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DESPITE THAT HE HAD continued to work until 11:30 last night, Glenn was awake at 5:15 so he could be on the road before rush hour traffic hit. He had seen where Will Washington had lived. Now he wanted to see where he had worked. Roy and Harper would meet him for breakfast at 7:00 at a Denny’s in a central location, and then they’d continue to work in the community while he went back to the hotel to deal with the influx of CDC workers from Pennsylvania and Atlanta due between 8:30 and 9:30. The director had decided to keep their New York people in place, because if the flu was in New Jersey, it was certainly in New York, or it would be soon, and the population density meant it would be even worse there than what was going on in Trenton.
But first things first. In the pale light of dawn, he drove up north toward the airport, to the gas station where Will had worked for the past four years. It was open—good. In addition to a small store, which had a coffee machine and a few racks of groceries, it had eight gas islands, one marked full-serve. The rest apparently were for gas and no extras. He parked as if he were going in to buy a candy bar or coffee, turned around in his seat, and watched the one uniformed worker move from car to car. The man knew what he was about. He efficiently started and stopped gas pumps, collected money or credit cards, returned change or receipts to the drivers, and moved at a good clip.
For the worker’s sake, Glenn hoped a second person came on during the heart of rush hour. It took fifteen minutes for the first driver to drive up to full service. Glenn watched the attendant wash the windows, ask questions—the driver shook her head to each one—and Glenn thought about how the attendant was leaning in toward that window, passing the flu if he was contagious.
That customer left, and Glenn kept watching, hoping for something to jump out at him. It was certainly enough that credit cards were handed back and forth, that the attendant leaned into the drivers’ sneeze zones. Maybe a flu carrier had passed through, on his way from somewhere else the infection had begun, and then drove on to a place where he or she spread the infection further. It could have been someone flying in from Hong Kong and driving to rural areas, for all he knew. An infected person living alone, maybe dying alone? That would explain why there wasn’t another outbreak cluster somewhere else.
Emile or Chanchal would be dealing with the WHO to check if there were outbreaks overseas. He’d remind them to check with Canada. Could be the driver came over at Niagara Falls driving south and Canada had cases too. They certainly might—the border is merely a line on a map, and viruses couldn’t give a damn about that.
He was about to give up and leave when an SUV came in. It was black, and it was spattered with a good amount of bird droppings—excreta, to use the term epidemiologists preferred. The attendant took out a rag and began cleaning the windshield.
Damn. Glenn was out of his car and running toward the attendant before he thought it through. “Drop the rag,” he yelled.
The attendant turned, eyes round. “Mister, if this is a robbery it’s a strange one. You want my rag?”
Glenn stopped seven feet short of him. Just beyond sneeze distance. “Drop it. Seriously, right now. I’m from the CDC in Atlanta. Disease control. You knew Will Washington?”
“Yes. I just heard this morning when I came in that he passed.”
“It’s not impossible that bird crap on a car is how he got the disease,” Glenn said.
The fellow looked once at the rag, and then he did drop it, scrubbing his hands on his trousers.
“Go in and wash up, with hot water,” Glenn said, and then turned to the woman as the attendant scurried off. “Ma’am, I’m sorry to bother you, but do you live on the coast?”
“The coast?” She looked confused. “Are you going to pump my gas?”
“I don’t work here, sorry. I’m trying to find out what made someone who works here ill. There are bird droppings on your car. Fresh ones. I’m wondering, are they from seagulls?”
“No. It’s from parking under the big old maple I have at home. Several birds visit it.”
The excreta looked pretty sizeable.
“What’s the biggest bird you see at your house?”
“I don’t know. Blue jays, maybe. They’re the noisiest.”
Passerine birds. Not impossible. But this bird excreta wasn’t necessarily the bird excreta. “Do you mind if I take a sample?”
“Whatever floats your boat, mister. You can have it all, as far as I’m concerned. Am I going to get my gas, or what?”
The attendant came back, looking nervous. “Am I going to be okay?”
“I’m not sure this is how Will got the flu. You should close down the full service lane, though, just in case it was. No reason for you to put your hands on that stuff right now.”
“You’ll have to see the assistant manager about that. He’s inside.”
While the attendant went back to doing his job, Glenn sprinted inside and introduced himself.
“Can I see some ID?”
“Sure, good idea,” he said, and passed over his ID.
“It says ‘colonel’ here. You aren’t wearing a uniform.”
“I don’t start work until seven.” Easiest answer for now.
“Oh. This is about Will, I hear?”
Glenn explained quickly and said, “I need some trash bags. Five or six of them. And I’ll take some of these coffee stirrers and an empty cup.”
