Кен Макклюр: Miasma

May 2018

Steven Dunbar, chief investigator of the Sci-Med Inspectorate (Sci-Med), an independent, but government-funded body located in the UK Home Office and his partner, Natalie (Tally) Simmons, a paediatrician at Great Ormond Street Hospital, took breakfast in their Marlborough Court, London flat while listening to the Today programme on BBC Radio 4. It had become their custom to listen to it every morning, using it as a primer to inform them of what was going on in the world before leaving for work. A politician was being asked what his party’s policy was on something he didn’t seem too keen to talk about. He waffled on about his leader having made it ‘perfectly clear’.

‘Why do they do it?’ Tally complained. ‘Why come on the programme at all when they have no intention of answering questions?’

‘Because they’re...’

‘Strike my last question,’ Tally spluttered, discovering that laughter and cornflakes didn’t mix. ‘I should know better than ask you for your views on politicians.’

‘True,’ said Steven, ‘Well, do you think we’ve heard enough bad news to set us up for the day?’

‘Mm, it would be nice to hear some good news for a change... but maybe that’s against news policy; it has to be bad.’

‘And the worse the better...’ Steven paused when the Today presenter interrupted proceedings with an item that had just arrived on his desk.

‘Early reports of a new outbreak of Ebola virus in the Democratic Republic of Congo are coming in...’

‘Oh, no,’ Tally groaned, ‘not another one, they’ve hardly had time to get over the last one.

They listened intently to further but sketchy details. Twenty-five people had died so far; the outbreak was in Equateur Province in the north-west of the country and, although its source had not yet been identified, there were fears that the outbreak would not be confined to rural areas. Cases had been reported in, Mbandaka, a major transport hub with a population of more than a million people.

‘This could be the one we’ve been dreading,’ said Steven, ‘the one that triggers a pandemic.’

‘Well, nobody can say that Sci-Med didn’t warn them,’ said Tally. She was referring to the fact that Steven and his boss, Sir John Macmillan, the founder of Sci-Med, had been unsuccessfully trying to persuade successive governments that public vaccination against killer diseases should be a priority, citing the fact that a killer strain of ‘flu had managed to sweep round the world back in 1918, killing forty million people at a time when public travel had been much rarer and more difficult than it was today.

‘We can only hope they’ll manage to contain it,’ said Tally. ‘Surely they’ll be better prepared this time?’

‘It was just plain luck that saved us last time,’ said Steven. He was thinking back to the near-nightmare scenario that had unfolded when a volunteer nurse returning from an outbreak in Sierra Leone to the UK and suffering from Ebola herself, had ended up wandering around a UK airport before boarding a scheduled flight back to her home in Scotland.

Steven refilled their coffee cups and asked in a quiet voice, ‘How are you feeling?’

Tally had lost her mother a couple of weeks before after a short illness had progressed to pneumonia and she had failed to recover. This was to be her first week back at work.

‘I’m fine,’ she replied, adding ‘really I am,’ in response to the look of doubt appearing in his eyes. ‘I’m glad I managed to spend some time with her before it happened. It was good to be able to say some of the things you’d regret not having done when it was too late.’

‘It’s still a big milestone losing your mother.’

‘And a pause for reflection,’ added Tally, ‘Makes you consider what you’re doing with your own life.’

‘You can’t have any problems with that,’ said Steven. ‘You’ve helped countless sick children: in many cases you’ve been responsible for ensuring they had a life at all. Now, you’re at the top of your game, practicing paediatric medicine at one of the best children’s hospitals in the world.’

‘Mm.’

‘I only wish my contribution to society was as clear cut.’

Steven was a qualified doctor too, but had chosen not to practice medicine, feeling at the time that he had been cajoled into medicine by school and parental pressure as bright children often are. After qualifying he had rebelled by joining the British army, initially as a soldier, but, over time, had become a specialist in field medicine — the medicine of the battlefield — as well as a trained Special Forces soldier. He had served with distinction in trouble spots all over the world, practicing both crafts in terrain ranging from jungle to desert. He had opted to leave in his mid-thirties without any real idea what he might do next — or be able to do, when he quickly discovered that openings for people with his skills were limited in civilian life.

Happily, and to his relief, Sir John Macmillan had come along to suggest that he might fit very well into his organisation, the Sci-Med Inspectorate, a small body of scientists and medics, which had been set up to investigate crime and wrong-doing in the hi-tech world of science and medicine — areas where the police might lack expertise. Macmillan had been right. Steven had taken to the role of medical detective like a duck to water and was now Sci-Med’s chief investigator.

Tally was surprised at Steven’s expression of self-doubt. ‘You are kidding,’ she said. ‘You’ve taken on some of the most powerful crooked individuals in the land and exposed their true colours: you’ve even come up against pure evil on occasion and won through. How many times have government ministers had reason to thank you personally for what you’ve done?’

Steven felt embarrassed to hear this from Tally. He knew how much she hated his job and the dangers that occasionally came with it. He wasn’t alone in experiencing these dangers. By association, Tally had come up against them too. He smiled, looked down at his watch and said, ‘You don’t want to be late on your first day back.’

The outbreak in Democratic Republic of Congo (DRC) was to impinge on both their days. Steven was about to be briefed by John Macmillan on the deaths of two eminent medical scientists, which had caught his attention when they were interrupted by John’s PA and Sci-Med’s office manager, Jean Roberts. She had come in to say that their attendance was requested by the Prime Minister at a COBRA meeting at 2 p.m. to discuss the latest Ebola outbreak in DRC.

Steven always thought it such a pity that the dramatic acronym, COBRA, only stood for Cabinet Office Briefing Room A, but the drama to those not in the know was always useful in suggesting that the government was taking something very seriously.

‘God knows why they’re asking us along,’ sighed Macmillan, ‘they’ve been ignoring our advice on vaccination for years.’

‘It’ll be interesting to hear what the Health Department has to say,’ said Steven.

‘Do they even have a vaccine against this damned disease?’ asked Macmillan. ‘If I remember rightly, it seemed pretty much like a rush job they came up with towards the end of the 14–16 epidemic.’

‘I suspect it’ll be the same experimental one.’

‘What exactly does ‘experimental’ imply?’ asked Macmillan.

‘Untested formally and therefore unlicensed. Because of that, they are obliged to point this out to everyone they intend offering it to and seek their permission before using it.’

‘Good God.’

‘Let’s hope he is.’

‘What do you know about this place, Mbandaka?’