pitch: A new variant of the human coronavirus, K2, sweeps through North Korea. An unsuspecting biochemist delivers a routine batch of flu vaccines to Seoul. When he agrees to play translator for an attractive reporter, he stumbles into a perfect storm of political and biological forces. If he’s going to survive, he’ll need all the principles of Taekwondo he’s been taught since childhood: courtesy, integrity, perseverance, a fast kick, and even faster footwork.
Until this project was hijacked by a virus, it was an exploration into artificial blood and other medical nanotechnology. Yes, these things exist. The future is here.
When civets were suspected of causing the Sudden Acute Respiratory Syndrome (SARS) epidemic in China, thousands were systematically hunted and exterminated. Recent studies suggest that bats may have been the real culprit, as with Ebola. Nonetheless, the purge left a void in the ecosystem. The coronavirus has one imperative—multiply. If one host is eliminated, the virus must adapt to another. Almost any mammal or bird could be selected. Middle-East Respiratory Syndrome (MERS), the fifth and deadliest incarnation of human coronavirus, spread through camels. For the purposes of this story, I’ve invented a fictional variant of the virus, K2, that can spread through cattle. Otherwise, the science you’ll read is as real as I could make it. See the cover for a computer model of what the killer looks like under an electron microscope.
SARS infected over 8000 people, killing about a tenth of its hosts. The Roman commanders used this tactic, known as decimation, to strike terror into deserters. Indeed, SARS terrified people around the globe by the speed at which it propagated. First it takes over your immune system, and then you become a virus factory, spreading the disease to anyone who gets within a meter. For the first two to seven days it feels like any other flu. After a week, most people get pneumonia. In extreme cases, the entire system crashes in an ominous event called a cytokine storm—a runaway feedback loop between the immune regulatory system and your white blood cells. Small pox, Ebola, the Spanish Flu, and all the big plagues had this end game in common. The old, young, diabetics, and those with immune problems or liver diseases seem to be hit the hardest. There is no cure. You just have to ride it out and stay away from others while you struggle to breathe.
That’s not the scary part. Since the original leap to our species, the virus has been learning by trial and error. The next time we face the coronavirus, it will have made improvements.
I describe conditions in North Korea as closely as I could secondhand. The horrific famines of the 1990s killed over a million people in the Democratic People’s Republic of Korea (DPRK). No one knows the full extent because the figures were suppressed. Nor have I been in a DPRK labor camp. The descriptions are stitched together from statements from rare survivors and former guards who defected. You can see the camps for yourself on Google Earth. The similarities to Dachau are eerie.
Only an insane person would get up before dawn to drive more than an hour to a job he doesn’t want. Daniel Mann fumbled for his glasses beside the alarm clock. Unfortunately, the vaccine lab was the only place around that offered long-term care benefits for his mother. While he was at work and on Saturdays, nurses worked twelve-hour shifts, leaving him with nights and Sundays. As he brushed his teeth, he reflected that her accident had crippled his future as well.
The foul mood only lasted till he saw her sleeping. At forty-eight, the woman was still the unwrinkled saint who had treated him like a prince. She didn’t deserve this. He owed her ten times the payback, but the hours were killing him. His only hope was that if the company struck it big, his stock options might enable him to return to school some day.
“Rise and shine, Mom.” Then he wheeled over the stand with her hairbrush, toothbrush, and after-bath splash.
In her native Korean, she said, “Empty that wastebasket before she gets here.”
He rolled his eyes. “The maid comes on Wednesday. We pay the nurse. If she wants it clean earlier than that, she can empty it.”
“Medical professionals are not janitors.”
But sons with a master’s degree in biochemistry are? She had wanted him to be a doctor like his famous uncles and father. Maybe Dad’s son from his second wife wouldn’t turn out to be such a disappointment. Nonetheless, Daniel took the tiny wicker basket to the kitchen and dumped the contents into the big garbage bin. He lined the wicker basket with a fresh plastic shopping bag before washing his hands in the sink.
As he returned to her room, she said, “Women like a tidy man. There are several nice girls at my church you should meet.”
Daniel smiled. By “nice,” she meant South Korean. He turned CNN on for her because she liked to stay current. The lack of rainfall in Korea was affecting farmers. “Remember our deal. Sunday, I take you in for church and pick you up after the coffee social. I get to eat out alone.”
