lookout for filovirus cases. GPs would also have to be alerted.
There were a lot of worried faces in the room when Steven arrived at City General, and his was one of them. The new case was on everyone’s mind, with some people learning about it only on arrival. Steven made his point about the need for forewarning. ‘It took three days in Scotland,’ he stressed. ‘The virus can do a lot of damage in three days.’ Everyone was in agreement except the Department of Health group led by Sinclair.
‘Perhaps a confidential memo to heads of A amp;E units might be in order,’ Sinclair conceded. ‘But we must guard against anything that will cause widespread public alarm.’
‘Is an epidemic really preferable?’ insisted Steven. ‘The warning must go out to all front-line personnel. All A amp;E staff and GPs must be included.’
‘With respect, Dr Dunbar, I think this area is outside your remit,’ said Sinclair with a smile that reminded Steven of the Cheshire Cat in Alice in Wonderland.
‘It’s not outside mine,’ Caroline Anderson intervened. ‘And I agree with Dr Dunbar. All clinical staff must be warned to be on the lookout.’
‘I’ll relay your comments to the appropriate ears, of course, but any sort of national decision must be taken at ministerial level,’ said Sinclair.
‘And probably in both parliaments.’ Steven sighed.
‘I beg your pardon?’ said Sinclair.
‘The Scots have their own parliament,’ Steven reminded him. ‘I presume the DoH in London has been keeping the Scottish Health Minister informed of events?’
The look on Sinclair’s face told Steven that he had scored a direct hit in spite of the blustering reply, ‘I’m sure all relevant parties have been kept informed of the current situation.’
‘It’s just a great pity that the staff on duty at Perth Royal Infirmary when McDougal was brought in or his GP were not “relevant parties”,’ said Steven.
‘Ah, such clarity of hindsight,’ said Professor Cane, with a sideways sneer at Steven. ‘I don’t think we can blame our London colleague here for not wanting to cause undue public alarm. The public are subjected to an endless stream of scare stories as it is, and it’s not as if we’re talking about an epidemic here.’
‘I think that’s exactly what we are talking about,’ said Steven. ‘And that’s foresight, not hindsight. I take it you and your team have made no more progress than I have in establishing the root cause of these outbreaks, Professor?’
‘My team is exploring every avenue, based on the data we have collected. I’m confident that the rigorous application of epidemiological methodology will prevail over more… unconventional means.’
‘Can we take that as a no?’ said Steven, ignoring the insult. ‘That leaves us with three outbreaks of a fatal disease and no idea where it’s coming from. If things continue like this, we’ll be faced with a country-wide epidemic within weeks.’
‘But they won’t,’ insisted Cane. ‘This is not the Third World. Medical science is on our side. Panic would be a bigger enemy than the virus.’
‘Hear, hear,’ said Sinclair.
‘There is a middle course,’ said Steven. ‘Simply saying, “Trust us,” is not enough. We have to make sure that hospitals and surgeries are on the lookout for this thing. Containment is an absolute must.’
‘Won’t the notifiable disease system ensure that anyway?’ asked the social work chief, Alan Morely.
‘This disease isn’t on the list,’ said Byars, sounding slightly embarrassed. He responded to looks of disbelief by adding, ‘Simply because it’s a new virus. The authorities don’t know what to call it, I suppose.’
‘Might I suggest that “the authorities” put it on the list?’ asked Steven. ‘Even if they have to call it Mary Jane for the time being?’
‘In due course,’ said Sinclair.
The ensuing silence made Sinclair’s words hang in the air.
‘Gentlemen, I think we really must move on to more immediate matters,’ Caroline Anderson interceded. ‘We’ve had one new case and there are four new possibles.’
‘All of whom are now here in the hospital,’ said George Byars, ‘but there is a limit to how many more we can cope with in terms of ward space and nurses trained in the appropriate techniques.’
‘It’s more than likely that these will be the last cases,’ said Cane. ‘It’ll all be over by Christmas.’ He laughed at his own joke and his team dutifully followed his lead. Steven couldn’t help but think that the last time someone in authority said that, it had been followed by five years of world war.
‘I still think we should be at least thinking about contingency plans, in the unfortunate event that we’re faced with a more lengthy outbreak than we had anticipated,’ said Byars, tiptoeing through a minefield of egos.
‘I must say I agree,’ said Miss Christie, the nursing director. ‘I think it would be an idea to broaden our nursing base for the courses to include nursing volunteers from other hospitals.’
‘We might also like to talk to the local council about suitable vacant accommodation that could be pressed into service — in the unfortunate event that the need should arise,’ said Byars.
Cane shrugged as if he wanted nothing to do with such considerations, and looked at his watch. He said, ‘I’m due to speak with my Scottish colleagues about the outbreak in Perth in ten minutes. We’re hopeful of being able to establish a link.’
‘Good luck,’ said Steven.
‘And so say all of us,’ added Byars. ‘I suggest we all meet again tomorrow morning to assess the situation. Miss Christie, I suggest you contact your colleagues at other hospitals with your idea, and perhaps Mr Morely might speak to relevant council officials about the accommodation issue — purely as a precautionary measure.’
Steven left the meeting with Caroline Anderson. When they were free of the others he said, ‘You look like a woman in need of a cup of coffee.’
‘I’d sell my soul for one right now,’ she replied.
‘There’ll be no charge.’ Steven smiled.
They sought out a local hotel and sat down at a window table in the breakfast room, where they both ordered black coffee and toast.
‘What’s the problem?’ asked Steven, seeing that she was preoccupied.
‘That damned disco,’ replied Caroline. ‘I’ve got a bad feeling about it now that the girl’s gone down with the disease. I’m beginning to think I should have put out that appeal yesterday.’
‘You called it as you saw it and, for what it’s worth, I think it was the right thing to do. The appeal wouldn’t have made any difference in practical terms. It’s not as if you were going to be able to take two hundred people off the streets and lock them away for two or three weeks. The best you could have hoped for was persuading them to stay at home for the period when they’re going to infect the people they’re most likely to infect anyway: their families.’
Caroline looked at him and smiled. ‘Thanks for the support. But I still feel bad because… because I…’
‘You didn’t play it strictly by the book, and that makes you vulnerable should the shit start to fly.’
‘I suppose that’s it exactly,’ agreed Caroline. ‘You sound as if you’re familiar with the feeling.’
‘Story of my life,’ said Steven. ‘Doing what’s right isn’t nearly as easy as people imagine. In your case the book might say that frightening two hundred kids to death is a good idea, but you and I know differently, especially when dealing with a disease we can do nothing at all about.’
‘Thanks. I appreciate your support.’
‘Actually, there’s something else I’d like you to do that isn’t strictly by the book,’ he said.
‘Hence the coffee.’ Caroline smiled.
‘That had nothing to do with it,’ said Steven firmly. ‘Do you think you could spare one of your people to carry out an inspection of a restaurant in town?’
‘I suppose so,’ said Caroline, a bit guardedly.
‘On a daily basis until I say stop?’
Caroline’s eyes opened wide. ‘Are you serious?’ she asked.
‘Never more so.’
NINE
