The Nightmare Scenario (24 page)

“The reason I am wondering, doctor,” she insisted, “is that, as you can see, the patient has coagulated blood in his left ear. Surely this is not a typical symptom of pneumonitis?”

As always, she didn’t know when to shut up. “No, it is not typical, but it does happen.”

“It might not be my place,” continued Suyin, “and I of course will defer to your opinion, but isn’t this case awfully close to the symptom descriptions of the new flu from the WHO’s latest flash report? Look at the specks of blood in the mucus he’s coughing up.”

Jafri had no idea what Suyin was talking about but maintained his composure. “No, I disagree, it is nothing like that. This is an archetypical case of pneumonia.”

“In that case, doctor, for our learning benefit, maybe you could clarify what part of the WHO’s description does not fit this patient?” said Suyin, handing him a WHO flash, her insolent cynicism all too clear in her voice.

Jafri skimmed the text, and even though his attention was elsewhere, when he came to the end, he realized its importance and reread it thoroughly from the beginning.

He went through the symptom characterization step by step, every now and then casting a quick glance at the patient or checking items on the patient’s chart. Once he realized that Suyin was indeed right, the muscles in his neck stiffened. His mind started racing. He needed a plan. Quickly.

Pondering his alternatives, he finally declared, “I still disagree with your assessment, but I have to admit there are certain aspects of the WHO’s statement that I overlooked. Let’s put the patient under observation. We will still go on with the antibiotics though.”

“But doctor, we have to isolate the hospital immediately! The instructions are unequivocal on that point.”

“Isolate the hospital? Nonsense! We will quarantine the patient. Put him in a separate room. That’s all.”

“Doctor, I will have to call this in. And I can assure you that once it reaches the WHO, they will call for full isolation of the hospital.”

“This is Kuala Lumpur’s largest hospital – the pride of our entire nation. We cannot shut it down on a whim. But to be prudent, we should take certain precautions. I will call the Ministry of Health to discuss this. I am certain that he will not close us down, but it is his call to make, not mine. Or yours.”

Jafri walked out of the ward calmly, only picking up the pace as soon as he was out of sight of the students. He grabbed his coat and briefcase and jogged to the elevator. Once down in the parking garage, he called Suyin on his cell phone.

“Suyin, I have spoken to the Minister. As doctors, we must put patient safety before politics and national
pride. I have convinced the minister that it would indeed be in our best interest to take certain preventive measures, even if they may seem drastic. We should shut down the ward at least. Contact the WHO and if they advise it, we will close the hospital.”

Jafri hung up and sped out of the parking garage, leaving the hospital well in advance of any potential quarantine being put into effect.

AUGUST 8
^TH
, 3 AM, AEOLUS RESIDENCE, LAUSANNE

A
eolus woke up with a jolt as the phone rang. He swore and hoped to God it wasn’t Ed calling with another false alarm. It wasn’t. It was Dr. Chen-Ung Loo.

“Aeolus, it’s in Jakarta.”

“What?”

“Yes, five people.”

“How come I’m hearing this from you and not my own staff?”

“Most likely because they’re sleeping.”

“Sleeping? All of them? Sometimes I wonder what I pay them for.”

“I’m calling to inform you that we, New Zealand, and, I think, Japan are now moving to a hard quarantine.”

“Sweet mother of Jesus...”

“I’m sure you all have work to do, so I’ll leave you to it.”

The line went silent.

Aeolus rubbed the sleep from his eyes and rushed to throw on some clothes. He didn’t bother to put on a tie. This was bound to shock people at the office, as he had never been seen there without one.

Upon arriving at the office by means of a cab Tomomi had managed to somehow conjure up within minutes, Aeolus was met by a flurry of activity. As he crossed the lobby the lone woman in the reception shouted, short of breath “Dr. Hughes, the phones are ringing off the hook. I can’t handle it. I’m not sure what to do.”

Aeolus didn’t slow down. “Ditch all calls from press and politicians until Stan Russell shows up. If it’s our staff, Walt will get back to them once we have a handle on things. Any calls from Indonesia or Singapore, though, go through to the SHOC. We need those calls so you have to keep the lines open. If you need help, Mandy should be here any minute. She’ll know what to do.”

