Pandemic

The translator waved his gloved hand. "No hospital in that town. Only the… clinic… where he worked. He used the best precautions he had, but…"

Haldane nodded absentmindedly. He was thinking of his colleague, Dr. Franco Bertulli, dying of SARS in a similar room in Singapore after following all the recommended precautions. He remembered how Bertulli joked about his mother encouraging him to go into medicine because she thought it was so much safer than his alternate choice, the police force. In the case of both Bertulli and Fung, the viruses managed to circumvent their protective measures. In the end, medicine turned out to be a very unsafe choice for both doctors.

Dr. Fung looked older than fifty. Behind a deathly pallor, his face was swollen and contused. His oozing lips were as thick as the endotracheal tube sticking between them and leading to a ventilator, or artificial life-support system. Bloody sputum fluttered inside the transparent plastic tube, flapping back and forth with each breath the ventilator forced in and out, like a piece of paper trapped at the opening of a vacuum hose. Bruises covered his flaccid arms. A blanket shrouded the rest of his skin from his chest down, but Haldane knew that he would see similar welts and bruises on any exposed surface. Haldane made the diagnosis from the foot of the bed: disseminated intravascular coagulopathy or DIC. The inflammatory reaction instigated by the virus was chewing up the clotting factors in the patient's blood. As a result, he was bleeding spontaneously under his skin; thus the bruises.

Haldane experienced the same helplessness he had felt in Singapore. The local specialists had done all they could — all anyone could — for their colleague. Standing at the bedside in his rubber suit, Haldane felt embarrassed, as if he were a nosy bystander gawking at the sight of a fatal car crash. He was of no use to the doomed physician. All he could do was try to prevent others from following down the same road. He silently vowed to do just that.

He'd seen enough. He spun and walked to the door. McLeod and the interpreter followed behind. Even McLeod was silent as they headed back to the change rooms where guards supervised their showers to ensure proper decontamination steps were followed.

Once they were dressed their translator led them into a modest gray office, which smelled of herbal tea, on the main floor. The associate director, Dr. Ping Wu, jumped up from his desk and walked around to meet them. Wearing thick glasses and a crisp white lab coat, the middle-aged doctor stood chest-high to his two Western colleagues.

The translator made the introductions, but the diminutive administrator addressed Haldane and McLeod in a slightly accented English. "My English is most poor, but I think I can manage," he said with typical Oriental humility. "I studied four years at UCLA." He waved to the interpreter who turned and left the room.

Haldane and McLeod sat down across the desk from Wu. "My deepest apologies, Doctors," Wu said. "The director, Dr. Huang, is at the provincial capital Lanzhou reporting to the governor. He very much wanted to meet you."

"We appreciate you taking the time to meet us, Dr. Wu," Haldane said.

Wu bowed his head. "It's an honor."

"Likewise," Haldane said. "Dr. Wu, I understand your hospital has had the most experience of any facility with this disease."

"Very true, Dr. Haldane," Wu said. "We have treated 146 cases at this hospital. As many as the other hospitals combined."

McLeod rubbed his beard roughly. "How many dead?"

"Twenty-seven." Wu cleared his throat. "I fear that number will rise to thirty by day's end."

"Including Dr. Fung?" McLeod said.

"Yes."

"It would be very helpful for us to hear about your firsthand experience with this virus," Haldane said.

"Certainly." Wu looked down at his desktop. "It began twenty-three days ago. A farmer from the north was sent to us with a high fever and complete respiratory failure. He died within twenty-four hours of arrival. We were concerned about the possibility of the Bird Flu or even SARS."

Haldane frowned. "Did SARS ever reach Jiayuguan?"

"No. Not anywhere in the Gansu Province. Still, we exercised precise pulmonary protocol with our patient. We did not know until the blood tests came back negative for the SARS coronavirus. Soon more patients arrived with the same symptoms. Abrupt onset of high fever followed by respiratory symptoms, pneumonia, often associated with hemoptysis." Wu used the technical term for coughing up blood.

"Followed by respiratory collapse," McLeod said.

Wu shook his head. "Not in all cases, Dr. McLeod. Over half the patients never became short of breath. Just a cough, fever, and severe weakness. Prompt recovery in less than four days in all cases. We believe there are still others who have a subclinical form of the illness and do not require treatment."

"And in those who did become critically ill," Haldane said. "What treatments have been tried?"