Authors: Wil Mara
“I don’t know of any cases where both symptoms occurred together,” Beck said, “so my gut tells me this is something different. Sheila, are any other CDC people on the ground?”
“No, but Ben Gillette is waiting for you at Valley Hospital in Ridgewood. They’ve moved all the bodies there.”
Gillette was one of New Jersey’s county epidemiologists, and Beck knew him from the University of North Carolina. He was a quality guy, in Beck’s estimation, serious and focused and thoroughly professional. One of his favorite memories of their college days was the time he had to pick up Ben from the Chapel Hill police station after he was arrested for stealing street signs. Gillette’s girlfriend had dumped him for one of the university’s wrestling studs, and he responded with a night of binge drinking and driving around in his ’74 Corvette with a pair of Vise-Grips.
“I know you’re a long way from your home in Seattle, but I need you to do this. Along with everything else, you need to be my eyes and ears on the ground.”
“Not a problem. What about autopsies?”
“They’ve done some and are doing more now. I’ll send the information as I get it.”
“Okay. We’ll be there shortly.”
“Please call and let me know what’s happening. New Jersey’s governor is crawling out of his skin.”
“I would imagine. What’s the latest—?”
“Hang on.…”
During the ensuing silence, Beck said softly to Porter, “Use the GPS on your iPhone to figure out the route.” She nodded and dug the unit out of her black leather bag, which had a small plastic skull dangling from one of the metal loops.
“Michael?”
“Yes?”
“That was Ben. Three more deaths have just been reported, same symptoms, and it looks as though six other people are in various stages of the infection.”
“Oh boy.”
“This looks like it could be something, so get moving.”
“We’re moving,” Beck said, pressing the gas as he weaved through the early afternoon traffic.
“And keep me updated.”
“I will.”
TWO
Epidemiology concerns itself with the finding and study of factors that negatively affect the health of a human population. That means epidemiologists are, first and foremost, detectives. They are concerned with the overall effects of an illness on large populations (macro) rather than specific symptoms or individual patients (micro). The results of their investigations then form the basis of a response strategy both in the short and long term—they aid not only the treatment of afflicted persons but also play a critical role in the containment and, hopefully, eradication of the illnesses. An epidemiologist’s casework can also lead to the establishment of improved guidelines and protocols in health-care facilities around the world.
Michael Beck was considered one of the best in his field. A brilliant student at UNC Chapel Hill’s School of Public Health, he earned his doctorate at the age of twenty-seven and immediately took a field position in the AIDS-ravaged lands of Sub-Saharan Africa. Four years later he moved to the Ivory Coast to help quell the rampant spread of Lassa fever. In the summer of 1994, he wrote the first of two textbooks,
Modern Epidemiology: Practices and Principles,
which became a graduate-level standard in its first edition. The second book,
Epidemiological Case Studies,
dovetailed the first as a kind of expanded supplement. Affordably priced as a paperback and updated biannually, it cemented Beck’s reputation as a leader in the discipline. Healthy sales also assured him a handsome secondary income. In 1998, he returned to the United States at the urging of Sheila Abbott, whom he had met while taking a summer course at Johns Hopkins. She had started with the CDC as a public liaison in ’90 and was patiently climbing the administrative ladder.
Beck pulled into one of Valley Hospital’s
VISITING PHYSICIANS
spots less than two hours after receiving Abbott’s call. Valley was located in the town of Ridgewood, about eight miles south of Ramsey. It serviced roughly fifty thousand people per year in New Jersey’s upscale northern suburbia. The hospital was a sprawling brick-and-glass structure that looked more like a corporate office in an industrial park. Categorized as a not-for-profit organization, it took in about $450 million annually and employed more than three thousand health-care professionals.
As the May sun sank away and twilight settled around them, Beck and Porter got out of the car and headed for the entrance. No sooner had they taken their first steps when they were descended upon by a herd of reporters and cameramen. What struck them as unusual was the fact that everyone in the crowd was wearing a surgical mask. A few had them tied over their nose and mouth, but most left them lying against their shirts.
With the bright lights glaring, the assault began—
“Excuse me, Dr. Beck?”