In the elevator, Aeolus repeatedly punched the button for the third floor, as if it would somehow make the ride faster. His eyes were fixed on a single speck of dirt on the floor, while his mind raced through what they needed to do, and ranking their order of priority.

When the doors opened, he was surprised to find, not an empty corridor, but people walking, talking, even running. It had to be the night shift, but he had no recollection of it being that large. Two people jogged past him, one snapping, “I don’t care about their historic health records! We need full history of their movements and interactions the last couple of days! Find them, right now! If they haven’t done it down there yet, get them started!”

In the corner of his eye he saw another staffer in an office yelling on the phone, with what he assumed to be hospital staff in Jakarta.

“Yes, we
do
have your symptom descriptions, but we want pictures! Pictures of the patients! We want to examine the visible symptoms ourselves. What? No! Pictures! You know, digital camera? Snap snap? Email?…”

The man’s voice faded as Aeolus continued down the corridor. He turned the corner to find a crowd outside the SHOC. After a couple of steps he realized why. A group of janitors had formed a line, with trash going out, and fresh office supplies going in.

He joined them and said, “You guys are here early, or late, or… whatever.”

“Yes, Dr. Hughes, we were just leaving for the night when we got the support staff emergency message, so we came right back.”

“The support staff emergency message?” Aeolus’s eyes found Walt, who shrugged.

“Whose idea…? Never mind.” Someone was taking initiative. There would be praise, but it would have to wait until a later time.

“Do you need anything else, Dr. Hughes?” asked one of the janitors.

“Yes, we’re going to need…” He stopped in mid-sentence as he saw the three freshly brewed pots of coffee already in place.

“Nothing, actually. We’re ready to go. Thanks, guys.”

“We’ll be outside if you need us.”

An hour later, the SHOC was full, with everyone trying to disentangle what had transpired and led up
five people now being in a hospital in Jakarta with the Maluku Influenza. What they’d managed to piece together so far was the following.

A week ago, a man of about seventy years of age had returned to Jakarta after visiting relatives in Bungaya. Bungaya was within the current quarantine zone, but was not at the time.

When he returned to Jakarta, where he lived with his two sons and their families, he fell ill. This was not unusual – he was old and weak and often fell ill. The family had not bothered to take him to a hospital as this was nothing out of the ordinary and they couldn’t afford the bills. Three days later, rather than being suspicious they remarked on how long he had lived – much longer than many people in the area.

The next day, the youngest grandson developed a very high fever. The following day, three other family members were showing symptoms, and the boy had started coughing blood. At this point, the family sought help at the local hospital.

They tested positive for the Maluku Influenza. Just six hours after their arrival, about the time when the tests came back, a fifth member of the family came to the hospital with a high fever.

The good news was that the old man hadn’t left the family’s apartment after arriving home. The others, however, had gone about their business as usual.

After hearing the back-story, Aeolus summarized his bleak view of the situation with an air of finality.

“Indonesia is lost. There’s nothing we can do to stop the spread in Jakarta, and from there, the entire
country as people start fleeing the capital. My guess is we already have fifty people walking around the city spreading the virus.

“I’m going to pull Rebecca out of Maluku. There’s nothing more she can do there and we’ve learned all we can. She’ll take over the New Delhi regional office and coordinate our response to any cases that might show up outside of Indonesia. And I’ll ask her if she can find anyone who’s survived the infection and speaks English to bring with her. Immunity could become a major asset very soon.”

“You’re not sending her to Jakarta,” noted Ed. “Why?”

“Because Jakarta is going to be a deathtrap in a couple of days, with or without respirators.”

“But, Dr. Hughes,” cried Ed, “we can’t abandon Indonesia! It’s moral turpitude. There are sick people there. They need our help. What about our duty as doctors?”

“I dare say, Ed, that I know very well what our duties as doctors are, and, believe me, it causes me great grief, but our duty as epidemiologists is to stop this from spreading, and that’s now best done outside of Indonesia. Treating the patients is going to have to be the job of Médecines Sans Frontières and the Red Cross.

