PROLOGUE
NORTHERN GANSU PROVINCE, CHINA.
The SUV rattled along the dusty road, twelve miles south of Jiayuguan's city limits. There was little to see in the unvarying dirt hills rolling past. Besides, Kwok Lee was too agitated to take in the scenery. He cringed with each rock that pinged off the windshield, and he cursed every pothole that rocked his precious new vehicle. Where was all the money the State Council promised for infrastructure ? In their pockets, Lee thought miserably, never considering that as an inveterate black marketer he fueled the province's systemic corruption. He consoled himself with the thought that in a few hours he would be able to replace this vehicle with ten more like it. Not that he needed a fleet of SUVs, just one for his girlfriend. Maybe that would quell some of her nagging, the way it had his wife's.
Lee glanced in his rearview mirror at his two backseat passengers. Since loading into the car, neither had spoken. Two hours driving, and not so much as a word out of them in Mandarin or even their native tongue, which they had claimed was Mongol though Lee knew better. Dressed in cheap suits, the men had darker skin, rounder eyes, and broader noses than the local Chinese. They could have passed for brothers, except the one who answered the questions was half a head taller than his colleague. Lee considered the possibilities, concluding they must be Malays. He guessed they were reporters. Why else would they want to see the godforsaken place? But their identity was of no concern to Lee. What mattered were the wads of crisp American bills that he'd seen in the briefcase of the shorter one.
In the distance, a building burst through the dust cloud. A bleak concrete structure, fenced and gated, it could have been one of a million such in China. It wasn't until Lee slowed for the approaching gate that he noticed a difference. If not for the semiautomatic rifles slung over their shoulders, the. soldiers manning the gate could have passed for surgeons. All three wore gowns, plastic caps, gloves, and surgical masks.
One of the soldiers leaned his head through the open driver's window and eyed Lee's passengers suspiciously.
"Missionaries," Lee explained cheerfully. "They've come to pray for their brother." He laughed and waved his documents in the soldier's face. "Like prayers will help the poor bugger!"
The soldier grunted a humorless chuckle, and then grabbed the documents. A few moments later, Lee slid his filthy car into a parking spot in the gravel lot. Outside the building's entrance, Lee and his passengers went through a similar security screen. And again one hundred meters down the corridor, but this time their papers were more thoroughly scrutinized by soldiers who wore lab hoods. At each checkpoint closer to the patients, Lee sensed a higher degree of disquiet among the guards. Inside the building, the tension in the air was palpable.
A guard led the three of them up the stairway to an office, where a small, balding, bespectacled official sat at a huge desk, which accentuated his diminutive size. He introduced himself only as Dr. Wu, but Lee knew he was the associate director of the regional hospital.
Wu studied Lee's silent companions for a few moments. "You are aware of the risks?" he finally asked.
Both men nodded.
"And yet you still want to see the patient?"
More nods.
"To pray for him?" Wu said with a raised eyebrow.
"He is our brother, sir," the taller man said in halting Chinese, leaving it unclear whether he meant the patient was a blood relative or a member of the same religious order. "We can't offer our blessings unless we see him in person."
"I see." Wu nodded, but his frown questioned the man's sanity. "By protocol, no one, not even family, is allowed to visit."
Lee shifted in his chair. What is this nonsense? he thought. Was this tiny bureaucrat renegotiating his price at the eleventh hour? Lee reached into his case and pulled out the thick envelope. "Doctor, I think these papers explain everything." He slid it across the desk allowing the envelope's flap to flash a glimpse of greenbacks.
In one motion. Wu swept the envelope into an open drawer and pushed it shut. He rose from his desk without gaining much height. "You will have five minutes. No more. Do not touch anything. You will wear full protective gear. You will need to decontaminate--" Seeing the confusion on their faces, he rolled his eyes and said, "You must shower after the visit."
The men nodded. Lee bowed his pudgy form toward the. associate director. "Thank you, Dr. Wu. You are most accommodating."
