The Hot Zone (26 page)

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Authors: Richard Preston

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Immediately afterward, Joe McCormick got up and spoke. What he said remains a matter of controversy. There is an Army version and there is another version. According to Army people, he turned to Peter Jahrling and said words to this effect: Thanks very much, Peter. Thanks for alerting us. The big boys are here now. You can just turn this thing over to us before you hurt yourselves. We’ve got excellent containment facilities in Atlanta. We’ll just take all your materials and your samples of virus. We’ll take care of it from here.

In other words, the Army people, thought McCormick tried to present himself as the only real expert on Ebola. They thought he tried to take over the management of the outbreak and grab the Army’s samples of virus.

C. J. Peters fumed, listening to McCormick. He heard the speech with a growing sense of outrage, and thought it was “very arrogant and insulting.”

McCormick remembers something different. “I’m sure I offered some help or assistance with the animal situation at Reston,” he recalled, when I telephoned him. “I don’t know that there was any conflict. If there was any animosity, it came from
their
side, not ours, for reasons they know
better than I. Our attitude was, Hey guys, good work.”

But McCormick and the Army had not been getting along well, and there was a history of conflict. In the past, McCormick had publicly criticized Gene Johnson, the Army’s Ebola expert, for spending a lot of money to explore Kitum Cave and then not publishing his findings. McCormick expressed his opinion of the Army to me this way: “They want to tell you about their experiments, but the way to tell people about them is to
publish
them. That’s not an unreasonable criticism. They’re spending taxpayers’ money.” And besides, “None of them had spent as much time in the field as I had. I was one of those who had dealt with human cases of Ebola. No one else there had done that.”

What McCormick had done was this. In 1979, reports reached the C.D.C. that Ebola had come out of hiding and was burning once again in southern Sudan, in the same places where it had first appeared, in 1976. The situation was dangerous, not only because of the virus but because a civil war was going on in Sudan—the area where Ebola raged also happened to be a war zone. McCormick nevertheless volunteered to go there to try to collect some human blood and bring the strain back alive to Atlanta. He traveled to Sudan in the company of another C.D.C. doctor named Roy Baron. McCormick and Baron arrived in southern Sudan in a light plane flown by two terrified bush pilots. Around sunset, they landed at an airstrip
near a Zande village. The pilots were too scared to get out of the plane. It was getting dark, and the pilots decided to spend the night in the cockpit, sitting on the airstrip. They warned McCormick and Baron that they would leave the next morning at sunrise. The doctors had until dawn to find the virus.

They shouldered their backpacks and walked into the village, looking for Ebola. They arrived at a mud hut. Villagers stood around the hut, but wouldn’t go inside. They heard sounds of human agony. A dark doorway led inside. They couldn’t see into the hut, but they knew that Ebola was in there. McCormick rummaged in his backpack and found his flashlight, but it was dead, and he realized that he had forgotten to bring batteries. He asked the crowd if anyone had a light, someone brought him a lantern, and they entered the hut.

Years later, McCormick told me that he would never forget the sight. The first thing he saw was a number of red eyes staring at him. The air inside the hut reeked of blood. People lay on straw mats on the floor. Some were having convulsions—the final phase, as death sets in—their bodies rigid and jerking, their eyes rolled up into the head, blood streaming out of the nose and flooding from the rectum. Others had gone into terminal comas, and were motionless and bleeding out. The hut was a hot zone.

McCormick opened his backpack and fished out rubber gloves, a paper surgical gown, a paper
surgical mask, and paper boots to cover his shoes, to keep them from becoming wet with blood. After he had dressed himself, he laid out his blood tubes and syringes on a mat. Then he began drawing blood from people. He worked all night in the hut on his knees, collecting blood samples and taking care of the patients as best he could. Baron worked at his side.

Sometime during the night, McCormick was drawing blood from an old woman. Suddenly she jerked and thrashed, having a seizure. Her arm lashed around, and the bloody needle came out of her arm and jabbed into his thumb. Uh-oh, he thought. That would be enough to do it. The agent had entered his bloodstream.

