Executive orders - Tom Clancy [491]
Ebola was an infectious disease, and such diseases started from a single place. There was always a first victim, called Patient Zero or the Index Case, and it spread from there. No disease just exploded in this way. CDC and USAMRIID, which had to make that conclusion official, would have the duty to assemble, organize, and present information in what was almost a legalistic structure to prove their case. For their medical institution, it was simpler, all the more so because Alex had commanded one of the divisions at Fort Detrick. Moreover, since there was a plan for everything, Johns Hopkins was one of the institutions tapped to receive cases in the event something like this took place.
Alex, the director of urology said, the literature says that Ebola is only spread by large particles of liquid. How could it explode so fast, even at the local level?
There's a sub-strain called Mayinga. It's named for a nurse who picked it up and died. The method of her infection was never determined. A colleague of mine, George Westphal, died of the same thing in 1990. We never determined the means of transmission in his case, either. There is thought that this sub-strain may spread by aerosol. It's never been proven one way or the other, Alex explained. Besides, there are ways to fortify a virus, as you know. You admit some cancer genes into the structure.
And there's no treatment, nothing experimental even? Urology asked.
Rousseau is doing some interesting work at Pasteur, but so far he hasn't produced any positive results.
A physical reaction, ripped down the conference table from one physician to another. They were among the best in the world, and they knew it. They also knew now that it didn't matter against this enemy.
How about a vaccine? Medicine asked. That shouldn't be too hard.
USAMRIID has been playing with that for about ten years. The first issue is that there seems to be a specificity problem. What works for one sub-strain may not always work with another. Also, the quality-control issue is a killer. Studies I've seen predict a two-percent infection rate from the vaccine itself. Merck thinks they can do better, but trials take time to run.
Ouch, Surgery commented with a wince. Giving one person out of fifty a disease with an eighty-percent mortality rate-twenty thousand people infected per million doses, of whom roughly sixteen thousand might die from it. Applied to the population of the United States, it could mean three million deaths from an attempt to safeguard the population. Hobson's choice.
But it's too early to determine the extent of the notional epidemic, and we do not have hard data on the ability of the disease to spread in existing environmental conditions, Urology thought. So we really aren't sure what measures need to be taken yet.
Correct. At least it was easy to explain things to these people.
My people will see it first, Emergency said. I have to get them warned. We can't risk losing our people unnecessarily.
Who tells Jack? Cathy wondered aloud. He's got to know, and he's got to know fast.
Well, that's the job of USAMRIID and the Surgeon General.
They're not ready to make the call yet. You just said that, Cathy replied. You're sure about this?
Yes.
SURGEON turned to Roy Altman: Get my helicopter up here stat.
* * *
49 - REACTION TIME
COLONEL GOODMAN WAS surprised by the call. He was having a late lunch after a check-flight for a spare VH-60 just out of the maintenance shop for engine replacement. The one he used for SURGEON was on the ramp. The three-man crew walked out to it and spooled up the engines, not knowing why the schedule for the day had changed. Ten minutes after the call, he was airborne and heading northeast. Twenty minutes after that, he was circling the landing pad. Well, there was SURGEON, with SANDBOX by her side, and the Secret Service squad and one other he didn't know, wearing a white coat. The colonel checked the wind and began his descent.
The faculty meeting had gone on until five minutes before. Decisions had