“If it were waterborne, wouldn’t more people have been infected?” asked one of the women.
“If the entire hospital supply was involved,” said Marissa. “But perhaps a certain water fountain . . .” Her voice trailed off. “Ebola had never been a water- or food-borne infection,” she admitted. “It is all very mysterious, and it just underlines the need for complete histories to try to find some area of commonality. Were all the patients on the same shifts? Were they all in the same areas of the hospital? Did they all drink coffee from the same pot, eat the same food, come in contact with the same animal?”
Pushing back her chair, Marissa went to a blackboard and began outlining a sequence of questions that each patient should be asked. The other doctors rose to the challenge and began giving suggestions. When they were done, Marissa added as an afterthought that they might ask if any of the patients had attended the eyelid surgery conference in San Diego that had been held about three months before.
Before the group disbanded, Marissa reminded everyone to adhere carefully to all the isolation techniques. Then she thanked them again and went to review the material that was already available.
As she had done in L.A., Marissa commandeered the chart room behind the nurses’ station on one of the isolation floors as her command post. As the other doctors finished their history taking, they brought their notes to Marissa, who had begun the burdensome task of collating them. Nothing jumped out of the data except the fact that all the patients worked at the Medica Hospital, something that was already well known.
By midday, fourteen more cases had been admitted, which made Marissa extremely fearful that they had a full-blown epidemic on their hands. All the new patients, save one, were Medica subscribers who had been treated by one of the original forty-two sick physicians before the physicians developed symptoms. The other new case was a lab tech who had done studies on the first few cases before Ebola was suspected.
Just as the evening shift was coming on duty, Marissa learned that the other CDC physicians had arrived. Relieved, she went to meet them. She found Dubchek helping to set up the Vickers Lab.
“You might have told me the damn hospital was quarantined,” he snapped when he caught sight of her.
“You didn’t give me a chance,” she said, skirting the fact that he had hung up on her. She wished there was something she could do to improve their relationship, which seemed to be getting worse in-stead of better.
“Well, Paul and Mark are not very happy,” said Dubchek. “When they learned all three of us would be trapped for the length of the outbreak, they turned around and went back to Atlanta.”
“What about Dr. Layne?” asked Marissa guiltily.
“He’s already meeting with Weaver and the hospital administration. Then he will see if the State Health Commissioner can modify the quarantine for the CDC.”
“I suppose I can’t talk to you until you get the lab going,” said Marissa.
“At least you have a good memory,” said Dubchek, bending over to lift a centrifuge from its wooden container. “After I finish here and I’ve seen Layne about the isolation procedures, I’ll go over your findings.”
As Marissa headed back to her room, she mulled over a number of nasty retorts, all of which only would have made things worse. That was why she had said nothing.
After a meal of catered airplane food eaten in an area of the outpatient clinic reserved for staff in direct contact with the presumed Ebola patients, Marissa returned to her chart work. She now had histories on most of the initial eighty-four cases.
She found Dubchek leafing through her notes. He straightened up on seeing her. “I’m not sure it was a good idea to use the regular hospital staff to take these histories.”
Marissa was caught off guard. “There were so many cases,” she said defensively. “I couldn’t possibly interview all of them quickly enough. As it is, seven people were too sick to speak and three have subsequently died.”
“That’s still not reason enough to expose doctors who aren’t trained epidemiologists. The Arizona State Health Department has trained staff that should have been utilized. If any of these physicians you’ve drafted become ill, the CDC might be held responsible.”