Silent Hill fic: Outbreak - Chapter 5: Epidemiological Report (cont.)

[mistressofmuses]

In chapter 5: Anna continues her investigation into the progression of the illness, up until the officially-declared beginning of the outbreak.

Anna Garcia’s Epidemiological report on unknown illness (cont.)

After the Labor Day weekend, which allowed ample opportunity for the illness to spread when families got together and celebrated, the symptoms began to escalate amongst the earlier infected.

Wednesday, September 07, 2016

Wednesday the 7th marked one week since classes at the public schools in Silent Hill began. It also marked the first widespread appearance of skin symptoms in the children who had first gotten ill. Judging by the preliminary data I have been given a chance to analyze, from these children and others, skin symptoms normally began to present seven to ten days after initial exposure, with younger patients skewing more towards the shorter span of time.

(As mentioned previously, I believe it is clear that Crystal Davis was actually the first known patient to have shown skin symptoms, having the disease escalate faster than would be expected. She was hospitalized on this date, though because of her atypical case, this is not currently considered the beginning of the outbreak. She has, however, already been included in the list of victims as of September 21.

Furthermore, I would still argue the likelihood that Kyle Ericson and Andrew Flynn represented even earlier infections, including the presence of skin lesions, though I grant that with no evidence beyond difficult-to-decipher video footage, that is not a provable claim.)

Several doctors reported getting calls on Wednesday from families concerned that their children had chickenpox. Due to the contagious nature of the suspected chickenpox, most medical professionals advised concerned parents to keep their sick children home, treat with soothing baths, topical anti-itch medication, and over the counter acetaminophen, and to seek further treatment if complications arose.

Far more damning, from a healthcare perspective, was the creation of a Facebook event by a local parent, expressing a desire to hold a “pox party” with her young children.

A relatively small fad, given undue prominence in the media, the idea of holding a “pox party” is one that has roots in previous decades, from before there was a vaccine for chickenpox (Varicella zoster virus). Due to the fact that severe complications from chickenpox grew more likely if it was contracted in adulthood, many parents would deliberately expose their children to infected classmates or friends to ensure they got it at a young age, when it was less likely to become dangerous, to confer immunity to them later in life. “Less dangerous” does not mean “free from danger,” and severe or even life-threatening complications could still happen in children. One of many reasons to be glad that a vaccine is now commonly available.

Unfortunately, the current unfounded trend toward being “anti-vaccination” means that far too many children do not receive the inoculations they should. It was among some of these “anti-vax” parents that the idea of holding a “pox party” for this illness originated and spread.

The event page on Facebook has since been deleted, but I have included screenshots provided by a patient I later spoke with. She did not send her children to the “pox party,” but she was invited to.

[Screenshot of a Facebook event page:

There is a banner image of two young children, a boy and a girl, both white, with blond hair. They are sitting next to each other, smiling.

Central Silent Hill Pox Party
Private – Hosted by Susan Michelin
Thursday, Sept. 08 from 10 AM – 5 PM
Tomorrow
[address redacted]

Details:

In this day and age, childhood infections of the chickenpox are increasingly rare. While many people think of this as a good thing, the truth is, it is NOT! Chickenpox has long been a NORMAL childhood illness. Exposure is what strengthens the immune system and makes the child immune for the rest of their life! Now, as Big Pharma increasingly pressures us to give our children more and more dangerous vaccines, full of unpronounceable chemicals, GMOs, and other morally questionable ingredients, we are told that our children should NOT get these perfectly normal illnesses. Instead the government tells us, they should get one of these unnatural mixtures FORCED into them. But in addition to all the unknowns that come with these vaccines, it doesn’t give any REAL immunity! The only way to do that is to be exposed the NATURAL way!

Fortunately, it seems that we do have chickenpox in our household! Even though some people may think it sounds mean, we are THRILLED and BLESSED that little Brayson and Genivieve both have broken out in spots! It means they get to be exposed the natural way and will enjoy a lifetime of REAL immunity!

To any other parents who want the same for their children, we invite you to come by to our house tomorrow at [address redacted], just a couple blocks away from Midwich Elementary. While we would like this event to remain semi-private, please feel free to invite any other like-minded parents and their children.

For anyone who has not yet made the mistake of vaccinating their child, but is on the fence about coming over, just think about it! Which sounds better to you? Having to get some mystery mix of who-knows-what injected into your son or daughter, with only a doctor’s word that it will “protect” them? Or let them come play with other children, maybe share some candy, and then go home to deal with some minor itchy discomfort for a few days/a week or so? Because we’ve known how to properly deal with chickenpox for GENERATIONS, and it’s not through Big Pharma!