Wu's eyes narrowed in disdain. "Five minutes" he reminded them. "One of my men will stay with you. He will tell you when--"
The shorter of Lee's customer, though much taller than Wu, spoke up for the first time. "No. Doctor. This is between our brother and God," he said in near-perfect Mandarin. "We need a few minutes of privacy."
Before Wu finished violently shaking his head, the man had his hand extended, offering another fat envelope from his briefcase.
Wu hesitated. For a moment it seemed as if he might refuse the offer, but he snatched the envelope and scrambled back to his desk. He dropped the envelope as if it were on fire in the same drawer he'd deposited the other. "Five minutes, not a second more," he said.
Another guard led them into the changing rooms. After gowning and gloving, they passed through two sets of doors that served as a makeshift hermetic seal. On the other side, they changed into yellow biohazard suits before donning particle-filtrating hoods. Lee thought they resembled three misplaced beekeepers, but he kept the thought to himself. He was gripped by sudden foreboding,
Following the soldier, they walked through another set of airtight doors and onto the hospital ward. The similarly garbed staff paid little heed as the three men headed down the dingy corridor, but with each step Lee's anxiety rose. He struggled to breathe in the suffocating hood. Beads of sweat ran down his face and pooled at his collar. No one had told him that he would have to join the others in the patient's room!
Their soldier escort stopped at the last door in the hallway. He knocked. A nurse emerged from inside and shut the door behind her. After a brief exchange, she nodded and walked off down the hallway. The soldier held up five fingers to the others.
The tall one entered first. Lee hesitated, but the crisp shove from behind left him little choice but to follow. Inside the cramped room, surrounded by machines and IV drips, a patient lay on the bed. At least, Lee thought he was the patient but wasn't certain since the form on the bed was entirely swaddled in plastic bundles. The beeping machines and the occasional rustle of the plastic sheets suggested someone might be alive under the sheets. The whirring from the life-support system's ventilator by his head obscured most other sounds. But the longer he stood, the more aware Lee became of a harsh gurgling sound. Appalled, he realized it emanated from the patient, not the machine.
No one moved. Then both Malays fell to their knees. Lee experienced a fleeting moment of relief. Maybe they had come to pray for their brother after all?
But the relief was short-lived. They weren't praying. They jumbled at their legs, eventually withdrawing packages from inside their boots.
Lee's chest thumped. Sweat drenched his neck. He felt unsteady on his feet. Even before the taller man pointed the gun at him, he knew everything was wrong.
The shorter Malay approached the patient. He began to unwrap the protective plastic. Soon the patient's face appeared. He might have been anywhere from twenty to eighty, but his face was so swollen and bruised Lee couldn't place his age. His eyes puffed out like apricots. His lips swelled out farther than his nose. The line of his jaw was lost in the unnatural folds of his neck. Between his sausage lips, a clear plastic tube led to the ventilator.
Lee stared transfixed as the Malay leaned over the creature's neck. With obvious expertise he inserted a needle into the ill-defined skin folds. Then he attached a test tube to the other end. A stream of dark red blood shot into the glass tube. Satisfied, he detached the test tube from the needle, shook it in his gloved hand, and laid it on the bed. He repeated the steps until he'd filled five large test tubes. He pulled the needle out of the patient's neck and then turned to his partner with a quick nod.
The taller Malay handed the gun over to his partner. Then, almost casually, he unlatched his hood and removed it. He walked over to the other side of the bed and leaned close to the patient's bloated face. With both hands he uncoupled the ventilator tubing, leaving an unattached endotracheal tube, which looked more like a toilet paper roll, sticking out of the patient's mouth.
The gurgling amplified, and drool formed at the open end of the tube. The patient writhed on the bed and the plastic covers shook as he struggled to breathe. He coughed in frequent spasms. With each cough, bloody sputum sprayed from the tube's end.
Out of reflex, Lee took a step back and closer to the door, but the gun waving at his head halted his retreat. Horrified, he watched the taller Malay stoop forward and without hesitating place his mouth over the open end of the tube and suck from it like a snorkel.