“Are you Michael Beck of the CDC?”
“Dr. Beck, are you here to investigate the epidemic?”
They ignored Porter, which was fine with her. She couldn’t help but feel a little sorry for her boss, though. Beck had become something of a minor celebrity in recent years, crystallizing into the “media face of the CDC” after his involvement in several high-profile cases. With his good looks and easygoing manner, he was a natural for the cameras. He disliked it nevertheless, which Porter found admirable.
Beck shielded his eyes and said, “Yes, I’m Michael Beck. Please, let me through. Please…”
They parted but maintained the attack.
“Dr. Beck, is this the result of a terrorist plot?”
“I don’t know. I just got here.”
“Do you know what the illness is?”
He kept walking; they followed. “I’m sorry, I don’t.” He was trying to be patient, Porter realized.
I would’ve told them all to go screw off by now,
she thought.
Parasites
…
As he stepped onto the walkway in front of the emergency room, the double doors slid apart and an aging security guard came out. He also had a surgical mask, plus a pair of latex surgical gloves.
“How many have died so far?” One reporter shouted, holding out a small digital voice recorder.
“I don’t know yet.”
“How many are—?”
“Guys, I just got here.” Beck gave a little smile, trying to defuse the tension. “I don’t know anything yet. Let me go find out.”
“Come on, get back,” the guard ordered, pushing a few of them away with his forearm. They responded with a selection of profanity and one halfhearted claim of infringement against the First Amendment.
“Dr. Gillette is inside, waiting to see you,” the guard said, his breathing heavy. His name tag read
E. HORTON
.
He’s been dealing with them for a while now,
Beck thought. “Thank you.”
“Here, put these on before you go in,” Horton handed each of them a surgical mask while the reporters continued firing away.
Once inside, they found a selection of people waiting in the emergency room—a pair of young women, one crying while the other held her; a little boy lying across his mother’s lap with his right arm in a temporary splint; an elderly man with an oxygen mask over his face, the small metallic tank parked in its two-wheeled carrier by her feet; a few others. Aside from the man with the oxygen, they were all wearing the surgical masks. A sign taped to the wall, hastily made with black Magic Marker on ordinary white paper, said,
IF YOU SUSPECT YOU HAVE CONTRACTED THE INFECTION, PLEASE REPORT TO THE RECEPTION NURSE
AT ONCE
.
A door by the vending machine opened and Gillette came out. Lush black hair with prominent streaks of silver, fashionable glasses, and warm green eyes that still held a faint twinkle of fun and mischief. He wore a long white lab coat with the hospital’s logo above the left breast pocket. And even though he had one of the ubiquitous masks, Beck could tell he was smiling.
“Michael, good to see you.” He offered his hand.
“You, too, Ben.”
“And Cara, how are things?”
“Fine, thanks.”
“Is this guy treating you okay?”
“More or less.”
Beck realized Gillette was acting casual for the sake of the others in the room. He had known Gillette long enough, however, to spot the truth behind the lie—he was worried.
To maintain the façade, Beck said, “So, I understand you’ve got some kind of outbreak on your hands.”
“Yeah, come on back and I’ll go over what we know so far.”
Gillette opened the door and led them down a long white corridor. When they pulled down their masks, Beck realized that Gillette looked a little older than he remembered—the lines around his face a bit deeper, the cheeks slightly more haggard. It’d been about two and a half years since he last saw the man, at a Christmas party in Scottsdale, Arizona. But they kept in touch a few times a month via email and the occasional phone call. Beck had been in California dealing with a bird flu scare when Gillette was appointed New Jersey’s state epidemiologist, so he sent a gift (a $250 certificate to Red Lobster, where they used to go as a “treat” in their penniless college days) along with an intentionally saccharine Hallmark card. Gillette was still single even though he had all the qualities of a “good catch”—charm, intelligence, money, and decent looks. Beck was all but certain he wasn’t homosexual, so the mystery of his bachelorhood always puzzled him.
“I’m sorry about the press on the way in,” Gillette said. “We can’t get rid of them.”
“Don’t worry about it.”
“The Organ Grinders of Doom.”
