"YOU'RE QUITE SURE?"
"The situation is nearly ideal," Daryaei's visitor told him, explaining further.
Even for a religious man who believed in the Will of God, the confluence of events was just too good to be true, and yet it was—or appeared to be so.
"And?"
"And we are proceeding according to the plan."
"Excellent." It wasn't. Daryaei would have much preferred to deal with each in turn, the better to concentrate his formidable intellect on the three developing situations one at a time, but this was not always possible, and perhaps that was the sign. In any case, he had no choice. How strange that he should feel trapped by events resulting from plans he himself had set in motion.
THE HARDEST PART was dealing with his World Health Organization colleagues. That was only possible because the news was good so far. Benedict Mkusa, the "Index Patient" or "Patient Zero," depending on one's favored terminology, was dead, and his body was destroyed. A team of fifteen had scoured the family's neighborhood and found nothing as yet. The critical period had yet to run out—Ebola Zaire had a normal incubation period of four to ten days, though there were extreme cases as brief as two days and as long as nineteen—but the only other case was before his eyes. It turned out that Mkusa was a budding naturalist, who spent much of his free time in the bush, and so now there was a search team in the tropical forest, catching rodents and bats and monkeys to make yet another attempt to discover the "host," or carrier of the deadly virus. But above all they hoped that, for once, for-
tune had smiled on them. The Index Patient had come directly to hospital because of his family status. His parents, educated and affluent, had let health-care professionals treat the boy instead of doing so themselves, and in that they had probably saved their own lives, though even now they were waiting out the incubation period with what had to be stark terror that surpassed even their grief at the loss of a son. Every day they had their blood drawn for the standard IFA and antigen tests, but the tests could be misleading, as some insensitive medico had foolishly told them. Regardless, the WHO team was allowing itself to hope that this outbreak would stop at two patient-victims, and because of that, they were willing to consider what Dr. Moudi proposed to do.
There were objections, of course. The local Zairean physicians wanted to treat her here. There was merit to that. They had more experience with Ebola than anybody, though it had done little good to anyone, and the WHO team was reluctant for political reasons to insult their colleagues. There had been some unfortunate incidents before, with the natural hauteur of the Europeans resented by the local doctors. There was justice on both sides. The quality of the African doctors was uneven. Some were excellent, some terrible, and some ordinary. The telling argument was that Rousseau in Paris was a genuine hero to the international community, a gifted scientist and a ferociously dedicated clinician who refused to accept the fact that viral diseases could not be treated effectively. Rousseau, in the tradition of Pasteur before him, was determined to break that rule. He'd tried ribavirin and in-terferon as treatments for Ebola, without positive result. His latest theoretical gambit was dramatic and likely to be ineffective, but it had shown some small promise in monkey studies, and he wanted to try it on a human patient under carefully controlled conditions. Though his proposed method of treatment was anything but practical for real clinical application, you had to start somewhere.
The deciding factor, predictably, was the identity of the patient. Many of the WHO team knew her from the last Ebola outbreak at Kikwit. Sister Jean Baptiste had flown to that town to supervise the local nurses, and doctors no less than others could be moved by familiarity with those under their care. Finally, it was agreed that, yes, Dr. Moudi could transport the patient.
The mechanics of the transfer were difficult enough. They used a truck rather than an ambulance, because a truck would be easier to scrub down afterward. The patient was lifted on a plastic sheet onto a gurney and wheeled out into the corridor. That was cleared of other people, and as Moudi and Sister Maria Magdalena wheeled the patient toward the far door, a group of technicians dressed in plastic "space suits" sprayed the floor and walls, the very air itself, with disinfectant in a smelly man-made chemical fog that trailed the procession like exhaust from an overaged car.
The patient was heavily sedated and firmly restrained. Her body was cocooned to prevent the release of virus-rich bleeding. The plastic sheet under her had been sprayed with the same neutralizing chemicals, so that leaks would immediately find a very adverse environment for the virus particles they carried. As Moudi pushed the gurney from behind, he marveled at his own madness, taking such chances with something as deadly as this. Jean Baptiste's face, at least, was placid from the dangerously high dosage of narcotics, marked though it was with the growing petechia.
They moved outdoors onto the loading dock where supplies arrived at the hospital. The truck was there, its driver seated firmly behind the wheel and not even looking backward at them, except perhaps in the mirror. The interior of the van body had likewise been sprayed, and with the door closed and the gurney firmly locked in place, it drove off with a police escort, never exceeding thirty kilometers per hour for the short trip to the local airport. That was just as well. The sun was still high, and its heat rapidly turned the truck into a mobile oven, boiling off the protective chemicals into the enclosed space. The smell of the disinfectant came through the suit's filtration system. Fortunately, the doctor was used to it.
The aircraft was waiting. The G-IV had arrived only two hours earlier after a direct flight from Tehran. The interior had been stripped of everything but two seats and a cot. Moudi felt the truck stop and turn and back up. Then the cargo door opened, dazzling them with the sun. Still the nurse, and still a compassionate one, Sister Maria Magdalena used her hand to shield the eyes of her colleague.
There were others there, of course. Two more nuns in protective garb were close by, and a priest, with yet more farther away. All were praying as some other lifted the patient by the plastic sheet and carried her slowly aboard the white-painted business jet. It took five careful minutes before she was firmly strapped in place, and the ground crewmen withdrew. Moudi gave his patient a careful look, checking pulse and blood pressure, the former rapid and the latter still dropping. That worried him. He needed her alive as long as possible. With that done, he waved to the flight crew and strapped into his own seat.
Sitting down, he took the time to look out his window, and Moudi was alarmed to see a TV camera pointed at the aircraft. At least they kept their distance, the doctor thought, as he heard the first engine spool up. Out the other window, he saw the cleanup crew respraying the truck. That was overly theatrical. Ebola, deadly as it was, appeared to be a delicate organism, soon killed by the ultraviolet of direct sunlight, vulnerable also to heat. That was why the search for the host was so frustrating. Something carried this dreadful "bug." Ebola could not exist on its own, but whatever it was that provided a comfortable home to the virus, whatever it was that Ebola rewarded for the service by not harming it, whatever the living creature was that haunted the African continent like a shadow, was as yet undiscovered. The physician grunted. Once he'd hoped to discover that host and so make use of it, but that hope had always been in vain. Instead he had something almost as good. He had a living patient whose body was now breeding the pathogen, and while all previous victims of Ebola had been burned, or buried in soil soaked with chemicals, this one would have a very different fate. The aircraft started moving. Moudi checked his seat belt again and wished he could have something to drink.