11 February 2014
15:58 Zulu
Like a majestic blue marble, Earth floated in the middle of the observation window that James was looking out of. His gaze currently fixated on Central Europe, Spain, Portugal, and England had just risen into sight moments ago. He watched quietly as the terminator crossed Eastern Europe and the extreme eastern edge of Africa, the dim lights of cities all across Russia, Byzantium, and Persia coming on as dusk fell across the land. It was a sight he never grew tired of, watching the sunset across the world. Amazed sometimes when the sunset allowed him to watch the distinct technology disparities in the world. Every knows about the "Island of South Korea", but equally fascinating to him is the pockets in Australia, most of the continent is still uninhabited, and when the sun sets, it becomes noticeable. Africa too, the heavily populated Mediterranean coast. Almost nothing in the Sahara, and then pockets of bright lights on the Ivory Coast, and a few spots in the interior, until you reach Cape Horn, where it looks just as bright and dense as the northern coast. He knew that, especially in Africa's case, it wasn't that there wasn't people living there, its that those people barely had running water, let alone lights. He'd feel a pang of regret when he dwelled on that topic for very long. Any place on Earth is infinitely more habitable than where he was standing right now, even deepest, frigid wasteland of Antarctica could support life for a few minutes if they had to step outside.
The door chime sounded. James waved Micheal into his office without turning.
"You wanted to see me James?"
He nodded, "Yes, Micheal. I'm sorry, but I have no other option right now than to have your ship remain docked here until further notice." James finally turned to him to read his reaction.
Micheal looked confused, "Why?"
James picked up a PDA from his desk and handed it to him, "We've been so focused on the Military and Political aspects of Earth's geopolitics, that we missed something even more important."
"An Influenza outbreak." Micheal looked up, "Are we being quarantined? No one on my ship has shown any symptoms."
He smiled, "That's right, we're all clean up here. Had anyone on your crew, or any of the passengers had it, they would have begun to show symptoms by now. We dodged a bullet this time. We're not quarantining us, we're quarantining Earth. I realize that that's not a big distinction at the moment, but when other facilities come online it will be."
"It's that bad?"
"It's already claimed sixty thousand lives. It's smashed the number of deaths in the 2003-2004 outbreak. Some think that it'll surpass the million mark, or even higher before the end of the season. It's highly contagious, and like they did in 2009, they got the wrong vaccine out there. A few are saying that this may rival the 1918 outbreak, they think it could claim fifty million lives or more.
"So, we can accept an inbound shuttle from the International Space Station, and that's it."
James nodded, "Correct, I've already spoken with the RSA and NASA administrators. The Expedition 36 crew will be leaving the station the day Expedition 37 arrives, and they will be coming here, rather than returning to Earth immediately. They will be taking the shuttle you left for them. There will be no change-over ceremony, there will be no contact between the 36 and 37 crews."
Micheal shook his head, "Surely they don't think Expedition 37 will be carrying the virus?"
James shrugged, "It's doubtful that they will be. The 37 crew has been isolated long enough from the general public that they shouldn't get it. But you never know. They may be being overly cautious, borderline paranoid, but, I'd rather they be paranoid than careless. Additionally, the 36 crew has spent almost six months in space, in complete isolation, which just the six of them for company. The administrations do not want them to land in the peak of the flu season and catch it while they are still recovering from the shock of returning to Earth. They'll come here, Susan will do their post-mission physicals. They'll spend recovery time on your Grav Deck, while ours is being finished, then they'll move over here and complete their recoveries until we lift the general quarantine of Earth."
Micheal nodded, "You realize, of course, that this will push our construction schedule back if we are stuck here for more than a month."
He sighed, "Can't be helped. We'd be doing more damage to our schedule, and ourselves, if we were to let an outbreak occur here."
"Just what happens if there's an outbreak here?"
James stood up, "I'm glad you asked, Susan and Kelly have been going over contingency plans in the Infirmary. Let's drop in on them and see what they've come up with."
Micheal turned and walked with James out into Ops, "If someone were to bring the flu here, they would be contagious 36 to 48 hours after contracting the disease, but they wouldn't show symptoms for 72 to 96 hours."
James looked down at Sam as they walked along the upper tank, the bruise on her forehead had all but faded, but she still occasionally rubbed it as if it still hurt. "Exactly, it's why the flu is so dangerous. You can spread the disease before you even know you have it. Ironically, once you know you have it, it's only another 12 to 24 hours before you are no longer contagious."
Micheal stopped at the lift area and pressed the call button, "With the ventilation system of the ship and the station, if someone became contagious, it would be all over either one in a matter of hours. If we scrubbed it at the filters, it would only infect those that came into contact with the carrier."
James stepped into the lift as the door opened up, "That's a possibility, there's plenty of chemicals that can kill the virus on contact. But," he paused as the doors shut the two of them into the lift, "What are the unintended consequences of that?"
He frowned, "What do you mean?"