“I’m just supposed to hand them over, am I? What is this, martial law?”
“Just a favor, from one person up early and working to another early riser. Are you feeling okay, by the way? Achy, fever, tickle in the throat?”
That distracted him from his officiousness. “No. You think we can get what Will got?”
“Yes, you might,” Glenn said. “Can I have the garbage bags, please?”
The fellow went to a door in back, unlocked it, and handed him a half-used roll of garbage sacks. “Take all you want. Should I see a doctor?”
“The instant you feel at all sick, yes. Even a one-degree temperature, rawness in your throat—absolutely, get to a doctor.”
“Okay, I will.”
Glenn believed him. “Thanks for the bags.”
Glenn went outside and stopped the woman in the SUV just as she was about to drive away. He took a second to scrape up some of the bird excreta, popped it into the coffee cup, and as she drove off, he bagged it.
He went over to the damp, filthy rag on the pavement, shook out another bag, and picked up the rag without touching it, holding his breath as he did. He triple-bagged that, tying each bag off individually, and then he tied off the coffee cup sample in the same manner. He put both specimens in his trunk. This was as safe as he could be with the equipment he had on hand.
The attendant waved him down as he was getting in his car. “Wait. Is that it? What should I do? Am I okay?”
“We don’t know yet how Will got sick, and this is just one possibility. So close down that full-service lane like I told you. Have the manager phone me if he needs to know more. Wash your hands every time there’s a lull. Don’t lean real close to people in the window, and try not to put your fingers in your mouth. That’s about as safe as you can be. And if you feel even a little sick, achy, fever, coughing, get right in to an ER or acute care clinic, okay?”
“Okay,” the attendant said.
Glenn sped off, shaking his head at himself. He could have handled that better. And now he had biohazards in his car’s trunk. He wanted to get that packaged right and off to a lab ASAP.
Next time, fool, have your respirator with you.
It’d be arriving this morning with the rest of the CDC people from Phillie.
––––––––
AFTER WASHING HIS HANDS for a solid five minutes at the Denny’s, he mentioned his bird-dropping theory to Roy and Harper over breakfast, and they both added it to their list of questions and things to look for around homes of the infected. “Make sure you ask again if they keep hens.”
Roy said, “Is that even legal here?”
“Googling,” said Harper, working on her phone. “Noooo, I don’t think so. I see a different area in New Jersey that has a half-acre requirement, but I don’t think they allow it here in Trenton.”
“What do you guess the compliance for the law would be?” Glenn said.
“Hmm,” said Roy. “Ninety-eight percent? Better? Chickens make noise, so you couldn’t exactly hide that you had some.”
“Ask anyway.”
Back at the hotel, he left voicemails for Chanchal and Emile about his gas-station brainstorm while he awaited the arrival of the Phillie team, who were all driving in. They brought box after box: office supplies, computers, hazmat gear, and more. He had them store most of it in the second conference room, which he hadn’t used until now. “Someone designated to package swabs and samples?”
A young man who looked to be of Middle Eastern descent raised his hand. “That’d be me. Javed Wasir.”
“I have some samples in the trunk of my car.” He described it and what was inside as he handed over the keys. “Put on a respirator and gloves, please, before you touch anything.”
“To Atlanta, or is Phillie okay?”
“Phillie’s lab will get me the results faster?”
“No, probably the opposite.”
“Then Atlanta, please.”
Before they were organized, the Atlanta contingent arrived, bringing gifts of boxes of donuts, muffins, and croissants. He designated one table a food table. “I’m going to see if I can get a big coffee percolator from the hotel.”
By the time he had returned from doing that, people were settling down. He called the meeting to order. There was someone from Communications who needed to meet with the mayor and Alverez, who was due any minute, and any other politico who might be dealing with the press. By noon Trenton residents would know there was an epidemic. Two on-site researchers would work under Roy, getting out to every clinic and doctor in the area to gather names and then interview sick people in their homes. Someone would visit mortuaries and explain safe procedures for handling bodies. One person each would stay at each of the two hospitals all day, liaise with Ellis and her counterpart at the second hospital, talk with hospital administration, and keep an eye on admissions and deaths. Javer would stay here and function as an overqualified administrative assistant to Glenn, one who could also field technical phone calls and understand what information was being phoned in.
The new Atlanta people reserved rooms at the hotel and reserved a spare, just in case the place got crowded and ran out of rooms. The Phillie people were going to commute. None of them showed any resentment at all that he was in charge, for which he was thankful. He’d have a hard enough time with the locals before this was all over—he didn’t need his own team rebelling.
