The babble sprang up again. Kira talked over it until it quieted. “To go back to your earlier questions, I mentioned measles. Measles is one of the most contagious viruses we have: it can hover in the air hours after the infected person has left the room, so another person can come in and contract it without ever having had person-to-person contact. There have been cases of people catching measles from colleagues who worked on different floors in the same building. As I said, we believe the R0 of measles to be between 12 and 20.” She paused, her eyes downcast. “We believe the R0 of the ART virus to be between 14 and 24.”

There was a stunned silence, and then an uproar broke out, every reporter in the room on his or her feet. Kira waved them down. “I said earlier it’s complicated, and here’s why. During the initial outbreaks, both in Europe and in Africa, it did not appear ART was very contagious. People were getting quite sick, but they weren’t spreading it to other people unless they had prolonged, direct contact. That made it relatively easy to control. But now we are looking at a different scenario, where it is obvious that in some locations the virus is spreading more quickly, especially on the East Coast of the United States. Why? Well, we now know there are at least two different circulating variants of the ART virus of clinical significance. One of them has an R0 of somewhere around 1.2 and the other has an R0 of around 20. The virus mutated, or another strain emerged independently.” She paused, looking into the camera. “And we believe the second variant is fully airborne.”

13

Every Armchair Virologist in America

KIRA

ATLANTA, GEORGIA

137 Days After Patient Zero

My branch at the CDC headquarters in Atlanta by day looked much the same as it did by night. Which is to say: more than four months since the death of Patient Zero, a reduced number of people worked in the building, but the ones who showed up toiled around the clock. Many of the faces I’d seen every day for years were absent, most having been deemed able to work from home. In their places, a new but smaller crop of faces appeared.

Like many complex organizations, the Centers for Disease Control and Prevention consists of a structured hierarchy. A lot of people don’t realize it, but the first letter of the acronym CDC stands for the word Centers, not Center. My center, the National Center for Immunization and Respiratory Diseases (NCIRD), further breaks down into divisions and then into branches. Then, within the branch, you have specific teams, and within those teams, you have leaders and, finally, various job titles.