We will be keeping both Brayson and Genivieve home from school, since not everyone has the same faith in the importance of natural exposure and illness, so they will be available most of the day. If your children are still going to school, we are happy to have visitors as late as 5! We would appreciate you messaging us here to let us know if you are coming over. See you tomorrow!]

Because the screenshot was taken shortly after the event’s creation, and it has now been deleted, there is no way of verifying just how many people were ultimately invited, expressed interest, or did end up going to Susan Michelin’s house, or how many children and adults were exposed to the disease in this manner. However, there are more than a few accounts from parents and children who later contracted the disease, who claim to have been exposed at this event.

I believe it should go without saying, Brayson and Genivieve were not infected with chickenpox.

In fact, none of the adults or children who have been admitted to Alchemilla with this illness have tested positive for chickenpox. It was one of the very first suspected causes, and was one of the first pathogens to be tested for. No one who fell ill was infected with Varicella zoster. We have yet to isolate any viral, bacterial, fungal, or parasitic infection responsible for the illness, but our familiarity with Varicella zoster made it an easy one to take out of the running, along with any potential mutations or new strains of the virus.

Getting a chickenpox vaccine would not have protected Brayson and Genivieve from the illness, but it is my belief the anti-vax position of their parents is directly responsible for the transmission and subsequent deaths of multiple young children, as they used unfounded fear of the vaccine to encourage deliberate exposure and infection.

Thursday, September 8, 2016

This was the date of the “Pox Party” being held by Susan Michelin. While we do not have any definite numbers for attendees, we can judge from later statements that at least 15 to 20 children, plus their parents, went to the Michelin home on Thursday. Considering the highly contagious nature of this disease (tentative estimates are for a basic reproduction number of 15 or higher), and the fact that it was being deliberately passed on, it’s likely that it would have approached a 100% transmission rate.

Doctors’ offices continued to report a spike in calls relating to suspected chickenpox cases, and even began the preliminary warnings for an outbreak by alerting public health officials, though the CDC does not require reporting of chickenpox cases. They continued to mainly provide diagnoses over the phone, though they sent cultures to be tested for confirmation in patients who came into the office. Many parents, despite the advice to stay home to avoid transmission, brought their children in anyway to get notes to excuse their absences.

In response to the reported incidences from doctors’ offices, as well as the number of illness-related absences, and the beginning of a pushback against their stated policy, Midwich Elementary School sent out the following memo to all parents:

[Memo sent home on Thursday, September 8 with all students; also sent by email to all parents, and posted on the school’s website:

Dear Parent or Guardian:

It appears there has been some confusion regarding Midwich Elementary School’s attendance policy.

While we made a few changes regarding “excused” vs. “unexcused” absences, this was in NO WAY intended to make a child come to school while ill! While we would like to have illness-related absences accompanied by a doctor’s note, we also recognize the need for some flexibility where this is concerned.

This is a reminder to please keep your child home if they are seriously ill or if you believe them to be contagious.

There have been a higher than usual number of reported chickenpox cases in our community this year, and we would like any students suspected of having been exposed to stay home if they are at all symptomatic.

While we want our students in class and learning, we also recognize the importance of health and safety. Please also review with your child the importance of things like hand washing, as well as covering their mouths when coughing or sneezing.

Help us all stay healthy this year!

Thank you, and be well!

Principal Patty Williams]

Friday, September 9, 2016

Although it’s been criticized as “too little, too late,” the memo from the school did appear to have an effect on attendance. More students were kept home from Midwich Elementary, with most absences reported as illness-related. The same was true for Carroll Middle School and Silent Hill High School, though the effect was less notable.

This was the first date that respiratory symptoms were reported in statistically significant numbers. While early reports included descriptions of minor symptoms like “sniffles”, and even occasional more troubling symptoms like shortness of breath, those symptoms had not previously been prominent.

At this point, the runny nose complaints grew more common, along with relatively minor coughing. In some cases, mostly those involving young children, the coughs were no longer mild, but became productive, and indicated fluid or inflammation in the bronchial tubes, or even in the lungs themselves. Most doctors advised these parents to bring their children in, and cough suppressants were frequently prescribed.

Frustratingly, there was minimal traceable pattern to the advancement of symptoms. While the most severe symptoms presented in younger children, and some of those children had been symptomatic for several days, for others these were the first symptoms they showed. Others who had been sick for longer did not experience any new aspects to the illness.

The same frustratingly unpredictable progression could be said of the outlying cases like Crystal Davis, whose illness appeared to present at a more advanced stage, or at least rapidly reach that more advanced stage in a matter of hours rather than days.