When this was all over? When would that be?
He set to work, organizing with Javer. Punching new staff phone numbers into his phone took him twenty minutes, and he resented every one of them.
Javer took mid-morning reports from Harper and Roy, and the identified cases were up to almost a thousand. This wasn’t going to be over any time soon. “We have no control at all over this,” he muttered.
“We’ll get there,” Javer said. “I have a few clips from the morning news and local talk shows queued up on my computer, if you want to see them.”
“Thanks. I guess we need a TV in here.”
“I’ll go arrange for that while you watch these,” Javer said, and he left the room.
The clips allowed Glenn to see the mayor of Trenton as well as Alverez, who came across as calm and capable on the screen. The mayor got a few details wrong, but he did get the right general message out, that there was a bad flu going around, schools would close early to keep children safe, and people should make sure to wash their hands often. Alverez asked that anyone who felt ill wear a mask when out in public. That was good advice, but only 5% would, and probably not until the illness had touched someone they personally knew. By the time they got 50% compliance, masks would be sold out and the flu would be raging through town, affecting most of the families in Trenton.
When Javer came back, he was lugging two big boxes. “From the front desk for you. From a Stevens in Atlanta—your wife, I assume.”
“Sister. I’m single. My uniforms.” He said, “I’m going up to my room to change.” The uniform would add some authority behind requests for—well, everything, from a couple of garbage bags at a gas station to a big percolator from the hotel to cooperation from a lieutenant governor, should he need that.
He phoned the desk and asked if they had a laundry service so he could get the dress blues pressed. They didn’t, but there was an iron he could request. Would he like that? He agreed and spent five minutes in his room ironing the worst creases out of the uniform. He hung the dress blues in the bathroom, turned on hot water in the tub and let it fill up a couple inches, closed the door, and hoped the rest of the wrinkles would steam out, trying not to resent the fifteen minutes he had spent at this. He donned his khakis.
Back in the conference room, he said, “What’d I miss?”
“Nothing I couldn’t deal with, but I’ll update you, if you’d like.”
He waved that away. “Okay, next up, we need to set up a clinical database. We need to get case definitions to get out to primary care providers and the hospitals. Coroner too. What is our case definition?”
“You tell me. I’ll take notes.” Javer bent over his laptop.
“Death from pneumonia for hospitals and the coroner. Everyone else, sick more than three days, fever of over 38C, conjunctivitis—make a note to check with the field team on that, but I saw it in the first cluster. Contact with birds or their excreta. Uhhhh.”
“Coughing, sore throat, usual flu symptoms?”
“Yes.” But he was trying to think of what would distinguish this from a head cold. “Difficulty breathing, O2 sat of under 85. No, call it 88. Can you phone the field team and read that to them? Start with Gillens and Bail, then the others. Ask for their input and adjust accordingly.”
“Will do.”
What else? He needed to draft a notice to the FDA about possible bird vectors for the flu. And he needed to hunt down New Jersey’s fish and game department, whatever that was called. He sat at his laptop and searched for the name, finding it in .32 seconds, bless the internet. Fish and Wildlife. He clicked on pages until he had a name and email address.
Somewhere, somehow, say this flu had gotten into American birds. And then it had made the jump to humans. Both of those were new realities. Both were mysteries. There were two possibilities regarding the birds that carried it. One, that they were only a host, didn’t get ill themselves, and merely transmitted the disease. Possibility two, that they did get sick and some died. He was trying to nail down the vector of transmission, the way that people got it and from which species, which might or might not be the host species, where the thing had resided before it started jumping to humans. Excreta or saliva from birds might be the means of transmission.
Here’s what he needed: One, any reports of unusual bird deaths in the past six months, though those should have been reported up the chain when they occurred. Two, collection of species and testing of blood. They needed gulls first—CDC New York had a vet who could do that within an hour or two. But every other bird was under suspicion—passerine birds, raptors, exotic birds at zoos. Zoos. Had he reminded his interviewers to ask about visits to the zoo? Was there a zoo in Trenton? He made a note to hunt down that fact.
He was starting to draft the memo about bird deaths for CDC Atlanta to send out to US Fish and Game and New Jersey Fish and Wildlife when his cell rang. It was Harper.
“We’re starting to run into each other out here. Do you want to reassign me?”
“Come on in if you don’t mind leaving the field. I want lots of data, crunched lots of ways. You can stay in here, take all those calls and emails, and work your magic on the facts. I want survival curves, race-specific, age-specific data, histiographs. And maps and pie charts for public consumption. All of it.”
“Headed back, boss. Want me to bring you lunch?”
