Jakarta Pandemic, The (77 page)

John Merrill stepped forward once again.

“At this time, we do not have any data regarding survival rates for ARDS, however, the occurrence rates for ARDS are around 5%, which is encouraging news. In Asia, some of the early data indicated ARDS rates as high as 10-20%.”

He stepped back to the left of Paul.

“Every time that guy steps forward, I get suspicious,” Kate said.

“Yeah, I think it’s a really sensitive topic that needs extra spin from the puppet master,” Alex added.

“Suzanne Wilkins, SPOT News. According to the National Pandemic Plan, your department is tasked with assessing surge capacity of medical and emergency response systems. What is DHHS’s assessment based on worldwide Jakarta flu trends?”

Surprisingly, to both Kate and Alex, John did not step forward, though he looked like he was straining to remain in his station next to Paul.

“Currently, our assessment is positive. Based on worldwide trends and our nation’s pandemic response capability, we anticipate sufficient surge capacity to handle the pandemic.”

John finally broke free of the invisible force keeping him in place.

“A few major factors affect this assessment. First, the U.S. is a nation with a modernized healthcare system, second to none in the world. I know that a few countries have already hit their surge capacity, but those models will not apply here. We have an incredible healthcare system, and the Strategic National Stockpile gives us the ability to enhance this system if necessary.

“Secondly, not every single person that is infected requires hospital care. The vast majority can be treated at home, especially when given antivirals to reduce the severity of symptoms. At this time, we do not anticipate the Jakarta flu overwhelming the healthcare system. With that being said, we are closely watching all aspects of the pandemic and will take the immediate and necessary steps if, and I emphasize if, that assessment changes. Thank you.”

A woman in the second row spoke up immediately after John’s comment.

“You mentioned the antiviral stockpile again as a key strategy for keeping the pandemic under control. The nation’s stockpile program is close to 32 million doses short of the projected 2012 goal to have enough doses for 25% of the population. Is this shortage figured into that assessment?”

Another reporter sitting behind her fired follow-up questions before either John or Paul could react.

“And what about reports of resistance to Tamiflu? Or that the Jakarta flu may require higher doses due to higher virulence?”

Paul took control of the situation.

“Ladies and gentlemen, one question at a time, please. First, the department’s assessments take into account the state level shortfall. As of last month, the Strategic National Stockpile contained nearly 39 million doses of Tamiflu, which is only a few million doses short of our goal. Unfortunately, the state level stockpiling effort fell short of our expectations. Our plan directed that 32 million doses be purchased at the state level, and currently, state stockpiles only account for about 7 to 8 million doses.”

The room started to stir, as nearly 100 reporters started whispering.

“However, DHHS has reached an agreement with Roche pharmaceuticals that will bridge this gap. Roche has agreed to divert all of their current inventory to the Strategic National Stockpile, and for an indefinite period, all future production of their antiviral will be dedicated to pandemic response efforts.”

“I didn’t hear anything about Biosphere?” Kate said.

Alex shrugged his shoulders.

“As for the rumors about resistance. It is true that a low incidence of resistance has been detected to older flu strains, like H1N1 and H5N1, but that has not been the case with H16N1. Data emerging from Asia does not suggest any resistance to currently available antivirals.”

“Nice that this data is readily available, but nothing about ARDS,” Alex commented.

“Right now, we are unaware of any need to increase the dose of Tamiflu to effectively treat the Jakarta flu. The CDC will be tracking this issue closely. With the current information available, we remain convinced that a typical course of therapy will be sufficient to reduce the symptoms and duration of H16N1 infection. Ladies and gentlemen, we’ll take a few more questions.”

This announcement brought most of the reporters out of their chairs, trying to gain Paul’s attention, many simply yelling their questions at Paul. Paul remained unmoved by their attempts, focusing toward the back of the room.

“Audra,” he announced, pointing to Audra Jefferson, from FBC. Most of the reporters lowered back into their seats.

“Thank you. Does your department recommend any action by state or local governments to implement community social distancing strategies, like school closures or work schedule modifications?”

“No, currently we do not recommend activating any of these strategies. Taking these actions too early can be severely disruptive on many levels. The department plans to reconsider this recommendation early next week, when more data is available to accurately forecast the flu’s impact on the nation. This does not preclude local governments from implementing these strategies, however, it is not warranted by current conditions.”

Alex looked at Kate, shaking his head.

“What do they think is going to happen over the next few weeks?” Alex asked.

“But given the case fatality rates demonstrated in Asia, specifically Indonesian and China, by your department’s own classification, this is a category 5 pandemic. And by your own national plan, in a category 5 situation, all of the community mitigation strategies would be implemented. Why wait for the pandemic to spread?”

John stepped forward to handle her continuation of the question.

“The pandemic severity index, linked to community mitigation strategies is a guideline for action. As Paul said, most of these strategies have a heavy impact on society. School closures force parents to find childcare alternatives, in many cases negating the benefit of a school closure. Many parents cannot afford these alternatives and will be forced to either leave children unattended or miss work, which causes more problems. If parents miss work, they may lose their jobs. Increased absenteeism, already an issue in a flu pandemic, can impact the delivery of essential services, like food, electricity, payroll, financial, and emergency services. Even the most mundane job can contribute to an essential service. Therefore, implementation of these strategies is not taken lightly, as they impact everyone.

“This department, with the full support of the administration, will continue to analyze all of the data, forecasts and recommendations provided by the CDC and ISPAC. By early next week, I am confident that we will understand enough of our situation to make decisions regarding community mitigation strategies.”

As John stepped back, all of the reporters flew off their seats, yelling and gesturing toward Paul, but the press conference was finished.