“A wife could cook a better breakfast for you.”
A knock saved him. He kissed his mother on the forehead and ran to unlatch the door. “Good morning,” he said in English.
“How is she?” asked Ms. Hernandez.
On Sundays, his mother mingled in public, and those nights she was always in a world of hurt. “I gave her a dose for the pain around two this morning, so she’s happy and chatty.”
The thirty-something nurse gave him a sad smile. “Which means you’re a little tired today. Do you want to take a nap before work?”
His eyes flicked toward his room. Tempting. With the round trip from the Philadelphia suburbs to the Baltimore outskirts, he had only half an hour wiggle room. “No. Every minute I delay, the traffic gets worse.”
“So you work a little less today. No one will notice.”
“I can’t cut corners. I sign off on product safety testing.” He pulled his premade lunch and a can of soda out of the fridge. Then he checked the digital thermometer by the birdfeeder on the window and grabbed a light jacket. October had brought a chill to the air. “Relieve you by six tonight as usual.”
“Watch out for the deer,” his mother shouted from the other room. She’d recently watched a news story about Pennsylvania ranking second nationwide in the number of deer strikes.
He waved as he ducked through the garage door. Maybe a crash wouldn’t be so awful. A stay in the hospital would be my first vacation in years.
His smartphone was still hooked up to the hybrid car’s sound system. He tapped “resume” on his current audiobook mystery and pulled out of the garage on mental autopilot.
When Daniel pulled up to the gates at Nano-Encapsulated Vaccine Research (NEVR), he saw a trio of cars in the parking lot. He double-checked the time because he was usually the first in. He had arrived two minutes earlier than normal and didn’t recognize the vehicles. The lean, African-American guard scanning his badge used the same tired joke he did every day. “Dan the Mann!”
“Hey, Murphy. Who’s here?”
The guard leaned closer to confide, “Le Grand Fromage escorted a few backers in.”
The board had appointed a French lab manager with extensive experience saving imperiled companies. His security and austerity measures were unpopular, so the employees seldom missed an opportunity to poke fun at him. Points were awarded for wearing Señor Frog’s T-shirts from Cancun, displaying Kermit the Frog, or using any cheesy French terms.
The ultra-secure NEVR campus was called Neverland by its employees, most of whom acted like teenagers. They held videogame tournaments in the lunchroom, NERF-dart battles in the cubicles, and contests to see who could cook the hottest chili.
As Daniel drove up to his usual space by his office, he noted the tax-exempt plates on two visiting sedans—government vehicles. NEVR belonged to the class of Washington businesses known as Beltway Bandits. In order to export superior vaccine products all over the world, they needed a government grant to ramp up to production levels. Last year’s anthrax vaccine had been a disappointment due to quality-control issues, so everything rode on the success of this year’s offerings. With flu season almost upon them, Daniel had delayed the already tardy product with an extra week of testing. According to company rules, any employee could delay production for safety reasons. However, management referred to this practice as “standing in front of the train.” Now, the investors were demanding early morning meetings.
Despite the chill in the air, he broke out in a sweat on the way to the side security door. He didn’t want to be responsible for another plant closure. If that happened, no one in the industry would hire him. Angry employees would egg his car and call his house at all hours. Last time, someone had lit a paper bag on his porch. Only after stomping out the smoking mess did he find it was full of cow feces. He’d thrown away that pair of slippers.
He ran his badge across the reader and stepped into the sterile hall. Voices from the cubicle farm caused his stomach to clench. He turned left abruptly, removed the static straps from his jacket pocket, and tucked them into his shoes. Lately, he spent far more time in the computer room than any clean room. If people were waiting to ambush him in his cube, then they wanted to know the results of his test suite. If so, he needed to see the printouts first and prepare.
Daniel badged into the small computer room, and the roar of the climate control system assaulted him. He liked the isolated chamber because it had its own printer, several large screens, and superuser access. He had also used the electron-microscope data to run simulations, which required massive computing resources.
He logged in and noted from the date stamp that the suite had completed thirty minutes ago. Next, he sent the report to the laser printer and scanned the summary as it emerged. The contamination tests all came back clean. Only two abnormalities emerged. The first had been expected. Steeling himself, he picked up the sheaf of papers and strode toward his cubicle.