Was it that late? He checked his watch. It was. “Yeah, anything, and something for Javer.” He waved at Javer, who was on the phone. He asked him, “Any dietary limitations?”
He wrote something on his laptop and held it up to show Glenn. “No pork.”
“No pork for Javer.”
“I’ll get the halal meal deal,” she said, but without rancor.
Still, not a joke to make anywhere in public.
“Sorry, weird sense of humor,” she said into the too-long silence.
“Be careful with it,” he said. “See you in—whenever.”
He had just hung up the phone when it rang again. Ellis. “Hey, Ellis,” he said. “What’s up?”
“We just moved the little girl from the Washington family into the ICU. I thought you’d want to know.”
“Shit,” he said. “Sorry about my language.”
“No, that’s about right. It’s my feeling about it too.”
“Not responding to the antivirals?”
“Apparently not. We do have one patient who might be. Or has a strong natural immune system—hard to say which.”
“What’s Jasmin’s status? The little girl’s?”
“Her BP is so low we can’t start an IV. They were about to intubate her the last time I looked in.”
“Is she going to make it?”
A hesitation. Then she must have realized she didn’t need to pretty it up for him. “I suspect not. If she lasts twenty-four hours, I’d be surprised.”
He felt helpless. If he were there, he couldn’t do anything either. He thought of Ms. Washington, losing a son and now her only granddaughter. “Grace White?” he said.
“Died this morning. I’m sorry.” After a moment of silence she said, “Not to be insensitive, but the death rate is making the staff extremely careful about following your protocol. Everybody is washing like mad. Respirators, face shields, the whole protocol, right down the line. Everyone is in compliance.”
“What is the death rate? I know there aren’t enough cases in the whole city to say yet.”
“So far, every ICU admission we’ve had isn’t making it 48 hours.”
“Every one?”
“So far.”
“That should improve. I hope.”
“We all hope.”
No kidding. A 100% fatality rate would be...“disastrous” wasn’t a big enough word for it. He found himself rooting for the typical HPAI rate of only 60%. Only.
He thanked her for the call and hung up, sparing a thought for the sweet, smart, sassy little girl he’d met in her house. Before he started getting teary, he turned his thoughts away. He had to work fast. Jasmin’s fate was sealed. Some other smart, sassy kid might still be saved.
Let’s hope she hadn’t infected her whole class. “Javer, you off the phone?” he said.
“Yes.”
“There was a girl mentioned in my notes—mailing them to you now—Jasmin Washington, JW, eight years old, African American. I’d like to track down what school she was in, what classroom, and interview contacts.”
“Yes, sir.”
He was giving up on correcting that phrasing. Besides, with the uniform on, he was “sir” to many of these people.
He drafted the memo and sent it to Emile with a covering note asking him to proof it and pretty it up and get it out under the official authority of Atlanta CDC. He phoned Chanchal to ask if they knew anything more yet about the virus. He knew she’d probably phone him as soon as she knew anything, but he was anxious for the information.
“Funny you should ask. I’m outside the lab right now, checking results.”
“What’s the story so far?”
“We’re still saying H5N1, but it’s looking more and more like it’s not anything we’ve seen before.”
“What do you mean?”
“Tentatively, based on preliminary RNA, we’re looking at a new subclade—2.2.3, I believe it will be. I’ll have to look it up at WHO to get the right number.”
“What’s going on here?” He was asking himself. She wouldn’t know more than he did.
“We need to sequence it to know for sure, so that’s not written in stone. You know that’ll take time.”
“But it is new? New-new?”
“Yes. I’m, oh, 98% sure no one has reported this flu before, not even in animals.”
“Chanchal.” He didn’t want to say it aloud, but it had to be asked.
“Yes?”
“Is this a natural mutation?”
She hesitated. “You know we can’t know that. It will take weeks to be certain.”
“Guess.”
“Not yet.”
“As soon as you have a guess, you’ll tell me?”
“Of course, if you promise not to quote me.”
He said, “Should we be calling in the FBI anyway?”
“And have them look where? We don’t even know the vector, much less the host. It could be entirely natural. You know as well as I how avian flu mutates.”
This was all true. “In my not so humble, etc., I think Compliance should call the labs that have been experimenting with H5N1 anyway and make sure it isn’t one of them and an accidental release.”
“Yes. I agree. I’ll take care of that. In fact, I’ll recommend on-site inspections. If we’re lucky, we’ll find it and shut down the source. If not, at least no one can say we didn’t perform our due diligence.”
“Good thinking. I sent some bird excreta to you this morning. It’s winging its way there now.”