This marks the end of the fictional Media segments.

Read on for excerpt of
Black Flagged

Excerpt from Black Flagged

BLACK OUT

April 8, 1999

2:35 P.M.

A few miles outside of Vizic, Serbia

Marko Resja peered cautiously over the top of the jagged stone wall, scanning the lodge's distant front porch with powerful binoculars. Through the driving downpour, he counted four men, which was a good thing. With the entire external security team in one place, he should have no trouble approaching unseen.

He lowered himself to the spongy, pine-needle-covered ground and leaned back against a sharp granite chunk that formed part of the estate's perimeter wall. Created by haphazardly dumping large uneven rocks around the lodge on all sides, the utilitarian border marked the divide between hastily cleared land and the impenetrable Fruska Gora National Forest.

Marko had arrived at the stone wall one hour earlier, hampered by the same relentless rainfall that had kept NATO aircraft at bay for more than a week. Concealed in the dense pine foliage behind the jagged barrier, he could hear the distant roar of high altitude jets through the unremitting storm. He guessed the NATO pilots were testing Belgrade's air defense network from a safe distance, impatient for the weather to clear over the northern Balkan Peninsula.

He stared out into the wavering pine forest before turning his attention back to the lodge. The two-story, modern, stone and beam structure looked sturdy enough to withstand an artillery attack. A similarly constructed, one-story garage stood between him and the house, partially obscuring his view of the main structure.

Srecko Hadzic, ruthless leader of the paramilitary Serbian Panther crime syndicate, had built the lodge for the sole purpose of hiding his brother, Pavle, from prying eyes. Rumors of NATO commando teams operating within Serbian borders had taken root among upper level leadership, raising paranoia to near panic levels, and Hadzic feared Pavle's capture more than his own at this point. Unfortunately for Hadzic, the Vizic compound was one of the worst-kept secrets in Belgrade.

He took one more look over the top of the wall, just to make sure all four men were still on the porch. He spotted the bright orange glow of cigarettes through the nearly impenetrable rain squall. He didn't expect any of them to emerge from their cozy shelter, but he had to keep in mind that these men were all current or former Serbian Special Operations types, and despite the overindulgences often associated with paramilitary security details, all of these men had been hand-picked for their competence. Three more had accompanied Radovan Grahovac, Hadzic's chief of security, into the lodge to meet with Pavle.

They had all arrived dressed in civilian clothes, which suggested that the crew might head north for a night of prostitutes and drinking along the banks of the Danube River in Novi Sad. Despite their casual dress, however, each man carried a compact assault rifle and a pistol. Under normal circumstances, this was not a crew he would cross. Today, Marko would make a notable exception.

Satisfied that all four men were still in the same place, he picked up a long, thick, black nylon duffel bag and ran to a position along the wall that was completely obscured from the porch by the garage. He knew from two previous reconnaissance trips that Radovan didn't stay more than ten minutes, which meant he was already running out of time.

From his new vantage point, he glanced over the wall and saw one of two dark blue Range Rovers that had arrived at Pavle's hideaway a few minutes ago, depositing Radovan and his heavily-armed security detail. The other Range Rover was parked several meters behind the first, hidden from his view by the garage.

He kneeled low and wrestled a Serbian-made light machine gun out of the soaked nylon bag, extending the weapon's foldable shoulder stock. He placed the weapon against the wall and reached back into the bag for one of two detachable ammunition drums. He swiftly attached one of the seventy-five-round drums to the weapon and placed the second in a hip satchel.

Beyond the high-capacity ammunition drums, he had four standard thirty-round magazines velcroed into quick-access pouches on his combat vest, nestled among four stun grenades. He screwed a large silencer to the machine gun's barrel and chambered a round with the weapon's charging lever. The final item he took from the bag was a gray, aluminum ice-climbing axe, which he attached low on the side of his vest. He was ready.

He gripped the sturdy assault weapon with his left hand and hopped over the rock wall, using his right hand for leverage. After splashing down in ankle-high mud, he slogged through the torrential rain to reach the left back corner of the garage. From that spot, he'd be able to see the four men leave the porch, which was critical to his plan.

Marko arrived at the corner, careful not to expose himself. He checked all of his gear one more time, wishing he could check the computer and satellite phone in his waterproof backpack, but just as quickly dismissing the idea as last minute paranoia. He knew the electronics rig worked, and that it would give him a secure satellite connection for both the satellite phone and his computer. He had assembled and tested it nearly a dozen times within the last twenty-four hours. He might not even need it, but he wasn't about to take any chances, and neither was General Sanderson.

The rain intensified for a minute, as sheets of water pummeled the side of the garage. Despite having been exposed to the frigid early spring rain for nearly two hours, he wasn't cold. Under his paramilitary camouflage outfit, he wore a waterproof, insulated one-piece jumpsuit. Certainly not standard issue for elite Serbian commandos or even the most pampered members of Hadzic's paramilitary forces.

Nothing in Marko's equipment load-out was standard Serbian issue, which distressed him, though it should have comforted him. As an American deep-cover operative, he hadn't fired or handled a weapon less than twenty years old since his arrival in Serbia two years ago. The model he held in his hand came fresh off the Zastava Arms assembly line, compliments of General Sanderson, but it felt alien to him. Instinctively, he knew everything he carried was superior to the ancient hardware handed down to him by senior members of the Panthers, who passed their equipment down to make room for newer toys. Still, it felt strangely uncomfortable.

He peeked around the corner of the garage and saw one of the men throw a lit cigarette out into the front yard. Another man talked excitedly into a small handheld radio and rapidly nodded his head. Showtime.