The Deadliest Strain

Chapter Twenty-Three

"I'm not sure, Mr. President, that it's a good idea for us to be in the same room as you," Faas said cautiously.

"Your people have investigated five sites now. Isn't that correct, Director Hanlon?"

"Yes, sir."

"And what were they?"

"Moosehead Lake in Maine. Sedona, Arizona. The law firm here in Washington. The Grand Plaza incident in Chicago. The fifth was the two bodies found last night at the bakery in Boston's South End."

"And have any of your agents been infected?"

"We've taken every precaution, sir."

"So none have been infected?

"No, sir."

"Then I consider myself safe."

Faas Hanlon would not have wished this mess on John Penn. He was a decent man and a pretty good president. But if being the first African-American president wasn't enough pressure in itself, Penn had taken office during a major scandal created by the former president, an election scam that had threatened both national security and the faith of the people in the whole electoral system. He'd quickly restored faith in the country's leadership, and for that alone, John Penn deserved four trouble-free years. Penn was popular with the people and with the elected officials in both Houses of Congress. As a result, for the first time in more than two decades, things were getting done in Washington. Congress was finally earning its salary, producing results for the people who'd voted the individual members into the office. Health care reform was being addressed. Education programs were formulated. The economy was on an upswing.

Unfortunately, not everything was going smoothly.

Troop reduction. Troop increase. Reduction again. Iraq had become a self-inflicted wound that wouldn't heal. America was too deeply entrenched in the troubles, not only in that country but in the entire Middle East. Aside from the ongoing civil war in the south of Iraq, Afghanistan had never been settled, and the Taliban continued to cause trouble. The Western world still depended on oil, and no one had an answer how to get out of the mess. There seemed to be no end in sight.

This outbreak, though, was potentially the greatest challenge John Penn's administration would face.

"What have you got for me?" Penn asked the group gathered before him.

Faas glanced at his boss, the secretary of Homeland Security, who had okayed them bringing along Bea Devera. She was just back from Sedona and, having worked the site there, she was a perfect candidate to offer constructive feedback. But they weren't the only ones on the hot seat. Cabinet Secretary James Abbott of Health and Human Services was there with the current NIH director, Rich Judson. NIH had been tasked with coordinating and interpreting all data on the victims. The EPA director had also been asked to attend this meeting, since every one of the sites where the disease had surfaced had to go through an equivalent of a toxic-spill cleanup. The press secretary had joined them a couple of minutes into the meeting, and assistants were hovering behind those at the conference table.

"It would not be inappropriate, Mr. President, to call this an epidemic, at this point," Dr. Judson admitted.

Faas and the NIH director had started this discussion on the phone before they all had arrived here. Including Chicago and Boston, the number of casualties had risen to twenty-four. Unlike the early outbreaks, though, when ten days had passed before there'd been another incidence of the disease, the outbreaks were coming at shorter intervals.

"I am sure that will make the American public feel much more secure. Maybe we should color-code it, too. Make use of some of the millions we spent a few years ago after 9/11," Penn said sarcastically. They were all used to his direct, no-nonsense approach. He turned to the Secretary of Health and Human Services. "Do you agree with that, James?"

"It's a mess, sir. I think that, at this point, it would be wise to put the fear of God in people."

"The fear of God is already in them," Penn commented.

"Not all of them, Mr. President," Judson replied. "Look at both Chicago and Boston. The casualties should have been limited to one at each site, but instead we had multiple deaths because of people arriving on the scene, discovering the bodies, and not taking the correct precautionary measures. I think most people still treat this as some sort of media invention."

The Secretary of Homeland Security chimed in. "A position that is understandable, considering we lose more people than this every day to car wrecks and cancer. But this situation is far different, and I don't know that finding the right words is enough to get this message across. Recent history has taught us to be wary of what is put in front of us. People have forgotten that they sometimes need to trust those in charge."

Faas knew Penn understood where the Homeland Security czar was coming from. During President Penn's reorganization of Homeland Security, Faas had been privy to conversations between his boss and the president. Several of those conversations had focused on how to regain the public's trust. For too many years, the color-coded Homeland Security Advisory System had been used too carelessly and with motives other than the national security. As a result, the general public had become numb to it. Several members of Congress had said publicly that the system had outlived its effectiveness. Faas agreed.

"I'm going to continue with my daily news conference until we have this situation under control," Penn told the group. "We won't keep any new incidents secret from the public. In fact, we'll announce that the incident in Maine has now been connected to this same outbreak. We'll increase the number of confirmed casualties, too."

