Another click. “Susan?” It was Ezra again, but his tone had changed.
“Yes, I’m still here.”
“That was the department secretary. The med student, what’s his name, Andy—he’s in the ICU over at University.”
“You’re kidding.”
“No, I’m not kidding. He’s got plague. He’s going to die.”
Sixteen
Alan Wheeler dialed ten times before he finally broke through the all-circuits-busy message.
Grif Richardson, Wheeler Energy’s CEO, didn’t even wait for him to speak. “Jesus, Alan. Where’ve you been? I’ve been trying to get hold of you.” Something thumped in the background, and then Richardson said, sounding out of breath, “We’re evacuating Wheeler’s executive staff. LAX has given us clearance for takeoff later this morning. Can you get to the airport?”
Alan pressed the phone against his ear and walked to a clear spot near the front of the hospital. He said in a low voice, “What the hell are you talking about?”
“I’ve been in touch with the governor’s office. The quarantine is not a precaution, Alan. It’s a desperation move.” Richardson grunted, like he was lifting something heavy. “This is a new antibiotic-resistant strain the public health docs have never seen before. They’re expecting tens of thousands to die. Maybe more. Can you get Brooke and Jason out to the airport in the next hour?”
Alan looked up the side of the University Hospital, to the floor where Jason lay on a ventilator. An ugly bubble formed in his chest and moved upward, lodging in his throat.
“I can’t leave. Jason’s in the ICU.”
“Shit.” Richardson sounded almost panicked. “They’re letting us out today, but there are no guarantees about tomorrow or the next day. What about Brooke, then? Can one of you stay behind and the other one get to safety?”
“I don’t know. I’ll ask her.”
“Call me back quickly. We can delay the departure an hour, maybe, but no more.”
Alan hung up and looked toward his son’s ICU room.
Jason, he thought.
Tyrone Hayden sat in the middle of the pack of reporters and felt outrage wash through him. He was the one who had broken the damned story, and yet thirty other journalists had somehow packed themselves in front of him, just because they had national press credentials.
Tyrone listened to the other journalists’ questions with frustration. They were fixated on the declaration of martial law, and although Tyrone certainly thought putting the city under military control was a draconian measure, he didn’t think it was unwarranted. Hadn’t these same reporters seen the craziness on the streets?
No, what astounded Tyrone was that not one of the so-called media elite thought to ask the most crucial question about the epidemic: what about this plague was so scary that it required the biggest city lockdowns in US history?
Tyrone thought he knew, which is why, after the governor’s press secretary failed to call on him for the fifth time, he simply stood up and shouted, “I have a question for Dr. Singh from Washoe County Medical Center! Dr. Singh, how many survivors have there been?”
Susan’s phone rang on the center console. She snatched it up.
“Holy shit, did you hear the press conference out of Reno?” It was Ezra. “Cat’s out of the bag now. All hell’s going to break loose.”
Although her car hadn’t moved more than 100 yards in the last twenty minutes, Susan was still breathless. She turned the radio down so she could hear Ezra better. “I think it already has, Ezra. The roads are paralyzed.”
“Tell me about it. I’m still on the 10. I’ve breathed enough exhaust in the last hour to rot my lungs for a lifetime.”
Susan peered at the motionless sea of cars in front of her. “How’re we going to get to the hospital?”
“Well, I don’t know about you, but I’m getting off the freeway.” She heard Ezra grunt and the sound of wheels squealing.
“What are you doing?” Susan cried.
“Taking surface streets.”
Susan calculated Ezra’s location quickly in her mind. Interstate 10 went through some of the roughest neighborhoods in Los Angeles. “Is that safe?”
“I’m just past downtown. It ain’t exactly Beverly Hills here, but it ain’t the most dangerous neighborhood either. Hold on.”
Susan heard a series of honks and the roar of an engine. She stared at the phone, horrified.
After a moment, she heard Ezra’s voice. “Susan?” He began to laugh.
“Ezra, what’s going on?”