Saturday, September 10, 2016

September 10 marked the official beginning of the outbreak, in terms of it being reported as such. It is possible that the date will be retroactively placed earlier to coincide with the onset of symptoms, but it is as yet impossible to identify the first infection from a scientific perspective. We currently can only judge by symptoms and their progression, as we have no diagnostic tests to determine infection. Indeed, we are still unable to even determine the type of pathogen that might be responsible, despite the number of proposed causes and tests that have been run.

Despite almost every medical professional in Silent Hill noticing the abnormally high number of patients they were seeing, that did not trigger the official report of an outbreak to the CDC and the Maine Department of Health.

The official declaration of an outbreak was triggered by a high number of hospitalizations on the afternoon and evening of the 10th. Alchemilla Hospital, the largest medical hospital in Silent Hill, was inundated with more than four times their usual number of patients to their ER. Alchemilla’s ER has only 8 beds, and on average expects to see somewhere around 20 patients on a weekend evening. In the twelve hour span from noon until midnight on the 10th, they had 104 ER visits. A majority of those were for children and teenagers.

(And how fortunate, in a bitter way, that expansion of the hospital, including the emergency department, had been a priority for the hospital. I’m told the expansion project was only completed a few years ago. I can only imagine how much harder this already-difficult situation would have been prior to the remodel, when emergency patients had to be brought to the second floor, and there was only one primary exam room on the first floor. Enough of the staff have remarked on this that I found it worth noting.)

[Construction at Alchemilla completed: hospital capacity nearly doubles
(originally published in the Toluca Times on July 22, 2012)

by Lawrence Gable

The multi-million dollar renovations on Alchemilla hospital have finally been completed. The ambitious project began in the fall of 2008, when it was determined that the hospital’s available capacity would not be able to continue serving the needs of the community.

The completed construction added an entire new wing to the building, effectively doubling its size and capacity. The ground floor includes a brand new 8-bed emergency department, with additional patient rooms and labs on the second and third floors.

It also brought about a fresh wave of modernization for the hospital, allowing them to invest in more new diagnostic technology than was previously available on hand.

“We’re very excited,” said one of the hospital’s doctors. “We’ll be able to treat far more patients here, rather than having to send them into Pleasant River or Portland for more specialized treatment.”]

The staff at Alchemilla should be commended for their handling of the situation; they were quick to respond with extra beds in hallways, and expanded their triage area to encompass the entire waiting area to assess patient needs, and in some cases even begin minor treatment. The wait times were several hours in most cases, but the staff utilized their resources in the best way possible. If the readiness of the staff should ever be thrown into question, I hope that it will be kept in mind that Silent Hill is a small town, and Alchemilla is a small hospital, unused to this number of patients or this kind of crisis. They handled it admirably.

Skimming through the intake records that night, there were 13 admissions for matters unrelated to this mystery illness—things like physical injury or allergic reactions. That leaves 91 patients visiting the ER who were probable victims of this illness, though as mentioned, we have no conclusive tests and must judge purely on symptoms and the absence of other cause. Of those, 72 of them were under the age of 18.

Typical symptoms included skin sores that had been mistaken for chickenpox. (Additional tests for Varicella zoster remained negative.) The sores had progressed from flat red spots to deeper, painful blisters with dark purple centers. Fevers were almost omnipresent, high enough to be worrying, in the 99 – 103 degree Fahrenheit range, but not so high as to present imminent danger. Respiratory symptoms were the more immediately dangerous ones; most patients had deep coughs, which were bringing up fluid from the lungs. Most patients presented symptoms of early stage pneumonia, though it was not yet severe in any of them. However, breathing quickly became labored for many of those admitted, especially the youngest, with many requiring respiratory aid by the end of the night. Another common symptom, though less threatening, was severe spontaneous nosebleeds.

The worse drain on resources was the fact that most of those who visited the ER necessitated admittance to the hospital proper. Their decline was often extremely rapid. Especially because most were pediatric patients, worsening symptoms were taken very seriously, with many children being moved to ICU for respiratory support. As nurses and doctors began to recognize the progression of symptoms, they often sent pediatric patients to ICU as a precaution, which may be credited with saving the lives of some of those children.

In at least three cases, a parent who had brought a child into the ER became suddenly symptomatic and required intake as well.

Midway through the night, the staff at Alchemilla began their own outbreak protocols, though nothing had yet been officially declared. They tried to obtain at least some recent medical data from family members, including cheek swabs, nasal swabs, and travel history. This data is still being analyzed, though in my opinion, it’s unfortunately unlikely to yield usable evidence, unless we can discover a diagnostic test.

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