"That was our largest blow as far as deaths," Judson reminded everyone.

"I don't want the focus to be on fear," Penn responded. "The truth is our best ally right now."

No one was about to disagree.

"What's happening with the DM8A production?" the president asked the HHS Secretary.

"The first production lots are out and distribution is going according to schedule," Secretary Abbott replied.

"Is it doing anything for us?"

"We don't know," the NIH director jumped in. "We think so. We have all the people who have had any contact with the victims on the serum now. There haven't been any more outbreaks, so we'd like to think the antibiotics are working, at least as a preventive measure with those who have had direct contact."

Faas knew it wasn't like Judson to be so vague, but there was so much that they didn't know about the disease and there'd been so little time for any serious research.

Penn rocked in his chair a few times, considering the situation. "Now, let's get to a more important issue. What's causing it?"

Faas felt as if he were back in high school. He didn't know the answer. None of the people in the room knew the answer and they were trying not to make eye contact. For his part, he'd heard very little chatter in the terrorist circuits about the attacks. Just as the health guys were working blind, the investigative effort was also operating in the dark.

"You must have something to tell me," Penn persisted. "How are these people contracting the disease?"

There was some shuffling of the papers. The president's stare was directed at the NIH director.

Rich Judson shrugged. "We know they're contracting it through something taken internally. At least, that's the situation with the first victim on each site. But we don't know what that substance is. We've ruled out any number of possible subst—"

"We know who the first victims were in each incident?"

"Yes, sir. From the autopsies, we've been able to determine the time of death, and in each incident, one victim is clearly more severely decomposed than the others. Our conclusion is that the initial victim contracted the disease prior to passing it on."

Faas saw Bea Devera take out a file and leaf through it.

"Also, there's the destructive path of the disease," Judson added. "It's clear that the first individual had contracted it internally. In these individuals, there's much more damage to the internal organs than to the external tissue."

"Okay, so then we know the primary victim must have contracted the infection by eating, drinking or inhaling the microbe," Penn summarized.

There was a general agreement.

"We have a wide age group here, ladies and gentlemen," Penn reminded everyone. "What would be a substance commonly ingested, whether we are talking about a teenager or a man in his seventies?"

"The substance is obviously not very common," Faas added, "as there have been only twenty-four deaths so far."

"The number of deaths is irrelevant, Mr. Hanlon," Penn shot back. "We've had four instances of this outbreak in the past forty-eight hours. At this rate of increase, we could be talking about twenty-four hundred deaths by next week."

Faas nodded. "Point taken, sir."

"Whatever this substance is, it has a nationwide distribution," Penn told them. "It's out there for the public to use. We seem to have a time-release bomb that is only starting to go off."

"They all had a cold," Bea Devera said in a lower voice.

This was the first thing she had said since the meeting began, and it took a few moments for the agent's words to register with everyone.

"What did you say, Agent…?"

"Devera, Mr. President. I said that one victim at each site had a cold or the flu. They were sick," she explained, leafing through her files and pulling out individual sheets of paper.

Faas noticed that the room had become totally quiet. All eyes were on Bea.

"Continue," the president encouraged.

"Moosehead Lake, Maine. One witness reported that the fourteen-year-old, Lizzy Hansson, was fighting a cold when they arrived for their vacation," Bea announced.

Faas noticed that one of Judson's assistants was taking notes. Another was leafing through her files.

"Rich, how does that match with the autopsy reports?" Penn asked.

Rich Judson's assistant slid a sheet of paper in front of him. "Lizzy Hansson appears to have been the first fatality on that site," the NIH director announced.

Penn looked at Bea again.

"Sedona, Arizona. Lenny Guest, age eighteen. He was fighting a flu or cold the day of his death. That was why he'd stayed off work and was hanging out with his friend."

Judson was looking over his people's files and gave a thumbs-up.

"Washington, D.C. Leo Bolender, age thirty-two, had a cold."

They all knew Leo was the only fatality at that site.

"Chicago, Illinois. Herman Ogden, age seventy-seven, had been fighting a cold for a week," Bea continued.

There was another nod by Judson.

"Boston, South End Bakery. Tasha Giles, age forty-nine, had returned to work after being out two days with a cold. She wasn't really improving, either, according to a boyfriend."

"This agrees with what we have," Judson said, nodding again.

Penn leaned back in his chair. "Very good, Agent Devera," he said. "This could be a breakthrough, ladies and gentlemen, don't you think?"

The energy in the conference room had definitely picked up.