He was still laughing. “Me and Steve McQueen, man, just like in Bullitt.” His voice rose with enthusiasm, his delight with himself unmistakable. “In fact, I am Steve McQueen. You take your time getting to the hospital, Susan. I’m sure you’ll get there sometime.” There were a few more honks—Susan wasn’t sure if they were Ezra’s or someone else’s—and then there was nothing. Ezra had hung up.
Susan stared at the stalled cars in front of her, shaking her head.
It was a beautiful day, sunny and clear, the high desert an endless carpet of sage, uninterrupted except for the occasional copse of poplar trees that marked a farmstead and the gray slash of Highway 20 cutting across the land.
Normally, this aerial perspective pleased Harr, but today, irritation coursed through him. Someone at the Bureau of Land Management had left a gate open, and half of Harr’s herd had crossed onto public property. It’d be a pain in the ass to get them back.
Harr turned his Cessna back towards the ranch, landed it on the makeshift runway by his barn, and made a beeline for the house. He wanted to call Jim Jenkins, the young man who worked the cattle with him, so they could round up his herd before it all disappeared on BLM land.
The blinking light on his answering machine pulled him up short, though. Like many Harney County ranchers, he used both a landline and cell phone, because cell phone coverage in the high desert was patchy. But that didn’t mean many people called his landline. On the contrary, almost everyone tried to reach him by cell.
Harr hit the play button.
It was the vet. “John, listen. Gage’s blood tests are back.” The vet’s voice sounded tinny on the answering machine, but there was no mistaking the urgency in his words. “He had plague, John. I’m sorry to do this to you, but we need to put you on antibiotics. Can you call me as soon as you get this message?”
Harr cursed softly. He saw himself in slow motion, carrying Gage to the truck, the small black flecks jumping from Gage’s fur onto Harr’s arms. But most of all, Harr couldn’t get one thing out of his head. The way his dog looked as he began to die.
Public Health put Jim Carson on hold.
On goddamn hold! He clutched the phone, his teeth clenched so hard his jaw hurt.
The nurse stood off to the side, a question clearly visible on her face, waiting for him to acknowledge her.
“What?” he finally snapped.
“I’m sorry. I just wanted to know what to do with the antibiotics.”
He wanted to say, Flush them down the toilet. They aren’t doing shit, anyway. But he forced himself to look at her. “Hang them as ordered.” Then he turned his back on her, to wait for the public health guys to finally take him off hold.
He waited.
And waited, the soft hold music tinkling in his ear.
He glanced back at the nurse. She had donned a full body suit, gloves, and a respirator mask and was entering the isolation room’s antechamber. She held the antibiotics in her hand.
Carson was tempted to slam down the phone, public health be damned. He knew what was happening in Los Angeles, Sacramento and Reno. He knew the San Francisco Department of Public Health needed to hear what he had to tell them. But he’d be goddamned if he was going to wait all day for them to finally pick up the phone.
He watched the nurse hang the antibiotics in the isolation room and check the ventilator. The lump in the bed, hooked up to the plastic tubing of the ventilator circuit, was unrecog
nizable, but Carson was painfully aware of who the patient was. He was the only other UCSF doctor besides himself who had seen Yoshiki Yahagi out of isolation, the only other person still alive.
But not for long, thought Carson grimly. The medicine resident, Ryan Milosz, didn’t stand a chance.
Seventeen
Tyrone Hayden pushed through the crowd at the end of the press conference. The other reporters were clamoring to get to the mayor and Nesbitt, but Hayden went straight for Mack.
“I’m sorry,” he blurted out.
Mack gave the reporter a long measuring look. In his heart, he couldn’t blame Hayden for revealing a truth that Mack felt everyone should know: the plague had no cure. But the public health officer didn’t like sensational media stunts, and Hayden had pulled two now.
He gave Hayden a hard look. “How’d you find out it was drug-resistant?” he asked.
Hayden looked momentarily surprised. “Twitter. There’s a lot of rumors going around under the hashtag DRYP. I confirmed it with a couple of nurses over at Washoe Medical Center.”
