"I want to talk to the surviving victims."
"In good time, Dr. Haldane."
"No, Dr. Levine. Now."
"Dr. Haldane, this is not China," she said quietly. She kept her eyes straight ahead, but her tone could have frosted the windshield. "You are here at the WHO's request. Not ours. Ergo, you are here to observe, not lead our process."
"Welcome to friendly London, Haldane!" McLeod piped up from the backseat.
Haldane looked over at Levine with an intentionally condescending smile. "Dr. McLeod and I have spent the last few weeks in the epicenter of this epidemic. We know it inside and out. I think it's safe to assume that we have more experience with emerging pathogens and viral hot zones than the rest of your Commission combined." He let his barbs hang in the air for a few moments. "But, Dr. Levine, if you don't see the sense of listening to our advice then perhaps your director will."
Her head didn't move, but the corner of her lip twitched. "We are closest to the Royal Free Hospital where the pediatric patient is," she said evenly. "We will begin there."
Dr. Nancy Levine had already cleared their presence with the Royal Free Hospital's administrators. After she flashed her identity card at the main desk, the three physicians were directed up to the Pediatric ICU on the tenth floor.
Outside the nursing station, a matronly middle-aged woman in a white uniform and headgear, which looked to Haldane like something from a black-and-white movie, introduced herself only as "Sister."
"Sister, we're looking for the patient Alyssa Mathews."
The woman shook her. "I am sorry, Dr. Levine, but she has already gone."
"Oh," Haldane sighed, assuming the worst. "When did it happen?"
"It?" The sister's face crumpled in confusion for a moment. "Oh, no, no!" She shook her head again. "Alyssa has not died. On the contrary, she has shown signs of stabilizing this morning. Today is the first day her doctors have deemed her stable enough to go downstairs for a CT scan of her chest. She only just left ten minutes before."
By the time Haldane, Levine, and McLeod reached the Radiology Department, Alyssa was already on the procedure table having her scan performed.
A radiology clerk led them to Veronica Mathews who paced nervously in the department's waiting room. Veronica wore hospital greens. Her long black hair was frizzled at the flyaway ends, and she only had speckled remnants of her blue eyeliner inside the dark circles encasing her eyes. Even still, Haldane had no trouble picturing her on a runway in New York or Paris, because her sharp features and tall graceful body were so striking.
They sat down at a bank of chairs in the far comer of the waiting room. Haldane sat directly across from Mathews, while McLeod and Levine sat on either side of him. During the introductions Veronica stared blankly over Haldane's head, appearing as sedated as a postoperative patient. Only when he explained how he had just come from China and had seen several other cases of the Gansu Flu did Veronica snap into focus.
Her eyes pleaded with Haldane. "You saw people who recovered from this thing, right?" she said in an accent that seemed to fluctuate between New Yorker and Brit on every second syllable.
"Yes, Mrs. Mathews." He nodded. "We saw people who had hovered on the brink of death and then rebounded. They were fine by the time we talked to them."
She reached out and grabbed his arm. "And children?"
"Yes, children too. Most of the children in China survived the virus."
She squeezed his arm and her lips formed a tentative smile. "But Alyssa has been so sick ..."
"But she has hung on for four days."
Mathews shrugged helplessly and shook her head. "So?"
"Four days was the magic number in China," Haldane explained. "All the patients who survived for more than four days went on to recover fully."
Mathews's fingers dug into Haldane's arm. Her eyes went wide. "Alyssa will recover?" she demanded frantically.
Haldane donned a reassuring smile. "I expect so, Mrs. Mathews."
She loosened the grip on his arm. Tears began to pour from her eyes. "Thank you, Dr. Haldane. Thank you so much ..."
"Not me," Haldane said. "The staff here at the hospital."
"Of course," she sniffled, but still clung to his arm.
Haldane allowed her a moment, and then asked, "Mrs. Mathews, do you have any idea where Alyssa picked up this virus?"
The sleeplessness caught up to her again. Her eyes glazed over. She waved a hand carelessly around the empty waiting room. "There are bugs everywhere. People sneezing and coughing, it's an insane time to travel--"
"Veronica," Haldane cut her off. "We're confident that Alyssa picked it up at the hotel. Probably five to seven days ago give or take. Do you remember seeing anyone who looked particularly sick at that time?"
She shook her head wearily. "I've seen so many red and runny noses ..."
"Think, Veronica, please. It's very important."
Haldane's request didn't appear to register on her blank face. "I tried to keep the girls away, but they're everywhere. In the lobby, at the restaurants, by the pool. Some places you can shield them a little, but what can you do when you're stuck on an elevator with someone who--" She stopped in midsentence. Her eyes narrowed. She began to nod.
Haldane leaned closer to her. "What is it, Veronica?"
"About a week ago, we were riding the elevator just before supper. We had just been at the swimming pool, the girls and I. They loved that pool ..." She smiled her first openmouthed smile in their presence, exposing perfect white teeth. "A woman was on the elevator. Standing by the buttons. She was coughing."
Levine cut in. "What did she look like, Mrs. Mathews?"
"Not well." Veronica shook her head. "She looked as if she needed the elevator wall just to keep her upright. When the girls headed for the buttons--they love to press the buttons--she backed away from them, as if scared."
"Can you be any more specific in your description?" Levine asked, her tone slightly critical.
"She was younger than me. I'd say, early to mid-twenties, at the most. Her thick sandy brown hair was a mess, but she was pretty. Big eyes. She looked pale, but I think that was because of her illness. To me, she looked Mediterranean. Italian? Spanish? Maybe even Greek, but I don't think so ... Spanish would be my bet."
"Anything else?"