“Anyway, our only chance now is a full quarantine of Indonesia, which will be tough given its proximity to, and the attitude of, Malaysia. That, and praying that no infected have left Indonesia already. If it hits the Asian mainland, there’ll be no stopping it.”

He turned to Stan, who had just joined them.

“Stan, options for extending the quarantine?”

“For the whole of Indonesia? That’s unprecedented, boss. You’ll need to pass a resolution in the General Assembly. The Security Council won’t cut it. Also, the Malacca Strait is long and narrow. I don’t see how it would be possible to uphold an effective quarantine.”

“I think I know some guys who can… What about the airport?”

“There, we might have some options. Pressure from the US might work.”

“Okay, I’ll see if Hank can take care of the airport. Surely, there has to be a brain somewhere within that mountain of adipose tissue. The flight to New York is eight hours, which would have me landing at about seven in the morning. How quickly can we call a meeting with the General Assembly?”

“That usually takes a couple of weeks.”

“Make it happen for one o’ clock local time, and also draft a resolution to the effect of what we just discussed. Have it ready for when we arrive.”

“But the representatives might not even be in New York.”

“We’ll take what we get. This might be the
last
chance we have to contain it. If we don’t, or if it’s already out there, we are moving from casualties on a scale of millions to a scale of hundreds of millions.”

“Okay, boss, I’ll get it done. Somehow.”

Aeolus grabbed his coat and went out to his car while raising Tomomi on the phone.

“Yes, Mr. Hughes.”

“Tomomi, I need a flight from Geneva to New York immediately.”

“Okay, it’ll have to be private, but there are available jets in Geneva.”

“I also want you to leave Hong Kong and go to your family in Japan.”

“May I ask, why, Mr. Hughes?”

“Because if I’m correct, Hong Kong is going to be a dangerous place in a couple of days. In fact, it might already be. I want you to leave straight away.”

“Mr. Hughes, I will leave when my shift is over.”

“Really, Tomomi, that’s not necessary. Mandy will be here any minute. I can take care of myself in the meanwhile.”

“Excuse me, Mr. Hughes, but we both know that’s simply not true. Anyway, my shift ends in five hours. I’ll be on the next plane and be set up and ready in Osaka before Jitsuko clocks out.”

“Fine. Then get me Hank Wiley.”

“Ryokai!”

It took about ten minutes to locate and wake up Hank. Aeolus was already walking up the stairs in his mansion as he came on.

“Aeolus, for God’s sake, it’s two o’clock in the morning. What on earth is going on?”

“Hank, listen. We have a confirmed outbreak in Jakarta. Several infected, not an isolated incident. Someone got out before the quarantine line was set up. We need to shut down the airport immediately. I’m going to address the UN and I’m convinced I can get the backing required retroactively, but we need it shut down
now
. If you can keep it out of operation for eight hours, I can take it from there.”

“I’m sorry, Aeolus, but I couldn’t do that even if I wanted to. Not just like that. This would be a serious international incident. We need to go through the proper channels.”

“Hank, you damned lemming, we need this
now
! We can’t wait for every government agency to weigh in. Just trust me on this – for once!”

“I simply can’t get it done. It’s not within my power. And even if I could, I’m not sure I would. I still don’t agree with your assessment of the severity of the situation. Just because those aboriginals can’t handle it does mean we can’t.”

Aeolus sighed and hung up without bothering to say goodbye. He was cornered. There was only one card left to play, one last rabbit left inside the hat. It wasn’t guaranteed to work, but it was all he had. He picked up his cell phone and pressed an icon labeled “Wonderful Words.” The screen went black and a call was connected.

“The Atlantis Hotel, good evening, how can I help you?”

“Good evening, my name is Dr. Hughes, could you connect me to Mr. Finegold, who I believe is staying with you tonight.”

“Dr. Hughes, are you aware that it is the middle of the night?”

“Yes, it’s sort of an emergency.”

“Okay, let me see… No. Apologies, sir, but there is no guest with that name staying with us.”

“I see, I’m sorry, I must have got my dates mixed up. Thank you anyway.”

Aeolus went to his study and found an IPS-encrypted cell phone in the top drawer of his mahogany desk. After ten minutes, the phone rang.