"I don't need to tell you what to do next. You each have your own jobs to do. But start with pulling any prescription or nonprescription medication these people might have taken. Test the hell out of anything that was left over in their cabinets." Penn turned to Faas. "Do you remember the cyanide injected into Tylenol bottles… what was it… twenty, thirty years ago?"

"That was 1982, sir," Faas answered. "Seven people in the Chicago area collapsed suddenly and died after taking Tylenol capsules that had been laced with cyanide.

Five females and two males, all relatively young. They were the first victims ever to die from product tampering."

Faas had been working for the FBI back then. Just out of college and the academy. A wave of copycat tampering had followed that original incident. They never caught the Tylenol killer. A somewhat bumbling suspect who had attempted to cash in on the unprecedented publicity was arrested and charged with extortion, but not with the murders. The police concluded he was merely an opportunist.

Faas considered the possibility of terrorists using this method to spread the microbes. No one was taking credit. Nothing was showing up on Al Jazeera. Nothing.

He wondered if their search in Iraq would turn out to be futile. What if someone here in the U.S. was responsible for the epidemic… just another case of product tampering? He almost hoped that was the case, but he wasn't willing to stop any part of this investigation.

"For a change, I can pass on some good news in my address," Penn told them.

"I would not advise that you be too specific, sir," the NIH director reminded the president. "We have billion-dollar industries that could be affected by this."

"Yes, pharmaceutical companies. Their lobbyists and lawyers will be all over us. I won't forget," he assured Judson. "I'll be vague but I'll make sure to hint at positive news in the ongoing investigation."

"Mr. President," Faas added. "If you could, continue to stress the importance of respecting the quarantine perimeters to impede the spreading disease."

"Point noted." Penn scribbled something on the pad of paper in front of him. "Another thing. I also want to talk about a Federal Bioterrorism Rapid Response Card."

"New York and a couple of other states have had cards available for a while, sir," the HHS secretary said.

"Yes, I have it here." The president took a multifold card from a staff assistant standing nearby. He pulled open the information card and tossed it onto the conference table. "I want the federal government to distribute one of our own. A card put out by New York isn't going to help people in Maine or Arizona or Montana… or wherever this thing hits us next."

Faas had passed New York State's Rapid Response Card on to the president's secretary this morning, and it was good to see Penn bring it out here in this meeting. When he'd sent it over, Faas had suggested that copies be requisitioned from New York and passed out in the D.C. area. The small brochure consisted of tables of information on recognizing and diagnosing illnesses possibly caused by bioterrorism, along with treatment and prevention measures for first-responders. Everything from inhalational and cutaneous anthrax through viral hemorrhagic fevers to smallpox was included. Naturally, there was nothing about any fast-acting flesh-eating disease.

"Combine the best of whatever is included on existing information cards, update it to include this situation, and make it available at every government office and distribute it through the schools and any other venue you can think of," the president ordered. "Aside from English, I want it printed in Spanish, Chinese, Japanese, Hindi, Arabic… whatever. And I want that out yesterday."

James Abbott signaled for one of his own staffers, who left the room running.

"People feel better when they have clear instructions," Penn said. "It lets them know that we care… and that each person has a stake and a responsibility in this time of crisis."

The president ran through his list of agenda items.

"Oh, yes. This brings me to a very important issue. This thing is getting big enough that it needs a name. In the past, we have dealt with SARS… Severe Acute Respiratory Syndrome… AIDS, avian flu and a hundred other conditions, all of which have a recognizable name or acronym. When we can put a name or a face to an enemy, that enemy becomes a little less frightening. We still respect it as a foe, but it is no longer the faceless monster in the dark. Am I making my point clearly?"

There was definitely a general agreement.

"The media has been calling it the flesh-eating disease," the president's press secretary said. "My office actually got a phone call asking if there were cannibals attacking people in D.C."

"I hope you told the caller that only happens on Capitol Hill," Secretary Abbott deadpanned.

There were a few chuckles.

"Flesh-eating disease syndrome," the NIH director mused out loud. "The acronym would be FEDS."

Faas shook his head as others laughed.

"I don't think that would exactly send the message we're looking for," Penn responded.

"Necrotizing fasciitis is a mouthful," said the press secretary.

Rich Judson wasn't giving up. "I do think that initials would serve to identify the condition without being a constant reminder of the horrific manifestation of the disease. Perhaps just using the initials of necrotizing fasciitis infection," Judson told them.

"NFI," Secretary Abbott said, jotting it down as he said it.

"NFI." Penn echoed as he leaned back in his chair. He considered that for a moment. "I say we go with that."