by Bobby Akart
Harper buried her face in her hands for a moment and then pulled her hair back behind her ears. In her mind, she was already preparing a statement for the press. People who were already showing symptoms—such as fever, cough, or difficulty breathing—could be identified, isolated, and treated.
First and foremost, she had to stress a containment strategy for those patients who presented with symptoms. She imagined a busy city sidewalk or a grocery store in which a-syms walked around spreading the virus to others. This was determined to be the case with COVID-19. For years after the pandemic was declared over, scientists continued to gather data. It was determined that the coronavirus was transmitted on average 2.55 days to 2.89 days before symptom onset. For days, a-syms comingled with healthy patients and shared the virus, infecting everyone they came in contact with.
Years of study revealed the hidden part of the COVID-19 iceberg was huge. Many people who were infected with SARS-COV-2 didn’t even know it. When the final tallies were made, the CDC determined the actual fatality rate of COVID-19 to be 0.26 percent of people it infected or about one in four hundred. The COVID-19 fatality rate turned out to be far lower than the seasonal flu. In the meantime, the economic damage to the world economy had been done.
Harper shook her head as she pushed off the floor to stand. She drained the last of the Red Bull and dropped it into a wastebasket in the corner. The lesson learned from 2020–21 was a simple one. Fear and panic are more dangerous than the disease itself.
She emerged from the conference room and immediately ran into Becker in the hallway. She was dressed in all white scrubs with a mask dangling under her chin. The safety goggles propped on her forehead completed her mad scientist look.
“There you are. I’ve been looking all over for you. We have some preliminary results from our geneticists.”
“That’s exciting,” quipped Harper.
“Yeah, no doubt,” Becker said with a laugh. “Talk about boring. Whew! Anyway, do you mind walking with me while I explain?”
“Lead the way, Doc Brown,” replied Harper.
“Who?”
“You know, Dr. Emmett Brown, the loony scientist from the Back to the Future movie.”
“Before my time,” said Becker dryly.
“C’mon, Becker, it was before my time, too. Don’t you watch classic movies?”
“Sure, just not that one. Do you wanna hear about this or not? It really is fascinating.”
Becker opened a file folder she was carrying and thumbed through the pages until she found the report she was looking for. She continued.
“Okay, so, Woolie and I have been puzzled by the known patient profiles. The victim’s ages, demos, medical conditions, etcetera absolutely defy logic. We needed to know why the virus is provoking only mild symptoms in some people while severely sickening or killing others.”
“I take it you have an answer.”
“Taking into account we are very early in this outbreak, we’ve started to form a hypothesis based on two commonalities. One is a person’s blood type. Patients with Type A blood had a fifty percent greater chance of suffering severe symptoms that required oxygen or a ventilator.”
“That’s odd,” muttered Harper. She was focused on Becker now, putting aside all the other aspects of the investigation that were running through her mind.
“Yeah, a real head-scratcher. Our working theory is that the location on the human genome where blood type is determined also contains a stretch of DNA that can trigger strong immune responses. The genetic variations associated with Type A blood seems to lead to an overreaction in the immune system, causing extensive inflammation and lung damage.”
Harper asked, “Tell me about the demographics of the known cases. Is there a trend based upon race?”
“Thus far, this disease has proven to be an equal opportunity bug. Despite the fact that the Type O blood patients, typically non-whites, seem to be catching a break, the patient counts reveal there is no definite trend across racial lines.”
“Viruses don’t discriminate,” added Harper. “What’s the second common factor?”
“The eggheads have homed in on six genes in the genome that could be influencing the course of the virus. They’re not sure which one is controlling the virus’s ability to attach to cells.”
Harper abruptly stopped in the middle of the hallway. “Becker, where are we going?”
“I think you need to go talk to the eggheads.”
Chapter Thirty-Eight
CDC Headquarters
Atlanta, Georgia
Nearly two centuries ago, scientists used a live virus from another animal species to combat smallpox, one of the most lethal human pathogens ever known. In the intervening years, science had provided the tools to intentionally produce in the laboratory other live viruses capable of protecting against their more lethal siblings. Through the use of genetic engineering, mutations in viral genomes were created to battle the misery of human infectious disease. Despite these leaps in scientific study, the efforts designed to eliminate infectious diseases from impacting society could not outpace emerging novel viruses.
Harper stood among the geneticists who were gathered in a small conference room with walls made entirely of whiteboards. Dr. Sanjay Chandra, a molecular biologist and former professor at Oxford, had the floor.
“Welcome, Dr. Randolph,” he greeted her with a smile and a nod.
“Thank you for allowing me to listen in. I understand you’ve made some progress.”
“Yes. You’re just in time. Let me explain.”
Dr. Chandra turned to the whiteboard and began to make scribbled notes using several different colored markers. He lent the appearance of an out-of-control orchestra conductor as he furiously wrote on the whiteboard. After a moment, he turned to the group.
