Chapter 173 - 133: Whistleblower 3
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Affiliated Hospital No. 1, Yang Xu’s office.
After receiving the identity information from Zhou Guanglin, Jiang He went to find his mentor.
Using his computer, he logged into the Yangcheng City Public Health Emergency Medical Treatment Information Network.
After the 2003 SARS outbreak, the country invested heavily to establish the China Disease Prevention and Control Information System.
It was an internal data aggregation system accessible only to hospital directors and above.
Today, it was a good thing this system existed.
Jiang He’s search terms were: "unknown origin," "severe pneumonia," "low white blood cell count," and "flu-like symptoms."
Within an hour, he had sifted through the infectious disease direct report cards and the fever clinic early warning case briefings uploaded by the City Eighth Hospital, the Provincial People’s Hospital, and the Pearl River Hospital.
He found many cases.
The emergency department of the Provincial People’s Hospital had admitted a 24-year-old male, Sun Songyu, who presented with a persistent high fever and difficulty breathing. He had diffuse infiltrates in both lungs and had already been intubated.
The infectious disease department of the City Eighth Hospital had admitted a 52-year-old female, Wang Cuiping, who was suffering from a fever with hemoptysis. She had already fallen into a coma upon admission, her blood oxygen was below 70%, and she was currently being resuscitated.
Adding to that Mark, from Affiliated Hospital No. 1’s respiratory department.
Jiang He grabbed a pen from the desk and quickly wrote on a blank sheet of paper.
Mark (source of infection) — Westin Hotel (point of contact) — Sun Songyu (close contact), Wang Cuiping (environmental contact).
This was an epidemiological chain of human-to-human transmission.
Sudden onset, short incubation period, and an extremely high rate of severe illness.
Furthermore, the taxi driver, Old Lin, was still out of contact. There was no telling how far he might have already spread the virus.
Jiang He tossed down the pen, picked up the paper with the connection diagram, and walked straight out of the office, heading for the Medical Affairs Department.
Yang Xu followed his student the whole way.
When they arrived at the Medical Affairs Department office, they saw Ke Zheng, the attending physician from the respiratory department, was also there, reporting on Mark’s condition:
"Not only is the antiviral treatment ineffective for Mark, but now even a pure oxygen mask can’t maintain his blood oxygen levels. I recommend transferring him directly to the ICU to be put on a ventilator."
"Go ahead with the transfer." The director of the Medical Affairs Department nodded. Seeing them enter, he asked, "Director Yang? Jiang He? What brings you two here?"
Jiang He got straight to the point. "Director, I have a theory. The patient from Mexico, Mark, doesn’t have a variant of the seasonal flu. It’s a brand new pandemic virus with an extremely high capacity for human-to-human transmission."
As soon as he said it, the office fell silent.
The director of the Medical Affairs Department shook his head. "Jiang He, ’pandemic’ is not a word to be used lightly."
Jiang He took out the diagram and pointed to it. "Just tonight, the Provincial People’s Hospital admitted Mark’s translator, Sun Songyu, who’s already been intubated. The City Eighth Hospital admitted Wang Cuiping, the cleaning lady who tidied Mark’s room, and she’s in a coma. And there’s still a taxi driver who’s currently missing."
"The incubation period is extremely short, with onset within 48 to 72 hours of contact. The disease progresses incredibly fast, going from fever to severe pneumonia in just one to two days. Standard doses of oseltamivir are ineffective in the severe stage. Most importantly, the current rapid antigen tests can only identify it as Influenza A; they can’t recognize its variant subtype. This has allowed it to perfectly masquerade as seasonal flu."
Ke Zheng’s expression changed.
He took a step forward, staring at the paper. "Are you certain these two people were in contact with Mark?"
"I’m certain. If it were just Mark, we could call it a sporadic case. But now it’s one case leading to two others, and all of them are severe. This reproductive number (R0) is definitely higher than that of the common seasonal flu. I recommend we immediately report this as a ’Public Health Event of Unknown Origin’ to the Provincial Disease Control Center. I also recommend that the municipal government... directly seal off the relevant exhibition halls at the Canton Fair, conduct a comprehensive disinfection, and quarantine all business people who were in contact."
Yang Xu had been following along the whole time.
He knew what his student was worried about, and his expression was grim.
Ke Zheng took a deep breath and shook his head. "That’s not possible, Jiang He. I’m afraid your proposal can’t be done."
"Why not?"
"It’s simple. According to the reporting procedures for infectious diseases, we need to send the patient’s respiratory sample to the Municipal Disease Control Center. If the municipal CDC can’t match it to a known virus, it has to be sent to the Provincial CDC. The province then has to perform virus isolation, cultivation, and finally, whole-genome sequencing."
Ke Zheng paused, looking at Jiang He.
"This whole process takes two to three weeks, at the very fastest. Without definitive genetic sequencing evidence, without a final classification from the Ministry of Health, who would dare to shut down the Canton Fair? If it turns out to be a false alarm, not even the hospital president could bear that responsibility."
Jiang He fell silent.
He glanced at his mentor.
Yang Xu also looked helpless. "Jiang He, even if I believe your judgment, the most I can do is initiate the highest level of infection control within our hospital. We can admit these severe cases, but issuing an external alert and ordering a lockdown must go through the CDC’s procedures."
Jiang He said, "By the time the CDC takes three weeks to complete the genetic sequencing, the virus will have already spread everywhere."
"There’s nothing we can do about that." Ke Zheng gave a wry smile. "Medicine is based on evidence. Until the genetic sequencing results are out, on a legal and procedural level, this can only be classified as ’suspected severe influenza’."
The office grew quiet again.
Jiang He knew that none of them were wrong.
’This is a barrier of our time.’
’The system’s caution is meant to prevent chaos. You can’t blame anyone.’
’Everyone is doing their best within the rules.’
’But it’s not enough.’
’Not nearly enough.’
Jiang He picked up the paper from the desk and turned toward the door.
Yang Xu asked, "Jiang He, where are you going?"
Jiang He replied, "To find evidence."
’Since irrefutable proof from genetic sequencing is needed to sound the alarm... ’
’...then I’ll have to find a way to shorten these long three weeks as much as possible.’
The door closed behind Jiang He.
Yang Xu watched the door close, then turned to Ke Zheng and the department director.
"Call the hospital president immediately. Regardless of what procedures the CDC is following, from this moment on, all fever clinics and the respiratory department at Affiliated Hospital No. 1 will operate under the highest level of infection control protocols!"
"Right."
...
In the hallway.
Jiang He first dialed Zheng Liyan’s number.
Unfortunately, no one answered. It was probably too late; the academician had likely already gone to bed.
After a moment’s thought, he decided to try Xu Wenpei instead.
"Hello, Director Xu, this is Jiang He."
Xu Wenpei from Peking Union Medical College Hospital had a gentle voice. "Ah, Jiang He, why are you calling me so late? I read your LNR paper. The younger generation is truly formidable!"
"Director Xu, I need to ask you for a favor. Could you help me contact a lab at the Institute for Viral Disease Control and Prevention of the National Disease Control Center (China CDC)? Preferably a core researcher who is directly in charge of genetic sequencing. I have a sample of an unknown respiratory virus that could potentially cause a global pandemic. I need to bypass the local CDC’s routine procedures and go through a national channel for expedited sequencing."
"?"
On the other end of the line, the smile on Xu Wenpei’s face vanished instantly.