“A brain-eating virus would starve to death out there,” Porter quipped.
“How did they find out so quickly?” Beck asked. “The two police officers?”
“Yes. They have media informants at the station, as you know.”
“Any idea how the officers became infected?”
He was in sleuth mode now. Porter had seen the transformation plenty of times. He was data gathering: the first step in the process.
“They were on a call. A woman who hadn’t come out of her apartment in a few days. One of her neighbors noticed a nasty smell from the vents. She was a quiet type, kept to herself a lot. But she worked for the town and hadn’t been seen in a while.” Gillette lowered his voice, as if imparting a secret. “They found her hanging by the ceiling fan in her bedroom, Michael, and it was
still going
. Her body was nearly black and covered with vesicles. When the trauma cleanup crew cut her down, her head came off.” He shivered. “I’ve seen a lot of bad stuff in my time, but this … I saw the body down at County. What that woman must have endured.”
“And the police
touched
her?” Porter asked.
“They said they didn’t. In statements given before their symptoms became severe, they both insisted, independently, that neither one touched her. The younger cop said they didn’t even go into the room. If that’s true, then we’re talking about mighty powerful contagions.”
Beck stopped walking. “When did this happen?”
“What, exactly?”
“The officers’ deaths. When did they succumb?”
“On Monday, both of them. Yesterday.”
“And when did they find the woman?”
“Friday afternoon.”
“From exposure to death in
four days
?”
“Yeah.”
“My God, Ben…”
“I know. This is what I told Sheila. We’re not dealing with chicken pox here.”
“What else can you tell me?”
“Not much. I’ve only been here since yesterday, remember. When the first case arrived on Sunday afternoon, the specialist called the NJDHSS, who then called me. As soon as I examined the bodies, I called her. That was this morning. Then she called the two of you. Everyone has followed the procedure to the letter.”
“How many deaths so far?” Porter asked.
“Twenty-six.”
Beck’s eyes fixed on Gillette. “How many?”
“Twenty-six.”
“Sheila said ten.”
“That was two hours ago.”
“There have been sixteen more
in the last two hours
?”
“That’s what I’ve been told.”
“All in this town?”
“No—seventeen here, four in Mahwah next door, and five in nearby Upper Saddle River.”
“What’s the mortality rate?”
“Based on the cases we know now, almost ninety-five percent.”
Beck stopped again.
“What?”
“That’s right—just under ninety-five percent of the people who contract this thing die.”
“And the others?”
“Beyond salvation. Physically disfigured, brain and organ damage. They’re all comatose. Extent of the damage varies, but certainly none of them will return to their former selves. Machine-assisted living.”
“Worse than dead.”
“Yeah.”
They began walking again. “Do you have any live patients right now?” Beck asked.
“We’ve got two, both brought in last night. We have them isolated, of course, and sedated.”
“I need to see them, Ben. Right now.”
“Of course.” Gillette looked at him sheepishly. “One of them, Michael … um.”
“What?”
“Well … follow me.”
* * *
The corridor terminated at a steel door with the words
INFECTIOUS ISOLATION AREA—KEEP CLOSED
in bold letters. Underneath was a variety of hazard symbols. On the other side was a second corridor, dimly lit, eerily quiet, and reeking of disinfectant. Beck and Porter could also hear the increased air pressure. This was by design to contrast the reduced pressure of the isolation rooms. About forty feet down, the walls became large panes of glass—observation windows. The first two rooms had empty beds; the third did not.
The patient was a white male, late twenties to early thirties, dyed blond crew cut, muscular. Around him, a series of machines stood blinking: machines that, Beck knew, would not be removed from the room because they, too, would carry the contagion. Most of the patient’s body was covered by a hospital sheet; only his arms, upper torso, and face were exposed—and they had been ravaged. There was a tattoo on his bare biceps, but the image was too distorted by the massive blistering to be recognizable. The fourth finger on his left hand was black and gangrenous. It took Beck a moment to realize this was due to the strangulation from the wedding ring when the tissues began to swell. What was most horrifying, though, was the suffering visible on the man’s face.
In spite of the heavy sedation, he’s still feeling it.