“We have learned, as is always the case, that viruses attack cells they recognize. This novel virus identifies specific receptors that are present on the body’s cell surfaces.
“Now, this virus, like so many others, evolved by borrowing and modifying cellular genes. Like other pathogens, it depends on specific cellular functions for its replication and survival in its hosts, both animal and human. Some of these functions required for viral replication are expressed in most cells, although there are exceptions not pertinent to this case.
“The human body has its own defense mechanisms. We have learned that this virus forms two groups, those that infect organs at or near a portal of both entry and exit, such as body orifices. This group multiplies efficiently and eventually yields to the body’s immune response. However, the second group is more powerful and potentially deadly. It remains after the infection and remains in a passive state for the life of the host. This second group leads to herd immunity, a critically important stage required to burn out a pandemic.
“I’ve been told Dr. Randolph went to extraordinary lengths to answer the question of where this virus originated. Our specimen, Canis lupus, the wolf known as Doggo, has now been confirmed as the intermediary host of this virus. Genome studies confirmed the disease was passed along to Doggo from the source animal.
“Our first suspect was Rhinolophus, the common horseshoe bat. We compared the genome sequence of Doggo’s remains to RATG13, the coronavirus commonly found in horseshoe bats. The genetic markers were insufficient to make a determination. We then conducted an analysis of other viral groups known to the region, including Western China, India, and Pakistan. One has to remember, this creature’s remains are fifteen thousand years old based upon our estimates. The world was a different place then.
“First of all, we learned bat genomes can be ruled out. We ran hypotheticals, genetic marker comparisons, and even took into account the intrusion of other animals that may have been in the region at the time of Doggo’s demise, such as civets and camels. None created a match.”
Harper fidgeted. While she was interested in the science behind Dr. Chandra’s conclusions, she was a bottom-line kind of gal, as was Beck
er, who leaned into her boss and whispered, “Just land the damn plane already.”
Harper allowed a slight smile and nodded. Dr. Chandra continued as he prepared for landing.
“We then looked to animals prevalent on the other side of China and found a genetic match. On the basis of our genetic analyses, we’ve determined the original host was none other than the scaly ant-eating pangolin. Today, this long-snouted mammal is rarely found in Western China, so it was initially overlooked as a culprit.
“Our conclusion, based on the genetic comparison of viruses taken from Doggo and from humans infected in the early stages of this outbreak, is that the genetic sequences are ninety-nine percent similar. We are now able to publish our report and formally pass this data on to Dr. Randolph.”
Spontaneous applause erupted among the geneticists. Harper and Becker glanced at one another before joining in the celebration. From this point forward, rather than trying to solve the mystery of this virus from the most recent patient to its beginnings, Harper’s team was capable of rapidly filling in the blanks.
She thanked Dr. Chandra and the other molecular biologists in the room. She turned to Becker and nudged her arm.
“While they finish their report, let’s see what we can do about treating these patients.”
Chapter Thirty-Nine
CDC Headquarters
Atlanta, Georgia
Harper and Becker made their way to the den of epidemiologists. More than a dozen disease detectives worked alone, or collaborated, on various aspects of the investigation. As soon as they entered the laboratory, heads turned and she was given a hundred percent of everyone’s attention.
“How’s it goin’, guys?” she asked casually.
The senior-most epidemiologist, who had remained in Atlanta while a much larger contingent of the Epidemic Intelligence Service had been dispatched to Las Vegas and Los Angeles, left his desk and greeted the new arrivals.
“As a matter of fact, Dr. Randolph, we have the invisible enemy in our sights. Would you like to see?”
“Damn straight,” she replied with a laugh.
He motioned for her and Becker to join him at a single workstation containing a large electron microscope. She rolled a chair in front of it and offered it to Harper, who chose to stand.
“It’s a phenomenal image of a dying cell infected with the virus. Take a look.”
“It’s amazingly crisp,” commented Harper.
“I like to generate images to convey that this is a living entity in an effort to demystify it, making it tangible for people,” the CDC’s leading electron microscopist explained.
“It’s a creature,” muttered Harper, echoing Dr. Boychuck’s words when the two first met in Las Vegas.
“Yes, in a way, it certainly is. It has purpose, although not conscious like most creatures. We often refer to it as the invisible enemy because it is during the early parts of our investigation.”
Harper stood back and allowed Becker to take a turn at the microscope. “It’s devouring the cell.”
“Indeed, it is. You’re looking at a world that people can’t get to see. This particular image represents a sample ten thousand times smaller than the width of a human hair. It’s one-billionth our size.”
“It’s difficult not to be awestruck,” Becker added as she stepped away from the microscope.
The microscopist agreed. “Despite the deadly nature of the viruses, I’ve come to appreciate the beautiful symmetry in many of them. They’re elegant and not malicious in and of themselves. They’re just doing what they do. Devour.”
Harper asked, “What can you tell us so far?”
“This particular virus has an elaborate biological structure, but it also has weaknesses that can be exploited. It’s these weaknesses that will lead you to developing a treatment protocol and a vaccine.