The short, squat lab manager spotted him from a distance, and Henri LeBeau scurried over to shake his hand. He wore a simple charcoal suit and green power tie. Daniel couldn’t help staring down at the flagrant comb-over that covered the man’s bald spot. In an outrageous French accent, LeBeau said, “Monsieur Mann, I have heard your name often lately. I hope not in vain, eh?”
Daniel struggled not to burst out laughing. Is this a test? Fortunately, his family did poker face well. He shook hands with Colonel Branson.
The colonel’s grip was firm and his crew cut was solid gray. “Like your haircut, son. You ever serve?”
Daniel shook his head. “No, sir, but high and tight was the style when I attended grad school at UT Austin.”
“Hook ’em Horns!” replied the colonel, the way an alum would.
This bonding ritual elicited a smile from LeBeau. “The colonel has a few questions for someone of your expertise.” He turned to Branson. “Monsieur Mann is one of our most diligent workers.”
Daniel adjusted his glasses nervously. “I’m new to vaccines, but I’ll try.”
Branson frowned, an expression that traveled clear to his eyebrows. “Then why did they hire you?”
“My specialization was nanomedicine.”
“You’re shittin’ me. Like Star Trek?”
Daniel nodded. “Here, we use custom molecules down to .002 microns, the nano level. That’s the new standard in this industry.”
“Do the Russians have this capability?”
“Yes, sir. Perftran is a perfluorocarbon product. PFCs are a relative of Teflon that can carry oxygen in a similar fashion to red blood cells. If you watched the movie The Abyss, you saw the deep-sea diver breathe the gel form of PFC instead of air. Other hemoglobin-based oxygen carriers or HBOCs are made from human or bovine blood. These last longer in the patient and can be stored at room temperature.”
“Injecting people with cow blood? What is this, the damned Island of Dr. Moreau?”
“The hemoglobin molecules are the same, but the amount of human blood is limited by donations. A lab near my grad school had a product that washed out during phase II testing. I was doing my thesis on solving the problems by wrapping the fake red blood cells in a biodegradable layer and adding a few enzymes. Unfortunately, the company closed its doors before I could finish. I tried to simulate the rest of the results, but the tools didn’t exist yet. I spent the rest of my time improving BioSPICE.”
When the colonel looked blank, LeBeau showed him a little mercy. “It’s a DARPA program to provide a common platform to model biological processes at the chemical and cellular level. It’s written in Java for portability.”
“I’ve heard of Java,” replied the colonel, grateful for something familiar.
“Mr. Mann was so good at this modeling that Harvard had accepted him into its PhD program. We hired him away,” bragged LeBeau. “When he worked for Pharmacyte, he saved them the expense of phase II by finding their flaw through his computer skills.”
Saved them a lot of salaries, too. Daniel was a little nervous that the head of the lab knew so much about his history. “Like NASA, human life is our first mission priority.”
Branson nodded, pleased by the sentiment. “How did you transition from blood to vaccines?”
Blood is an $8 billion industry with the stigma of failed start-ups. On the practical side, vaccines are a well-established $160 billion cash cow. Daniel couldn’t afford another failure. “I’ve been interested in germs since age eleven when I almost died of pneumonia.”
“The encapsulation technology is identical to the Pharmacyte lab in Pennsylvania. We use the same fabrication machines, scanners, and contamination tests. Only here, we apply polysaccharide or PLGA coatings onto vaccines for improved T cell response.”
The lab manager seemed interested in this revelation, but Daniel had just lost the sponsor. He struggled to explain the process the way he might to his grandmother. “You know the basic principle of vaccines. We introduce a dead or weakened bug to the body, so the immune system learns how to beat it.” On the back of his printout, he sketched a picture of a dead bacterium. “That learning process only takes place if our product gets to a memory component known as a T cell. It’s a little fish in a big bloodstream.” He added a representation of the immune cell.
The guest grunted his vague recollection of this topic.
Daniel continued. “If we just throw in an empty hook, we won’t catch many fish. A lot of the vaccine could degrade before it reached the desired target. Not very efficient. So we bait the hook with polysaccharide worms in a ball around the dead germ.” He added squiggles around the bacterium. “This signals the T cells like a dinner bell.” He drew an arrow from the T cell to the bait.
