“Wait a sec. I don’t want you leaving the house. And you can’t have any friends over. Okay?”
“Whatever.”
The second her father was off, Emma called her best friend, Kyra, and announced, “Guess what? I’m cutting.”
Kyra asked why.
“My dad is making me. Seems there’s an epidemic or some such shit.”
“I didn’t hear anything.”
“He said it’s not public yet. Come over and let’s hang out.”
“I don’t want to get detention.”
“You won’t. He’s going to write notes for us.”
“Seriously?”
“Yup. Where’s your mom?”
“She worked last night. She’s not home yet.”
Emma had one word for her. “Perfect.”
*
Jamie did the best he could to look presentable and hustled over to the small conference room in the Biocontainment Unit. The unit had six high-level isolation rooms. The last time one had been used was for a suspected case of Lassa fever a year earlier. He had turned the rest of the floor into a makeshift quarantine shelter for the medical workers and patients unlucky to be in the ER when Andy Soulandros came in. As a precaution, the emergency exits were alarmed, and the elevators programmed to skip the floor. Cots had been wheeled into the corridors and Jamie walked softly so as not to wake people.
The conference room had a video link to the O’Keefe Auditorium where medical grand rounds were held every week. Checking the video feed, he was surprised how many were present this early in the morning. The people he recognized were all from Mass General—the CEO and chief operating officers of the hospital, the physician-in-chief of the department of medicine, the chief of infectious diseases, the chief nurse, and the chief of the infection control unit.
Creighton Collins, the hospital CEO, was stooped over, talking to a much shorter man. He noticed Jamie when the projection screen came alive and transferred him from the large screen to a laptop on the podium.
“This is Dr. Abbott,” Collins said, calling the shorter man over. “Jamie, this is Dr. Hansen from the Center for Disease Control.”
Hansen was mostly bald and a little fat. When he furrowed his brow, the folds extended up to his scalp.
“Mark Hansen,” the man said. “I’m the director of the Global Rapid Response Team. We’ve got a team of officers here from viral special pathogens, epidemiology, and emergency operations. I’m sure we’ll be making all the introductions. It looks like all the right people are here from the state and city. Good job mobilizing resources quickly.”
“We just called everyone we could think of,” Jamie said.
“Feeling okay?” Hansen asked, as a doctor would.
“I’m good. No symptoms. As far as I know, everyone in quarantine is well this morning.”
A burly fellow in a dark suit was standing nearby, talking to the Boston Police Commissioner. He joined the gaggle and was soon filling Jamie’s screen with his pugnacious face.
“So, you’re the asshole who got me out of bed at three this morning. I’m Dmitri Kovachek, the mayor’s chief of staff. You better not be the boy who cried wolf.”
Jamie wasn’t sure if this was tongue-in-cheek, but he didn’t think so. “You’d prefer a real crisis?” he said.
“To a highly embarrassing public relations disaster? The way I’m feeling right now, it’s a toss-up.”
Hansen leaned into the laptop microphone, lowering his voice. “I’m afraid this is the real deal. We put out a network alert six hours ago, describing what we knew about Dr. Abbott’s index case and the related case from Baltimore. We’ve been getting pinged all night about possible cases from multiple states, the District of Columbia, and Puerto Rico. You’re not even alone in Massachusetts. The last data I got on board the plane indicated four other possible cases in Boston, one in Fall River and one in Worcester. Dr. LaMotta, the director of the Viral Special Pathogens Branch—the woman over there on her tablet—is getting real-time data. She’ll update us.”
“Jesus,” Kovachek said. “Do I need to be wearing a mask?”
Collins told Jamie that after the preliminaries, the CDC wanted him to present what he knew about the gene therapy trial and the clinical status of the first patient. Then the CEO stepped to the podium to call the meeting to order and pushed a key on the laptop to transfer Jamie’s feed to the big screen. To get everyone oriented, he had people stand and introduce themselves. It took several minutes to make it around the auditorium because, in addition to the hospital personnel, there were representatives from the Massachusetts and Boston departments of health, state and local preparedness and emergency services, law enforcement, and a sizable contingent from the CDC.
“All right,” Collins said, when the last person spoke. “It isn’t every day when a neurologist closes down the largest hospital in Boston, but Dr. Abbott sounded the alarm on a troubling case and our disaster protocols kicked in. Dr. Abbott is speaking to us from our Biocontainment Unit where he, and other personnel who were in the Emergency Department when the patient was brought in, are in quarantine. Dr. Abbott, you have the floor and given the video link, let’s everyone try to hold questions until he’s finished.”
Jamie started with a summary of the Baltimore clinical study and the events leading to Mrs. Noguchi’s death. He followed with Andy Soulandros’s presentation to the ER the night before. Then he segued into Mandy’s initial analysis of the hybrid virus and its altered NSF-4 payload.
Despite the CEO’s plea, Jamie saw a hand go up from the audience. It was the mayor’s chief of staff.
“Look, I’m not a brilliant doctor like a lot of you ladies and gentlemen,” Kovachek said, “but how the hell do you get off unleashing dangerous viruses into the world?”
Jamie chose his words carefully. “Over the past twenty years there have been thousands of gene therapy clinical trials approved and conducted worldwide. The vast majority have utilized adenovirus vectors similar to the one that Dr. Alexander developed in Indiana. Every aspect of the Baltimore trial was done under the auspices of an FDA-mandated safety committee. Multiple levels of checks and safeguards were built into the protocol.”
“And yet, here we are this fine morning,” Kovachek said.
Jamie said, “It’s undeniable that certain protocol violations occurred in Baltimore. They shouldn’t have happened, but they did.”
Jamie saw another hand go up. “I don’t know who that is but the woman in blue, your question?”
“Hi, I’m Heidi Moscowitz, one of the CDC epidemic intelligence officers. When are we going to have more data on the sensitivity of the suicide gene?”
“Soon, I hope,” Jamie said. “We’ve been trying all night to reach the principal investigator of the trial, Dr. Steadman. The assembly of the viral payload and the fail-safe gene took place in his lab. Hopefully, we’ll know more this morning.”
The commissioner of the Massachusetts Department of Public Health wanted to know who had received doxycycline.
“About thirty people, most of them staff. Everyone who was in the Emergency Department when the patient was admitted.”