The last entry in Ms. Townsend's outpatient file recorded a visit to an OB-CYN man for cystitis. Alan had seen an orthopod the previous year for a sprained ankle he'd suffered in a hospital basketball league. Except for the medical secretary and the lab tech, there was the strong suggestion that Dr. Richter was the source of the illness. The fact that he'd seen five of the patients just before he developed symptoms had to be significant.
Marissa could explain the lab tech getting the illness by his sticking himself with a contaminated needle, but she couldn't immediately explain Helen Townsend. Marissa had to assume that Helen had seen Dr. Richter sometime earlier in the week. She had come down with the illness just forty-eight hours after the doctor. Maybe he had spent a lot of time in medical records earlier that week.
Marissa's musings were interrupted by the ward clerk, who said that Dr. Navarre had called to ask if Marissa would kindly come down to the hospital conference room.
Returning to the room where she'd started the day reminded Marissa of how long she'd been working. She felt bone weary as Dr. Navarre closed the door and introduced the other person who was present. He was William Richter, Dr. Richter's brother.
"I wanted to thank you personally for being here," said William. Although he was impeccably dressed in a pin-striped suit, his haggard face was mute testimony to his lack of sleep. "Dr. Navarre has told me your tentative diagnosis. I want to assure you that we will support your effort to contain this illness to the limits of our resources. But we are also concerned about the negative impact the situation could have on our clinic. I hope that you agree that no publicity would be the best publicity."
Marissa felt mildly outraged, when so many lives were at stake, but Dubchek himself had said essentially the same thing.
"I understand your concern," she said, uncomfortably aware that she had already spoken to a reporter. "But I think we have to initiate further quarantine measures." Marissa went on to explain that they would have to separate the possible contacts into primary and secondary contacts. Primary contacts would be those people who had spoken with or touched one of the current eight patients. Secondary contacts would be anyone who had had contact with a primary contact.
"My God," said Dr. Navarre. "We're talking about thousands of people."
"I'm afraid so," said Marissa. "We're going to need all the manpower the clinic can spare. We'll also tap the resources of the State Health Department."
"We'll provide the manpower," said Mr. Richter. "I'd prefer to keep this 'in-house.' But shouldn't we wait until we actually have a diagnosis?"
"If we wait, it may be too late," said Marissa. "We can always call off the quarantine if it is unnecessary."
"There's no way we'll keep this from the press," moaned Mr. Richter.
"To be truthful," said Marissa, "I think the press can play a positive role by helping us reach all the contacts. Primary contacts must be
instructed to stay as isolated as possible for a week and to take their temperatures twice a day. If they run a fever of 1010 or over, they'll have to come to the clinic. Secondary contacts can go about their business but should still take their temperatures once a day.
Marissa stood up and stretched. "When Dr. Dubchek arrives he may have some suggestions. But I believe what I've outlined is standard CDC procedure. I'll leave its implementation up to the Richter Clinic. My job is to try to find out where the virus originated."
Leaving two stunned men in her wake, Marissa left the conference room. Passing from the hospital to the clinic building, she approached the clinic information booth, asking directions to Dr. Richter's office. It was on the second floor, and Marissa went directly up.
The door was closed but unlocked. Marissa knocked and entered. Dr. Richter's receptionist was dutifully behind her desk. Apparently she hadn't expected company,
Marissa could explain the lab tech getting the illness by his sticking himself with a contaminated needle, but she couldn't immediately explain Helen Townsend. Marissa had to assume that Helen had seen Dr. Richter sometime earlier in the week. She had come down with the illness just forty-eight hours after the doctor. Maybe he had spent a lot of time in medical records earlier that week.
Marissa's musings were interrupted by the ward clerk, who said that Dr. Navarre had called to ask if Marissa would kindly come down to the hospital conference room.
Returning to the room where she'd started the day reminded Marissa of how long she'd been working. She felt bone weary as Dr. Navarre closed the door and introduced the other person who was present. He was William Richter, Dr. Richter's brother.
"I wanted to thank you personally for being here," said William. Although he was impeccably dressed in a pin-striped suit, his haggard face was mute testimony to his lack of sleep. "Dr. Navarre has told me your tentative diagnosis. I want to assure you that we will support your effort to contain this illness to the limits of our resources. But we are also concerned about the negative impact the situation could have on our clinic. I hope that you agree that no publicity would be the best publicity."
Marissa felt mildly outraged, when so many lives were at stake, but Dubchek himself had said essentially the same thing.
"I understand your concern," she said, uncomfortably aware that she had already spoken to a reporter. "But I think we have to initiate further quarantine measures." Marissa went on to explain that they would have to separate the possible contacts into primary and secondary contacts. Primary contacts would be those people who had spoken with or touched one of the current eight patients. Secondary contacts would be anyone who had had contact with a primary contact.
"My God," said Dr. Navarre. "We're talking about thousands of people."
"I'm afraid so," said Marissa. "We're going to need all the manpower the clinic can spare. We'll also tap the resources of the State Health Department."
"We'll provide the manpower," said Mr. Richter. "I'd prefer to keep this 'in-house.' But shouldn't we wait until we actually have a diagnosis?"
"If we wait, it may be too late," said Marissa. "We can always call off the quarantine if it is unnecessary."
"There's no way we'll keep this from the press," moaned Mr. Richter.
"To be truthful," said Marissa, "I think the press can play a positive role by helping us reach all the contacts. Primary contacts must be
instructed to stay as isolated as possible for a week and to take their temperatures twice a day. If they run a fever of 1010 or over, they'll have to come to the clinic. Secondary contacts can go about their business but should still take their temperatures once a day.
Marissa stood up and stretched. "When Dr. Dubchek arrives he may have some suggestions. But I believe what I've outlined is standard CDC procedure. I'll leave its implementation up to the Richter Clinic. My job is to try to find out where the virus originated."
Leaving two stunned men in her wake, Marissa left the conference room. Passing from the hospital to the clinic building, she approached the clinic information booth, asking directions to Dr. Richter's office. It was on the second floor, and Marissa went directly up.
The door was closed but unlocked. Marissa knocked and entered. Dr. Richter's receptionist was dutifully behind her desk. Apparently she hadn't expected company,
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