He pressed on with his sales pitch. “With this method, we handle the big five—salmonella, strep, pneumonia, flu, and meningitis. Those can wipe out someone who’s had their spleen removed.” This scenario was of one his more complex test cases for any new product. “We can also enhance vaccines for hep B, anthrax, typhoid, herpes simplex, HPV, and Newcastle.” He had explicitly avoided the subject under current testing—hantavirus. Asia experienced over sixty thousand cases a year, but a vaccine had never before been made in the US.
“AIDS?” asked the colonel.
“I’ve read about exotic HIV experiments with gold encapsulation.”
“Sounds pricey and years away.”
Daniel nodded. “But polysaccharide is cheap and reproducible.”
Colonel Branson jerked a thumb at the report Daniel had drawn on the back of. “What do your fancy models say about my vaccine?”
He handed over the pages. “We knew it wouldn’t work on infants under eighteen months. Their immune system hasn’t developed a response to polysaccharides yet. The more expensive version adds a protein peptide that stimulates extra histamine responses. That’s like adding a flashy silver lure to the hook as well. However, you wanted the prototype fast and cheap for combat-age personnel.”
“What happens to kids who take it? I mean, one of my women could be pregnant.”
“The mother’s immune system covers the child for six months. Other infants would process it as waste. I modeled the breakdown using BioSPICE. In the worst-case scenario, the sugars reach the large intestine and overfeed the bacteria there.”
“What will that cause?” asked the colonel.
Straight-faced, Daniel replied, “The baby’s poop will stink more.”
Branson burst out laughing and clapped Daniel on the back. “I like you, Harvard. The last lab couldn’t even document their testing procedure. Henri here was showing me the manuals you’ve written since you’ve been here. I didn’t know there were six hundred types of blood. You’ve added test cases for every vaccine lab error in the last twenty years. The government loves paperwork like that. Demonstrate this vaccine by injecting one of your staff, and you’ve got a contract.”
“I believe in an ancient Roman practice. The engineer who built a bridge should lie under it as the first wagon rolls across. Makes people more careful.”
The lab manager wore a huge smile. The company was saved.
“We can do that as soon as a technician arrives,” Daniel said.
“I want you to do it. I mean, that’s something they teach people to do in grocery stores, right?”
“You can inject me,” volunteered LeBeau.
Daniel stammered, “Can-can I talk to you in private a moment, sir?”
“He wants to take my medical history,” the Frenchman ad-libbed. He guided Daniel to the break room. “Zees ees the moment of truth. Don’t drop the ball now.”
“Th-there’s a reason I never became a doctor. I can’t stand the sight of blood,” Daniel admitted. At age sixteen, he had watched his friend Paul bleed out after a snowmobile accident involving barbed wire. “I get dizzy. It’s called a vasovagal response.”
“So much for your career as an ax murderer, eh? Surely you had to inject someone to get your degree.”
“Several rats and a pig.”
“An old frog is not too different.” The humor shocked Daniel, so the man continued, leading them back to the colonel. “I trust you with my life. So much that I am naming you head of testing for the company. Just smile and stick me with a needle. Yes? I will procure the resources to speed your testing of the next batch. We can’t keep the customer waiting like this again. You say Pharmacyte has everything we need? I will convince the board to acquire them from bankruptcy.”
Excitement overcame Daniel’s reluctance. “The company will compliment ours perfectly, sir.”
LeBeau waved his hand. “Perhaps, but it is the production capacity we need now. If we can merge quickly, Neverland can still make a profit this flu season.”
Pale and shaking, Daniel shoved a needle into the big cheese’s shoulder. His boss’s boss managed not to wince.
When the dose was administered, LeBeau announced, “I’m going to escort the first shipment of the product to the base. The colonel’s men are waiting to deploy. Feel free to take a long lunch and celebrate your promotion with your friends. Your new office will be ready for you when you return.”
Daniel’s head was spinning from both the stabbing and the generosity, so he didn’t monitor himself. “Yeah, you’ll want to be in the demilitarized zone in case the famine makes the North Koreans reckless.”
Branson’s head snapped up as if a gun had been drawn in the room. “Interesting. Who told you that?”
“It’s not brain surgery, sir. You’re in a rush to get a unit vaccinated for Korean hemorrhagic fever. I watch the news. There’s only one place that would be necessary for US troops.”
“In the future, keep your guesses to yourself.” Frowning, the colonel told LeBeau, “I want full DoD contractor checks done on all your personnel before the next shipment.”
“Of course, sir.”