At dawn, they gathered up their tubes of blood and ran to the airplane and handed the samples to the pilots. The question for McCormick was what to do with himself, now that he had been pricked with a bloody needle. That was a massive exposure. He probably had three to four days before he broke with Ebola. Should he leave Sudan now, get himself to a hospital? He had to make a decision—whether to leave with the pilots or stay with the virus. It seemed obvious that the pilots would not come back later to pick him up. If he planned to leave and get medical help for himself, the time to do it was now. There was an additional factor. He was a physician, and those people in the hut were his patients.

He returned to the village with Baron, and rested that day in a hut. That evening, he and his
colleague had dinner with some local United Nations officials, where McCormick drank at least half a bottle of scotch. He got talkative, then he collapsed. Baron dragged and carried McCormick to a nearby hut, sat him up on a cot, and gave him a large transfusion of blood serum from Africans who had survived Ebola. This might help McCormick fight off the virus. Or it might not. That night, whirling drunk on scotch, McCormick still could not sleep. He lay awake, thinking about the needle jabbing into his thumb, thinking about Ebola starting its inevitable replication in his bloodstream.

He worked with Ebola patients for the next four days inside the hut, and still he did not have a headache. Meanwhile, he watched the old lady like a hawk to see what happened to her. On the fourth day, to his surprise, the old lady recovered. She had not had Ebola. She had probably been suffering from malaria. She had not been having an Ebola seizure but, rather, had been shivering from a fever. He had walked away from a firing squad.

Now, at the meeting at Fort Detrick, Joe McCormick of the C.D.C. was convinced that Ebola virus does not travel easily, especially not through the air. He had not become sick, even though he had breathed the air inside an Ebola-ridden hut for days and nights on end. He felt strongly that Ebola is a disease that is not easy to catch. Therefore, in his view, it was not as dangerous as perhaps the Army people believed.

Dan Dalgard asked a question of the assembled experts. He said, “How soon after we give you samples can you tell us whether they have virus in them?”

C. J. Peters replied, “It may take a week. This is all we know.”

Joe McCormick spoke up. Wait a minute, he said—he had a new, fast probe test for Ebola virus that would work in just twelve hours. He argued that the C.D.C. should have the virus and the samples.

C. J. Peters turned and stared at McCormick. C. J. was furious. He didn’t believe McCormick had any quick test for Ebola. He thought it was Joe McCormick blowing smoke, trying to get his hands on the virus. He thought it was a poker bluff in a high-stakes game for control of the virus. It was a delicate situation, because how could he say in front of all these state health officials, “Joe, I just don’t believe you”? He raised his voice and said, “An ongoing epidemic is not the time to try to field-test a new technique.” He argued that Fort Detrick was closer to the outbreak than was the C.D.C., in Atlanta, and therefore it was appropriate for the Army to have the samples and try to isolate the virus. What he did not say—no reason to rub it in—was that seven dead monkeys were at that very moment being examined by Nancy Jaax. Even as they argued, she was exploring the monkeys. What’s more, the Army was growing the virus in cultures. Possession is nine tenths of the law, and the Army had the meat and the agent.

Fred Murphy, the other C.D.C. man, was sitting next to McCormick. He began to realize that the C.D.C. was not in a good position to argue the matter. He leaned over and whispered, “Joe! Calm your jets. Stifle it, Joe. We’re outnumbered here.”

General Philip Russell had been sitting back, watching the argument, saying nothing. Now he stepped in. In a calm but almost deafeningly loud voice he suggested that they work out a compromise. He suggested that they split the management of the outbreak.

A compromise seemed to be the best solution. The general and Fred Murphy quickly worked out the deal, while McCormick and Peters stared at each other with little to say. It was agreed that the C.D.C. would manage the human-health aspects of the outbreak and would direct the care of any human patients. The Army would handle the monkeys and the monkey house, which was the nest of the outbreak.

THE MISSION
1630 HOURS, WEDNESDAY

Colonel C. J. Peters now felt that he had permission to get the action under way. As soon as the meeting broke up, he began to line up his ducks. The first thing he needed was a field officer who could lead a team of soldiers and civilians into the monkey house. He needed to form a military-action unit.

He had already decided who was going to lead the mission. It was going to be Colonel Jerry Jaax, Nancy’s husband. Jerry had never worn a space suit, but he was the chief of the veterinary division at the Institute, and he understood monkeys. His people, both soldiers and civilians, were certainly going to be needed. No one else had the training to handle monkeys.

