What was unfolding in the FBI’s conference room shocked Paul beyond imagining. He hoped to God the scientists had some solutions.
Dr. Sarnahan continued, “The terrorists will need a delivery system. We don’t have a clue what that might be.”
“At least security is much tighter today,” Paul said.
“True, but the world has grown more vulnerable to the disease.” Sarnahan unwrapped another Snickers bar. “Considering that routine vaccination of Americans ended in 1972, we have a nation that is totally vulnerable to the virus.”
“How much of a spread are we talking about, Doc?” Conway asked.
“Epidemiologists have models that can tell them how fast a disease will spread. The main figure they concentrate on is the number of people who will contract the disease from an infected person. It’s called ‘R-zero,’ or the multiplier of the disease. It tells them how fast the disease will spread.
“In a modern country like the US, with mass transportation, shopping malls, and a mobile population, the multiplier is between three and twenty. An infected person could pass it to three or as many as twenty people.” Dr. Sarnahan moved to the whiteboard next to the table and started to write.
No one interrupted him.
“Let’s say smallpox has a multiplier of five. The spread will be explosive because five multiplied by itself every two weeks—the incubation period—can reach millions of people in a few months.” He drew the numbers on the board. “Like a forest fire that feeds on itself, there would be an explosive transmission through a population of people—with no immunity.”
No one moved.
Conway interrupted. “But wouldn’t you put up a fire ring around the outbreak and vaccinate everyone possible?”
“Classic response. The CDC has stockpiled millions of doses of vaccine, but it’s never been tested since the disease has been eradicated. And to build the fire ring, we’d have to quarantine everyone in the Twin Cities in their homes for two weeks or more while the medical teams vaccinated them all.”
Heads nodded.
Sarnahan took a bite of his candy bar. “If we can’t contain it quickly enough, we lose, and the virus crashes through our defenses. It’s designed to go out of control, to kill as many people as possible, anywhere it can find a human host.”
“Wouldn’t these cases be caught by doctors treating patients?” Paul said.
“Doubt it. They wouldn’t even know to look for it.”
Valentini walked to the end of the table. “Am I the only one here not buying all this? We’re not living in Jakarta or some shit-bag slum. I don’t get why we can’t simply contain it.”
With a wave of his hand, Dr. Sarnahan brought a small man out of the corner of the room. “This is Dr. Kumar, our expert on that issue.”
A young Indian man with straight black hair started to speak. He wore a black shirt, a black jacket, and leather sandals. “We have expert teams trained to respond. These teams are vaccinated and can deploy to the hot zone to confirm the diagnosis and work to contain it. We call it ‘quarantine-ring vaccination.’ That’s the simple part.
“The vaccine is useless if administered more than four to five days after exposure because the virus will have overwhelmed the immune system, which won’t be able to kick in fast enough. Other than getting people together for a Vikings game, think of how hard it will be to congregate people fast enough to administer the vaccine. Two months? Too late.”
Valentini looked down at the carpeting. “Half the public wouldn’t believe us and wouldn’t cooperate, anyway.”
He must be really worried, Paul thought. Like the rest of us. Paul could sense the fear in the room by the lack of any sound. Dr. Kumar reached inside his jacket and scratched for a long time, as if he had some disease.
Conway cleared his throat. “Like I said earlier, what can we do to help?”
Sarnahan joined Kumar. “Frankly, Bill, the disease isn’t our greatest problem. That’s not the reason a terrorist would introduce it.”
“You just scared the shit out of us, and now you say it’s not a problem?”
“Sit down, Bill,” said Sarnahan. “The fact is, no pandemic has ever been controlled. We hope our response team can do that. In the meantime, we have to deal with something far worse—the fear factor.” He finished the last of his Snickers bar and tossed the crumpled wrapper on the table. “Remember the panic everyone felt after 9/11? Multiply that by a thousand. If the public learns of what we’ve been talking about, what do you think their reaction will be?”
“So that’s the ballgame,” Conway said. “I can imagine if crowds of people stampede the vaccine centers. And then there’s the transportation systems, schools, malls, and hospitals.” He looked up with gray, sagging eyes. “They’ll all crash.”
Paul said, “And if they try to get out of town, to flee?”
“Worst possible thing to do,” Sarnahan said. “It will amplify the spread. Our local first responders won’t be immune, so when they try to control the population, they’ll succumb also.”
“Katrina,” Valentini reminded everyone. “Complete breakdown of a civil society.”
In a whisper, Conway asked, “What can we do? We can’t just sit here.”
“We have one shot at controlling this,” Sarnahan said. “If we know the delivery point, we can quarantine a manageable zone and vaccinate everyone inside the zone immediately. We may be able to control the spread. I’ve already contacted the CDC’s war room. They’re sending a vaccinated team while we talk. Should arrive here tonight.”
Dr. Kumar said, “We need law enforcement to help keep the outer perimeter of the quarantine area sealed.” He scratched his arm. “It will still be a great risk to all of us to even be near the scene.”
“What should we tell the public?” Paul said.
“Good question. Studies have shown that when we tell the public the truth, they ignore it,” Sarnahan said. “If we assure people we have everything under control, not to panic—the response is panic. I suggest we mention very little of this to the press. If we do, my concern is the news will spread faster than the disease. Even if we don’t have a pathogen introduced, the news itself will cause a panic and chaos.”
“One small problem remains,” Paul said. “Where’s the delivery point?”
Chapter Thirty-Eight