"About twenty years ago there was a short lived science-fiction series called 'Earth 2'. The premise behind it was that the Earth was gradually becoming uninhabitable, and they sent a ship out to colonize another planet, Earth 2. Before then, almost the entire human race was living in space stations that orbited Earth. A small, but not insignificant, percentage of the population born on the stations were inflicted with a disease that they simply called, 'The Syndrome'." The lift doors opened up on them and gave them access to the Promenade. Despite the lack of shops, there was significant traffic on the Promenade, off duty personnel using the wide open space as a recreational facility. Sitting on or floating over the various benches that gave them a view of Earth, the Moon, or just a plain star scape. A couple people were playing catch, others were running around the circular track. "The thought behind 'The Syndrome' was that it was caused by the artificial constructs of the station, rather than being where 'we belong' on the surface of a planet. I think they may have been right, but not for the reason the characters suggested." James pressed the open button for the Infirmary, "'The Syndrome' acted a lot like an Auto Immune Deficiency Syndrome. And while there was no mention of HIV or AIDS on the program, being born and raised in a completely sterile environment like a Space Station is bound to cause more than a few people to not have a fully functioning Immune System."
"There's something to that, Captain." Susan spoke up from the far side of the room. "Creating a completely sterile environment is great for medical purposes, but lousy for living purposes. There's so many every day bacteria, even viruses, that our body just cannot live without for very long. No matter how hard we try, we can't yet replace the human immune system. Like the muscles in our bodies, it needs to get used once in a while or it loses it's effectiveness." She paused and looked to her college, Dr. Kelly Norman, "I am assuming, of course, that you were talking about killing the virus with the filtration system."
James and Micheal both nodded.
Kelly shook her head, "It can be done in short term situations, but it is counter-productive to do it over a long period of time. This is exactly why, when I was in the Navy that, we had a strict vaccination program in place."
James frowned, "I'm not a conspiracy theorist, I may talk with people that are, but I'm not one. But I do know the problems with the heavy vaccination programs that the US Military uses. I know of the side effects. I'm not going to mandate that anyone who steps foot on this station be subjected to that kind of vaccination regimen."
Kelly looked to Susan to see if she would support her, when it was apparent that she wasn't she turned back to him, "We wouldn't need that strict of a regimen, we don't need vaccinations for half of what the US Military vaccinates for. Most of their vaccinations are geared towards providing protection from a biological weapon, rather than something that anyone can just pick up off the streets."
Susan stepped forward, "It is the side effects of those vaccinations that concerns me the most. Look, we will be entering uncharted waters here. While none of us have been in space very long, even James, who's spent more time than anyone else here, has been planet side within the last three months. The longest time a single person has spent in space is thirteen and a half months, we're going to pass that eventually."
James raised his hands to forestall any further arguments, "Enough, I didn't want this to become a moral and ethical debate on the vaccination program as a whole. I wanted options, IF and WHEN an outbreak occurs here, how do we deal with it?"
Kelly started to answer, but Susan spoke up first, "I don't think there's much to worry about, James. We're looking at the hypothetical, if it happens. I don't believe it would. I know Kelly disagrees with me, but let me tell you why I don't think it would happen first. Everyone that enters the Freighter, goes through Decontamination. We can detect the influenza virus, in addition to a number of other communicable diseases in the air samples from the decontamination process. If someone has the flu, we can isolate them, give them Tamiflu, and keep them separate from the rest of the crew until they are no longer contagious. In order to get to the station, they have to come through the Freighter. This station should NEVER get an influenza outbreak."
Kelly shook her head in disagreement, "The influenza virus is only detectable after it's incubated long enough to become contagious. That's a minimum of 24 hours, usually more like 48. Someone could contract the virus on Earth, get through Decontamination, and make it to the station before they become contagious. It's only a couple of hours from orbit to here. Also, we are going on the assumption that other ships would use as stringent of a decontamination process as you do, I doubt that medical professionals will be a very high priority on any of the civilian ships. They'll be ok to handle cuts, bruises, broken bones, and the like. But if any of them get sick, it will be up to us to deal with them."
Micheal raised a finger, "What about taking blood samples?"
James and Kelly both shook their heads, Kelly answered, "The virus doesn't incubate in the blood stream, it incubates in your throat."
Susan nodded, "Yes, that's exactly why we'll never have to worry about it, we do take phlegm samples, that detects the virus even in its incubation stage."
James lowered his head, "I still want a plan of action. Say somehow you do manage to miss it, or that the CMO of a civvie ship decides that that part of the decontamination isn't important."
Kelly turned to a monitor, "We're actually OK in that regard. Susan is right, we can detect it when it's airborne. When the virus passes through a filtration station, we know it. We can treat the air coming from that section, and implement isolation and quarantine procedures. We can't stop it from spreading through every section the infected person was in, but we will catch it early, and keep the infection from spreading throughout the station. The biggest problem we will have is the Promenade. Because of the volume of air in the Promenade, it will take some time for the virus to make its way to the filters, but smaller areas we'll know within minutes of an infected person in the section. Once the section is isolated, we can send medics in to bring the potential infected into quarantine and just wait it out. We'll be better off here than anyone on the surface would, because they'll get immediate medical attention before they even start showing symptoms. We shouldn't have a single influenza death on the station, if we all do our jobs right."
Susan nodded in agreement, "Yes. I don't think an outbreak is likely, but if it does happen, we have procedures in place to prevent it from spreading fully. I also don't think we need to quarantine Earth. Not for the flu. Although I do agree with the decision to bring the ISS crew here first."
Kelly nodded, "As do I. I also don't think a quarantine is necessary."
James scratched his chin as he thought over his options, "I'll talk with World Health officials, but unless there's overwhelming opposition to it, I'll lift the quarantine."
Susan shook her head, "WHO is only clamoring for a quarantine because they know that the average person doesn't have the instant access to health care the way we do. If someone gets sick here, they are in Sickbay or the Infirmary within an hour. Not days because someone doesn't realize just how sick they are, or don't think that they can afford the care. We'll be fine."