Veronica thought. "She was dressed a little"--she searched for the word--"seductively, considering."
"Considering what?" Haldane asked.
"That she obviously wasn't well." Veronica said. "She wore a tight blouse and jeans, along with a fair bit of makeup. It struck me as out of place for someone fighting a rotten cold. Especially in November."
"Did she speak to you at all?"
"No," Veronica said. "When I apologized for the girls crowding her at the control panel, she smiled nervously and stumbled back away from the girls." Veronica's eyelids drooped again from fatigue. She looked at Haldane, sadly. "The poor woman just sort of wilted in front of my eyes."
"That was the only time you saw her?" Haldane asked.
Before Veronica could answer, a man emerged from the CT scanning room, wearing the gown, mask, and gloves. Once outside, he pulled off his mask and walked over toward the bank of chairs.
As soon as Veronica saw him, she leaped to her feet and ran over to him. "What did it show, Dr. Mayer? How is my baby?" She reached out to touch him.
CHAPTER 17
DEPARTMENT OF HOMELAND SECURITY, NEBRASKA AVENUE CENTER, WASHINGTON, D.C.
Hobbling into the conference room, Gwen Savard couldn't conceal her gimpy ankle from Alex Clayton, the CIA Deputy Director of Operations, or any of the other members of the Bioterrorism Preparedness Council. Gwen had no one to blame but herself. She had continued to run on the treadmill at the gym for days after her injury, and now she paid the price. Maybe Peter had been right when he'd once jokingly described her as a dog with a bone and a bad case of lockjaw.
All fifteen members of the council were already around the oval table when Savard took her seat at its head. After she made a few brief remarks, the meeting unfolded predictably. They discussed the old standards of bioterrorism--smallpox, anthrax, the plague, and so on--recycling data they had seen before without shedding new light. They reviewed the sixth draft of the generic urban centers' Emergency Response Plan to Biological Attack, known by most of them as ERPBA, without reaching consensus.
Savard had difficulty concentrating on the debate. After her conversation earlier in the week with Haldane, she had filed the Gansu Flu into the recesses of her mind; worthy of no more than a mental footnote. Now with its sudden reemergence, she could focus on little else.
After the committee covered the agenda items, Gwen said, "No doubt, everyone here has heard that the Gansu strain of influenza has shown up in London. At last report there are at least fourteen cases and three deaths. And in Hong Kong, there are now five confirmed infections and several more suspect cases."
Halfway down the table Moira Roberts, the Deputy Directory of the FBI, leaned forward and squinted at Gwen. "And this has to do with bioterrorism how?"
In a plain black suit and gray blouse, which matched her prematurely gray hair worn in an outdated bob, Roberts struck Gwen as the epitome of frumpy. "No one seems to know how the virus got to England or Hong Kong," Savard said.
"Have you considered travelers from China?" Roberts asked in a tone that made it unclear whether or not she meant to be facetious.
"It did occur to me." Savard matched Roberts's tone. "But unlike SARS where the index cases were easily traceable, they have found no link in London or Hong Kong to the Gansu outbreak."
"Which means it must be bioterrorism, right?" Roberts said, no longer bothering to mask her sarcasm.
"Which means," Gwen said slowly, suppressing her mounting irritation, "we cannot discount the
possibility
of terrorism."
"It might be a while before you can discount any possible explanation for the outbreaks," Roberts pointed out.
Gwen didn't doubt Roberts's intelligence, but her agitative personality made it impossible to warm to the woman. "So in the meantime we just ignore it?" Savard said.
Roberts folded her arms and sighed. "That's not what I'm trying to say."
Annoyed, Clayton cut in. "What are you trying to say, Moira?"
"I remember we had similar discussions around SARS," Roberts replied, talking to the table instead of Clayton. "Some people were convinced it was a biological weapon dreamed up by Al Qaeda. That didn't exactly pan out, did it?" She sighed. "No doubt this new virus poses a potential major public health risk to the United States. I don't discount that for a minute. What I suggest is that we wait to learn more before we overreact and waste precious resources chasing phantom terrorists when other departments, like Health and Human Services, will have more pressing priorities to address."
A few of the members around the table nodded, but none spoke up, appearing content to sit on the sidelines.
Ignoring Roberts, Clayton turned to Savard. "Gwen, how do we find out where this virus came from?"
"Finding the index case or cases is the key," she said.
"And if we don't?" Clayton asked.
"That would concern me," Gwen said gravely. "With almost every epidemic of this magnitude, the index case is readily identifiable. The person usually seeks medical attention just like any other victim. And if they don't then you have to wonder if he or she is deliberately avoiding detection."
"But, Dr. Savard," Roberts said, "I understand from the newspaper that this bug is only twenty-five percent lethal."
"Only!" Gwen said. "That's a devastating mortality rate. Most flus run at a mortality rate of far less than one percent. And those influenza strains kill only people at the extremes of age. This bug is killing otherwise healthy children and adults at a rate of twenty-five percent. That is up there with smallpox and flesh-eating disease!"
"And people recover quickly from it," Roberts continued as if Gwen hadn't spoken. "So the index case might have already recovered without thinking he ever had anything more than a bad flu. Or conversely, he might have died somewhere and no one has connected his death to the outbreak."
"So two people carry the virus over from China to London and Hong Kong, simultaneously, and then both die in obscurity? What are the chances?" Savard held out her hands, palms up.
"I'm simply suggesting that there are several reasons aside from terrorism for the index cases not to have materialized." Roberts nodded to Gwen, as if mollifying an irrational child.
"Moira, Moira, Moira," Clayton said with an exaggerated sigh. "I've heard the Tony Robbins tapes too, but wishful thinking isn't going to make everything okay this time."