Mack’s eyebrows rose faintly. It didn’t take him long to figure out what the acronym stood for. Drug-resistant Yersinia pestis. He grunted.
Hayden jerked a thumb at the gaggle of national reporters at the front of the room. “Come on, George. You know those guys don’t give a shit about Reno, but I do. So why don’t you and I call a truce? I can help you disseminate information. People trust me here.”
What he’d said was true. Hayden had reported in Reno so long that the city council was bound to name a library after him some day. But that didn’t mean Mack was going to let the reporter off scot-free.
“Okay, Tyrone.” He’d dragged the reporter’s name out, almost like a sneer. “I’ll play it straight with you, but if you pull any stunts on me, any more back-handed scoops, I’ll nail your balls to that wall over there.”
Hayden pulled a narrow reporter’s pad from his jacket pocket. “All right then, let’s start with the number.”
“What number?”
“Your cell phone number,” Hayden said.
Mack glared at the reporter, but he gave it to him.
The gymnasium was full. Hundreds of people crowded into Reno High School’s gym, some lying on cots, some sitting on the floor, all of them with masks on their faces. Mack surveyed the crowd grimly, trying not to flinch at the constant coughing.
Within hours, Nesbitt’s POD had turned into a triage center.
A nurse in a bunny suit and respirator mask marked people’s foreheads with markers. She looked up at Mack briefly before turning to a glassy-eyed boy who lay lethargically on one of the cots. Purple mottling had begun to appear on the boy’s hands and fingers. She marked his forehead with a black slash and pulled a blanket up to his chin before moving on to the sobbing woman next to him.
“What’s she doing?” Hayden asked. He stood next to Mack in a bunny suit and N95, his voice muffled by the mask’s thick material.
“Triage,” Mack said shortly. “Black means no transport.”
“No transport?”
“Too late. He’ll die soon.”
Nesbitt stood at a makeshift desk talking with some of the staff. A man handed him a clipboard, which Nesbitt looked at with a frown on his face. He glanced up as Mack approached.
“Fifty already, I think,” Nesbitt said.
“Fifty?” Mack echoed. That wasn’t good. He had expected some sick patients at Nesbitt’s Point of Dispensing center, but not fifty. The center had only been open a few hours.
“We’ll transport about half of them, but the hospitals can’t handle these numbers if this keeps up.” Nesbitt handed the clipboard back to the man. “I think we have to reassess our strategy.” Nesbitt suddenly noticed the reporter standing next to Mack. Wariness descended over the CDC officer’s features.
Hayden didn’t appear to notice. His face had turned pale, and he was breathing in shallow, rapid puffs.
“I don’t think Tyrone has ever seen the face of death up close and personal, Nesbitt. Or at least, not like this.” Mack looked briefly around the gymnasium. It was warm and humid inside. Sweat trickled down the side of his face. “What about the other POD?”
“About the same. They’re already triaging hundreds.” Nesbitt turned slightly from the desk, as if to gain more privacy. His next words were low and quiet. “George, two PODs aren’t enough to handle this volume. All we’re doing at this point is triaging. We don’t have the personnel to even consider mask distribution.”
“Can we get more PODs up and running?”
“Yes, but it will take time, and I’m not sure we have the time. We’ve got hundreds of cases now, between the PODs and the hospitals.” He looked at Mack meaningfully. “Much worse than initial estimates.”
“Then we’ve got to change our strategy,” Mack said.
Hayden quietly sank into an empty chair behind the triage desk. He dug out a narrow spiral bound notebook from his bunny suit pocket and started to write something, but then he abandoned the effort. He dropped his head between his legs.
“Jesus,” said Nesbitt. “Look at the guy. He’s about to faint.”
“Nah,” said Mack. “He’s just not used to the respirator mask. He thinks he’s suffocating.” Mack turned back to Nesbitt and the matter at hand. “We go to push,” he said. “We’re using a pull strategy right now, dragging people out of their homes to come to the PODs for mask distribution. We need to bring the masks to people in their homes.”