Nausea swept over Lee. It was all he could do to stop from vomiting into his hood. He had never believed the sick brother story, but only now did Lee realize what the two maniacs had in mind. For the first time in weeks Lee thought of his daughter and son, My Ling and Man Yee, who were at the state school not ten miles away.
Watching the stranger inhale breathfuls of the deadly saliva Lee realized his own fate had already been sealed. The panic vanished, replaced by calm remorse.
One thought reverberated in his head: what have I done?
CHAPTER 1
GEORGETOWN UNIVERSITY, WASHINGTON, D.C.
The sharp, red point zoomed around the screen, before settling on the spiky gray structure in the center. "Ugly little bastard, isn't he?" the lecturer said. "Looks like something a junkyard dog ought to wear around his neck."
The remark was met by scattered laughter in the packed auditorium; Dr. Noah Haldane's lectures were always a huge draw. Among the medical students, the infectious diseases specialist and world expert on emerging pathogens had a reputation as a hip and irreverent speaker whose lectures managed to cut through the esoteric bullshit and get to the meat of the matter. There was another factor, too. At thirty-nine, without a trace of gray hair in his short uncombed hair, he stood six-two and still fit into his college jeans. His blue-gray eyes, sharp features, and readily amused smile helped pull in several women and even a few men who weren't even registered for the course.
Haldane ran the laser pointer around the circumference of the structure on the screen, following the spikes of the outer ring. "But this particular virus"--he tapped the crystal with the laser pointer's light--"he caused us no end of grief the year before,"
"Please, no letters to the dean's office." Haldane held up a hand in mock disclaimer. "I refer to all viruses as male." He shrugged, unapologetically. "Maybe it's because they're so basic. So incomplete. So dependent on others to sustain their existence." He paused. "Like my couch potato of a brother-in-law, it's unclear whether viruses even represent a true form of life." He waited for the laughter to subside. "Whereas I think of bacteria, which are far more complex, independent, and beautiful, in the female sense."
"How about parasites?" someone called out. "What sex are they?"
Haldane squinted through the dimness until he spotted the questioner in the fifth row. "Mr. Philips, I don't think of parasites in terms of gender."
"Why not?"
"Because they remind me too much of med students."
More laughter. Haldane circled the bug on the screen again with his pointer. "Does anyone recognize our ugly friend?"
"SARS-associated coronavirus?" a young, thin woman tentatively ventured from her front row seat, where she hunched over her notebook, scribbling madly even as she spoke.
"Exactly, Ms. Tai." Haldane nodded. "Or coronavirus TOR2."
Haldane clicked a button in his hand. The sterile electron microscope's image disappeared, replaced by a blood-spattered female cadaver whose eyes were blacked out by a solitary bar. Without comment Haldane tapped the button again. A human lung sat perched on a steel gurney. Another click. The screen sprang to life. A pair of gloved hands grasped the lung. One hand steadied the lung, while the other sliced into it with a scalpel. Bloody fluid spurted out as if a wineskin had been slashed open.
As he let his students absorb the images of an anonymous pathologist dissecting the pus- and blood-filled lung, Haldane wondered how lecturers in the age before Power Point and multi-media managed to make any impact. "Four days before the video was shot, this lung belonged to a perfectly healthy forty-two-year-old
nurse ..."
He clicked the button and the black and white viral crystal reappeared. "Then she breathed in a few particles of SARS-associated coronavirus.
"Like all self-respecting coronaviruses, he has an affinity for the human nasal mucosa. He easily penetrates the epithelial barrier and replicates inside the mucosal cells." The scientific sketches on the screen changed in rhythm with Haldane's explanation. "That's when the body's armed forces, the immune system, mobilizes. Think of the phagocytes and neutrophils as the infantry in this battle. Doing the dirty work--the cell-to-cell combat. While the lymphocytes are more like the artillery, lobbing their ammo, in this case viral-specific antibodies, from afar.