“But that was before they knew about the Dormigen shortage,” I pointed out. “Everything is different now. We have a safe treatment, but it’s going to run out. What’s the harm in testing something that might work?”
“That’s true,” Tie Guy conceded. “But we still need a theory. We have to have some explanation for what’s happening here. Why would people get sick from Capellaviridae when they are no longer around dust mites? And why would reintroducing dust mites make them healthy?”
“If it works, we can figure out the theory later,” I said.
“We don’t have time to do any meaningful trial,” Tie Guy declared. “Capellaviridae is not fatal most of the time anyway, so it would take a long time to figure out if the dust mites have any real impact. Besides, I think it’s a dead end. There’s a confounding variable out there that we haven’t figured out. The data are right, but we’re not hearing what they are telling us.”
“Why can’t we just test the dust mites?” I insisted. “We need a Jonas Salk.”
Tie Guy’s tone turned caustic. “Really? Tell me how that would work.”
My mind worked slowly as I tried to figure out why Tie Guy sounded so dismissive. Salk was the inventor of a polio vaccine. Like other successful vaccines, it works by introducing a weakened form of the virus to the subject, whose body then creates antibodies to fend off the full-strength version of the disease. Salk offered himself and his family as test subjects. As my mind ground away slowly, Tie Guy continued, “Why don’t you give yourself the virulent form of Capellaviridae and then try the dust mite cure?”
My mind caught up to him: We still had no understanding of when or why the virus turned virulent, so even the notion of exposing someone to the harmful form of the virus was beyond us. I couldn’t test the dust mite cure on myself because I did not know how to make myself sick with the virulent form of Capellaviridae in the first place. “I’m a little worn down,” I said.
“The media stuff looks awful,” Tie Guy said, finally betraying some sympathy. There was a brief pause and then he asked, “Don’t you think the Chinese are going to pony up the Dormigen in the end?”
He had never asked me about any deliberations beyond the science. At that point, I had not been privy to the discussions on Air Force One, but I had heard enough at the White House to know that the President would likely refuse any offer that required abandoning the South China Sea Agreement. I took a seminar on negotiations in graduate school, a class where we broke down in pairs and did mock exercises. One of the things I learned is that sometimes there is not a deal to be had. Fifteen different pairs of negotiators read a set of secret instructions—half of us were banana plantation owners and the other half were fishermen—and somehow we were supposed to figure out how to split limited water resources in our village. All fifteen teams returned to the classroom ninety minutes later, and not one of us had managed to come to agreement. There just wasn’t enough water. That was what we were supposed to learn from the exercise.
Tie Guy’s question was instructive to me. He was a hardheaded analyst if there ever was one, and here he was assuming optimistically that everything would work out okay. That may be a unique American gift, this ongoing optimism. It all works out in the end. How else can one explain what happened at that Washington Nationals game? The President of the United States gives the middle finger to the country offering us the Dormigen that would get us through the crisis, leaving us in a situation where thousands of people might die unnecessarily. The Atlanta Braves pitcher points at the flag, causing people to get to their feet and cheer for nearly five minutes. Why? Because they believed it would work out okay.
There are two things I do not understand about that baseball game moment, even now as I write. First, Americans despise politicians. Faith in government has been trending down for forty years. The approval rating for Congress is routinely in single digits. Even politicians can get an easy laugh by bashing politicians, or better yet “government bureaucrats.” Our funding at NIH had survived more or less intact because we did work with counterterrorism implications, but my colleagues working on dementia or diabetes or heart disease had no such luck. Their budgets were all lower than they had been back at the turn of the millennium. Who did all these folks eating hot dogs at the Nationals game think was going to bail them out? Should I go back to the NIH, where teams were working around the clock, and yell, “Hey, everybody, it’s after five! Time to go home. This is government work”? What little we did know about lurking viruses came from research mostly funded by government grants. Who else cares about a lurking virus until it’s too late? When I told people I was a government scientist—at a party or my college reunion or among my parents’ friends—they would often make a wisecrack about studying the mating habits of potbellied pigs, intimating that my work was a waste of their hard-earned tax dollars. This, by the way, was often coming from someone who was marketing dandruff shampoo or doing research for a hedge fund, as if fighting bad hair or further enriching rich people were some kind of high calling. (Yes, that is a bit of a rant, but given my role in this whole debacle, I am entitled to some venting.)
Second, things do not always work out okay. That is just an objective historical fact. Have these people not read about the Civil War? I am no historian, but I know enough to recognize that Americans could see that crisis coming for forty years before the shooting started at Fort Sumter. There are historical examples of when politicians did things that caused needless deaths and suffering (World War I, Vietnam). There are historical examples of when politicians did not cause the problem but were unable to stop the devastation (the Spanish flu pandemic, the opioid crisis). There are examples of when politicians were heroic and successful but the social cost was still enormous (World War II). In any event, I do not understand how anyone could make even a cursory examination of American history and just assume that the Outbreak was going to turn out okay. As I stood wrapped in a towel in Jenna’s apartment, I did not believe the President and the Chinese were going to come to a deal. In some ways, the President had backed himself into a corner with his cowboy-like takeoff from Honolulu. For their part, the Chinese would lose face (and all the diplomatic prestige that came with it) if they walked away from most of the bold demands in the “Friendship Agreement.” The two parties might have reached some agreement if the negotiations had been conducted in private, but that ship had sailed. (Or, to keep the metaphor correct, that plane had flown west.) The likelihood of some scientific breakthrough was getting less likely by the hour. Tie Guy was correct: we had run out of time to do even a simple clinical trial.
I dressed and sat down next to Jenna on the couch in her tiny sublet apartment. I had known her for a mere three hours. It was clear that there was some connection between the two of us, though I had not told her I was still living with Ellen. I could try to explain that my relationship with Ellen was already over but that would make me sound like a lecherous sixty-year-old telling some young thing that his marriage had been “dead for a long time.” The fact is that I felt much better with Jenna sitting next to me on that couch. Not coincidentally, her instincts regarding Capellaviridae were good. I appreciated having a fellow Huke acolyte to share ideas with. In the back of my mind—lurking there, if you will—I was convinced that his approach was fundamentally correct. Our best hope was to “think like the virus.” There had to be some reason for the pattern we were seeing—some reason that Capellaviridae or the dust mite benefited in the long run from making people sick. As Huke told us repeatedly, “It’s all about evolutionary advantage.” So why couldn’t I figure that out? What organism was getting what advantage from this bizarre pattern we were seeing?