“Tell me that wasn’t an intentional pun.”
“Well, yeah, it sort of was.”
Chanchal made a choking sound. “I hate puns.”
“I’ll control myself in the future.”
“And I’ll get those samples tested as soon as they arrive. We need people looking at bird mortality.”
“They just sent off the memo a minute ago to involve Fish and Game. I was CCed.”
“Good. Stay in touch.”
“You too.”
He took a moment to check his notes and he did some more Googling. There wasn’t a Trenton Zoo. There was a Philadelphia Zoo, and there was a safari park in New Jersey, but not in this county. He made a note to have someone call each and see if they had unusual bird deaths. Next, he took a moment to organize and consolidate his to-do lists, which were getting spread all over several documents and devices. Once he had done so, he jotted down priority ratings for everything on the list. Eleven items were highest priority. First thing, he wanted a CDC vet here as part of his team. That person could also contact the zoos. He phoned Emile and made the request, asking that it happen by tomorrow morning.
By the time he made it halfway through the list of eleven crucial tasks, Harper was there with lunch for the three of them.
He caught up her and Javer on what he had done, but he didn’t mention Chanchal’s suspicions. He wanted his team keeping an open mind about everything, and not until he had an official determination about clade or origin of the virus was he going to share it. As to the question of if the mutation were natural or designed by people? He was sure that question was already in the minds of most people here.
The afternoon passed in a blur. He asked that everyone be back for a 6:30 dinner meeting and sent Javer out with his credit card to find a grocery store so that dinner could include salads and fruit for a change. He hoped everyone was stopping for meals, but if they weren’t, he could at least make sure they ate one good meal a day.
Javer pointed out that the hotel might not like them bringing in their own food, and he asked him to please do whatever needed to be done to smooth that over, and then he promptly forgot about it.
At five, he turned on the local news to see how the flu story was being handled. It was buried after the first commercial break. The CDC communications expert, a woman named Bird, strangely enough, had gotten the message more on-target, but it was still Alverez delivering it, which was as it should be. The mayor was nowhere to be seen, not in the broadcast he watched.
His staff started filtering back. A few helped Javer set up a buffet table for dinner, and some of them began to eat. At 6:30 most were back, and the presentation began.
Harper had been working diligently all afternoon and had even better maps and data than before—and she didn’t have to dumb down her presentation for non-epidemiologists this time. The one crucial piece missing was a mortality rate. She said to the group at the end of her slideshow, “We don’t have enough cases yet to set a fatality rate or anything that flows from that data. Probably it will be Friday before that’s possible, and even then, it’s not going to be good enough for public dissemination. Just enough to help guide our thinking.”
Others reported their discoveries, asked each other questions, and reminded each other of gaps in the investigation. Glenn mentioned his phone calls to the zoo and safari park, and that no bird deaths—nor mammalian deaths—had been reported there. The meeting took over an hour, and then he sent everyone off with an instruction to get a good night’s rest while it was still possible. The Phillie people had an hour’s drive to get home.
He stayed, finishing work, and Harper stayed too, typing fast into her laptop.
“I though I told you to get some sleep,” he said.
“I will when you will,” she said, without looking up.
“It’s an order,” he said.
“You aren’t going to pull rank on me, are you?”
“I could. I’m dressed for it now.”
“Hmm,” she said, finishing with a couple of slow clicks of keys, and then looking up. “Maybe I’m trying to nudge you toward getting your own good rest. I’ll leave when you do. If you exhaust yourself, I’ll be exhausted too. Only if you rest can I.”
“Are you the oldest in your family, Harper?”
Her lips twitched in amusement. “Only child. But yes, I am bossy.”
“Well, when you’re right, you’re right. I’m tired.” He stretched and then rubbed his eyes. Maybe just one more thing. He knew better than to go down that road. He closed the lid on his computer, sending it into standby mode, unplugged it, and stuck it in its bag. “I’m done.”
“Half a sec.” She finished up something on her computer, shut hers off, and tucked it into her rolling suitcase.
They shared an elevator ride up. She was on floor three. He was on four. “Goodnight,” she said. “Don’t cheat and work again.”
“Yes, Mom.”
She smiled and stepped into the hall, but then stuck her hand out and kept the doors from closing. “You do look tired. Have you taken your temp today?”
“No, but I will. You do too.”
“Already have.”
He made it to his room, hung up his uniform, and collapsed on the bed in nothing but shorts. He flipped on the TV, which he hadn’t had on since he’d been here. It was tuned to a network that showed old sitcoms. A Gilligan’s Island episode was on. He lay back, and the familiar voices had him asleep within two minutes.