“In the example you just viewed, the larger folds and contusions represent the surface of a diseased kidney cell from one of your Las Vegas index patients. The dozens of small spheres emerging from the surface are the virus particles themselves.”
He waved to get the attention of a member of her staff.
“Yes, sir?”
“Please bring up the image taken from Doggo’s kidney, and give me a side-by-side on the center wall monitors.”
The epidemiologist nodded and scampered back to her desk. A moment later, a second image appeared. It was similar to the first except the virus particles were more clustered.
“The difference between the two represents the stage in which the hosts were under attack. Doggo’s sample, revealing the close cluster, indicates the wolf had been infected a relatively short time before his death. While he might have been exhibiting symptoms, it was not likely the cause of death.”
Harper turned to Becker. “Do we have a final necropsy report from Dr. Sales yet?”
“Nothing official,” replied Becker.
“Unofficially?” Harper asked.
“He drowned. There was evidence Doggo’s body was deprived of oxygen, resulting in damage to the lungs and brain.”
The microscopist continued. “The image from the index patient gives us a window into how devastatingly effective this novel virus appears to be at co-opting a host’s cellular machinery. Just one infected cell is capable of releasing thousands of new virus particles that can, in turn, be transmitted to others.”
“Are you prepared to classify this virus?” asked Harper.
He nodded and then explained, “Of course, we look at four primary characteristics in classifying a novel virus. We consider their nucleic acid, whether RNA or DNA, as well as its strandedness, whether single or double. Then there’s the protein shell, the replication method, and other lesser details to consider.”
Once again, Harper was waiting for the plane to land.
The microscopist walked past Becker and retrieved a notepad from his desk. “Preliminarily, I have confidence in this designation.” He showed them the notepad with a series of numbers and letters scribbled on it. The final conclusion was circled at the bottom.
“Type A influenza?” asked Harper.
“Yes, specifically, antigen Type B because it is apparent the virus changes by a more gradual process of antigenic drift.” Antigenic drift is an abrupt, major change in an influenza virus, resulting in new proteins capable of infecting humans.
He continued, pointing to his notes as he explained, “At this time, I’m declaring the host of origin to be a pangolin rather than the canine. Based upon my conversation with Dr. Sales and thanks to the remarkably preserved stomach contents of Doggo, we’re confident in our hypothesis.” He paused and gathered his thoughts before continuing.
“The geographical origin is the Tibetan Plateau or the Himalayas. World Health will have the final say on this. Very political, you know.”
Harper nodded. No nation wants a deadly disease associated with its name.
He continued. “Because there is no evidence of an avian or swine relationship, it appears there was the entry of bat influenza into the pangolin’s mammalian cells. Therefore, the appropriate designation is H17N12, a truly novel virus.”
Becker solemnly repeated the designation. “H17N12.”
The microscopist added, “The long form is Virus Type A, Tibet, Strain Number 05, Year 30, Virus subtype H17N12.”
Harper furrowed her brow and walked toward the images displayed on the wall. “Now that we know who you are, let’s figure out how to beat you.”
Chapter Forty
CDC Headquarters
Atlanta, Georgia
They stopped by Becker’s office to drop off the goggles and mask; plus both of them needed a much-needed chocolate break. Stress relief was best achieved with a handful of M&M’s properly parceled out, of course. A text message notification was heard, so Becker quickly retrieved her cell phone from her lab coat.
“It’s Woolie. He and Kwon need to meet with us in the Bergermeister’s small conference room as soon as possible.”
/> Harper looked down to her perky assistant. “Does he call Dr. Reitherman, Bergermeister, too?”
Becker laughed. “No. Those two get a kick out of speaking to one another with phony German accents. They constantly refer to one another as Herr Doktor.”
Harper shook her head in disbelief. “I never looked at Dr. Reitherman as having that kind of sense of humor.”
“Your pal, Woolie, has that effect on people. You know his real name is Wolfgang, right?”
“Yeah. Which do you like better?” Harper asked.
“Woolie makes the most sense. Actually, and don’t tell anybody, but he’s the second person I’ve met recently that I can’t come up with a better nickname for.”
“Really?” asked Harper.
“Yup. Can you imagine calling that eccentric cadaver carver anything besides Woolie?”
Harper was clearly entertained, enjoying the lighthearted moment. “No, I suppose you’re right. Um, wait. You said he’s the second person you can’t apply a nickname to. Who’s the other?”
Becker quickly responded, “Kwon.”
“Why’s that?”
“Too scared.”
Harper continued laughing. “Becker, you don’t have to be afraid of Kwon. He’s one of us.”
“How would I know? He’s barely said two words to me.” She reached into her lab coat several times until she’d retrieved three like-colored peanut M&M’s.
“He’s not much of a talker,” Harper said reassuringly.
“Not true. He talks to you. And Woolie. And the Bergermeister. But not me.”
Harper looked away from Becker because she wasn’t able to make the statement with a straight face.
