himself cast in a medical drama. He was short and pudgy, with thinning reddish brown hair, a wispy little mustache, and a severe wandering eye. Rowen learned quickly that he did not have the looks to thrive in Los Angeles; he was further disappointed to discover that his nursing background offered no casting advantage in medical dramas. (As the balance of this incident will demonstrate, Larry was no genius.) Rowen supported himself in Hollywood by working at an exclusive plastic surgery practice in Brentwood and doing two night shifts a month at a twenty-four-hour clinic in Pasadena. It was in the former that Rowen developed a deep antipathy for the stars and starlets coming in to have their breasts, lips, calves, chins, and butts improved. And it was in the latter where he had access to Dormigen during the stretch when the supply was still unsecured.

  Having stolen a thousand doses of a drug that was potentially more valuable than heroin, Rowen soon realized that he had a problem: he had no distribution network. There is a reason that drug kingpins offer a big cut to the street gangs that push their stuff; one cannot sell heroin (or stolen Dormigen) without finding customers, and it is hard to find customers when the product is illegal. Rowen had two additional challenges. First, the window during which his stolen Dormigen stash would be valuable was very small (and could close, if the government found some fix for the crisis). Second, as noted earlier, the man was no genius. He may have had a social conscience on par with the typical drug dealer, but he was not nearly so clever. Rowen—who remains fodder for late-night comedians—envisioned a scenario in which he could strike back at the Hollywood establishment while simultaneously enriching himself.