“How do we do that? We don’t even have personnel to man another few PODs.”
“US Postal Service.”
“You mean, stick masks in mailboxes?”
Mack gazed at the long, snaking line at the POD intake desk. “We don’t want people standing in line with a bunch of sick patients to get masks.”
Nesbitt nodded slowly. “Is the postal service still working?”
“So far, they are.” Mack had seen bunny-suited letter carriers bring packages to the public health office. “But it will take a top notch CDC sell job to get them to deliver masks, Nesbitt. You know, the kind only a Hopkins man could deliver with any weight.”
Nesbitt rolled his eyes.
Tyrone Hayden stumbled over. His face was pale, but he no longer looked like he would faint. “Did I miss anything?”
The two public health officers looked at the reporter and then at each other. Mack shook his head. “Yes, Tyrone, let me bring you up to date.”
Beside him, Nesbitt stifled a laugh.
The medical school campus was eerily empty when Susan arrived. She bypassed the shuttered bookstore and cafeteria and went straight to Stauffer Hall.
Hodis was in his office. “Oh, you’re here,” she said. She hadn’t really expected the older researcher to be there, but she reminded herself not to underestimate him. Hodis could drive as well as she could. “How did you get here?”
“I never left,” he said, rubbing his eyes and looking unhappily at his empty coffee cup. “I wanted to run the data. Besides, I knew the quarantine was coming.”
Susan was astonished. “But I thought you said—”
“I didn’t know when you left last night, but I put some calls into the CDC, and they came clean with me. I figured I should stay here and get some work done, because I didn’t know what the roads would be like this morning.”
Susan slipped into the chair opposite Hodis’s desk. “Is the sequencing done?”
“Yes. That’s just what I’ve been looking at.” He hit a key on his computer and spun the screen so they both could see it. A colorful map popped up. “See this? This is the genome of Yersinia pestis isolated from Jenna Niven’s blood.” He hit another key, and two graphs appeared. “This is a comparison between Jenna’s Yersinia pestis and the Yersinia pestis sequenced at the Sanger Institute in England some years back. Mostly similar, but not quite the same.” He pointed at one section of the graph. “There are differences here on the F1 antigen, which is considered a vi
rulence factor—a gene that makes Yersinia pestis especially effective at infecting people. It might explain why Jenna’s Yersinia pestis seems to be so lethal; that’s assuming that Jenna’s is the same Yersinia pestis as the one that is attacking all these other people in Los Angeles, Reno, and Sacramento.”
“So it’s a mutation,” said Susan, sitting back. “An especially lethal mutation of an already lethal gene.”
“It appears so.”
“But that doesn’t explain the drug-resistance.”
“No,” said Hodis. “But this does.” He pressed a key, and a second genetic map appeared. “This is a new plasmid.”
Susan peered at the colorful illustration of the rogue DNA.
“It has all the genes for the classic antibiotic-resistant enzymes.” He pointed at the screen. “Cat1 stands for chloramphenicol acetyltransferase. Its enzyme product inactivates chloramphenicol, one of the classic antibiotics to treat plague.” He pointed again, further down the map, and rattled off several more antibiotic-resistance genes.
Susan frowned. “Are all the resistance genes on this one plasmid?”
“Yes. At least, the ones to all known antibiotics previously considered to be effective against plague.”
“That’s a pretty deadly plasmid.”
Hodis nodded. “Especially when it’s found in Yersinia pestis. The question is: where did this deadly plasmid come from? We’ve seen antibiotic-resistant plague before—there were a couple of cases in Madagascar in 1995—but those strains were still susceptible to at least one antibiotic. This one, though…” Hodis took off his reading glasses and placed them gently on desk.
They were both silent for a second. Finally, Susan said, “The Madagascar outbreak didn’t go anywhere.”
DRYP Trilogy | Book 1 | DRYP [The Final Pandemic] Page 16