He found Jerry in his office, staring out the window and chewing on a rubber band. C. J. said, “Jerry, I believe we have a situation down in Reston.” A
situation
. Code for a hot agent. “It looks like we’re going to have to go down and take those monkeys out, and we’re going to do it in Biosafety
Level 4 conditions.” He asked Jerry to assemble teams of soldiers and civilian employees to be ready to move out with space suits in twenty-four hours.

Jerry walked over to Gene Johnson’s office and told him that he’d been put in charge of the mission. The office was a mess. He wondered how Gene, as large a man as he was, could even fit himself in among the stacks of paper.

Jerry and Gene immediately began to plan a biohazard operation. There had been a general decision to take out one room of monkeys, and see how that worked, see how things went—see if the virus was spreading. They set up their priorities.

Priority One
. Safety of the human population.

Priority Two
. Euthanasia of the animals with a minimum of suffering.

Priority Three
. Gathering of scientific samples. Purpose: to identify the strain and determine how it travels.

Gene felt that if the team did its job properly, the human population of Washington would be safe. He put on his glasses and hunched over and fished through his papers, his beard crushed on his chest. He knew already that he was not going to go inside that building. No way in hell. He had seen monkeys die too many times, and he could not bear it anymore. In any case, his job was to
gather equipment and people and move them into the building, and then to extract the people and equipment and dead animals safely.

He had saved lists, long lists of all the gear he had brought to Kitum Cave. He pawed through his papers, swearing gently. He had literally tons of African gear. He had squirreled it away in all kinds of hiding places at the Institute, where other people couldn’t find it and rip it off.

Gene was terribly excited, and also afraid. His nightmares about Ebola virus, the bad dreams of liquid running through pinholes into his space suit, had never really gone away. He would still wake up at night thinking, My God, there’s been an exposure. He had spent almost ten years hunting Ebola and Marburg in Africa, with little success, and suddenly one of the bastards had reared its head in Washington. His favorite saying came back to him: “Chance favors the prepared mind.” Well, the chance had come. If a piece of gear had been handy in Kitum Cave, it would be handy in the monkey house. As Gene thought about it, he realized that the building was very much like Kitum Cave. It was an enclosed air space. Dead air. Air-handling system broken, failed. Dung all over the place. Monkey urine in pools. A hot cave near Washington. And there were people who had been inside the cave who might be infected with the virus by now. How would you move your teams in and out of the hot area? You would have to set up a staging area. You would have to have a gray area—an air lock with a chemical shower of
some kind. Somewhere inside that building lived a Level 4 life form, and it was growing, multiplying,
cooking
inside hosts. The hosts were monkeys and, perhaps, people.

2000 HOURS, WEDNESDAY

Dan Dalgard left
USAMRIID
and drove back to his office on Leesburg Pike, arriving there around eight o’clock. The office was deserted; everyone had gone home. He straightened up his desk, shut down his computer, and removed a floppy disk that contained his daily diary, his “Chronology of Events.” He put the disk into his brief case. He said good night to a security guard at the front desk and drove home. On the road, he realized that he had forgotten to call his wife to tell her that he would be late. He stopped at a Giant Food supermarket and bought her a bunch of cut flowers, carnations and mums. When he arrived home, he reheated his dinner in the microwave and joined his wife in the family room, where he ate sitting in a recliner chair. He was exhausted. He put another log into the wood stove and sat down at his personal computer, which was located next to his clock-repair bench. He inserted the floppy disk and began typing. He was bringing his diary up to date.

So much had happened during the day that he had difficulty keeping it all straight in his mind. In the morning, he had learned that the monkey
caretaker named Jarvis Purdy was in the hospital, reportedly with a heart attack. Jarvis was resting comfortably, and there had been no reports that his condition was getting worse. Should I have notified the hospital that Jarvis might be infected with Ebola? If he does have Ebola, and it spreads within the hospital, am I liable? Jesus! I’d better get someone to go over to the hospital first thing tomorrow and tell Jarvis what’s going on. If he hears it on the news first, he’s liable to have another heart attack!

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