Chapter 282 Managing An Epidemic

Shout-out and thanks to Leo_Micado for beta-reading this chapter.

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Before Josie departed, she and Jean immediately went about cleansing the area with the aerosolised disinfectant and set up a large group of triage tents to manage the treatment of the infected. As it stood, those affected by the disease were spread out within the quarantined region. It would be inefficient to administer and manage care in this dispersed state, so the first order of business would be to herd the affected into a cohesive area.

Why was this preferred? Wouldn't this increase the chances of spreading the illness amongst the population? That would be true if the herding was done haphazardly.

Managing any disease or epidemic can be achieved through passive or active means. The former involves establishing general guidelines that an individual or group must follow to prevent the spread and proliferation of an illness. This is usually generic and preventative in nature, in that there is no targeted action involved. Wearing facial coverings, maintaining safe working distances, cleaning oneself regularly, and not eating food that is left uncovered for a long time fall under this category.

Active management is more aggressive and targeted in its approach. However, this also means that it is often more rigorous to implement. But it can be boiled down to a three-step process: identifying the disease, combating the disease, and preventing it from occurring again.

Identifying the disease involves learning everything there is to know about the disease. Where did it start? How does it spread? How does it enter and affect the human body? These are a few of the questions that must be addressed first, as they determine the efficacy of the response.

It is important to identify the source of the epidemic so that it can be properly contained or eliminated altogether. This is to avoid causing a resurgence of the same epidemic while it is being managed. Josie had confirmed with certainty that the creature she had just battled was the instigator of this illness. For all intents and purposes, the source had been eliminated, so Jean shouldn't need to worry about the illness rearing its head once again. However, Josie said in no uncertain terms that the creature could have escaped. Although this was still an uncertainty, Jean could not discount the possibility even if it was minuscule. But she could do nothing for now except depend on Josie to handle the leg work of finding and eliminating the source in the meanwhile.

The next order of business is identifying how the illness propagates and restricting it. This is to limit the spread temporarily so that those affected can be treated without having to worry about new - preventable - cases. This is where the herding of the affected comes into play. Instead of grouping everyone into one tent or room, the incoming horde (as herded by Josie while she travelled all over the quarantine) was split into three categories. The first were the ones showing symptoms of the infection, the second were those suspected of being exposed but asymptomatic and the third were unexposed and asymptomatic.

The first group was easy to deduce. The symptoms of this particular illness weren't paced in its progression; it went from zero all the way to a hundred within days. As a result, there were very few in the group displaying signs of the illness. The ones that did were on their last legs, and Jean could do very little except for offering a diluted drop from the Draught of Living Death - an extremely concentrated potion capable of putting even an erumpent to a comatose sleep with a human-sized mouthful.

The second and third groups were tougher to distinguish. In both cases, the suspects were asymptomatic so judging through a cursory glance was impossible. Furthermore, the folk refused to answer questions truthfully. When Jean urged them to declare if they had even been exposed to the illness in any way, they all shook their heads and moved towards the third tent. When she added that those in the second tent would receive primary care, they all moved towards that tent.

In the end, Jean was forced to step in and enforce some order among the din. She decided to go with the most effective strategy of running blood tests on all those present to see if there were any indicators of their illness in their system.

This carried on to the third part of identifying the illness, which was to actually determine its nature and behaviour. This is to determine the optimal treatment strategy. Under Mister Larks, Jean learned that the three primary causes of acquired illnesses in people are bacteria, fungi and viruses. This knowledge broadened Jean's horizons vastly.

Through her research with her father, she'd somehow stumbled upon these three culprits. She had already noted the differences through her observations, but she didn't classify them. However, by assigning a classification and name, her understanding of how to treat illnesses induced by these three improved marginally.

According to Mister Larks, for diseases caused by bacteria, specialised antibiotics are usually the preferred treatment method. In the same way, antifungals work for fungal infections. For viruses, the preferred method is through antivirals. Antibiotics, antifungals and antiviruses offer three different treatment pathways depending on the type of infection since bacteria, fungi and viruses work in different ways.

After learning the mechanism of how these types of medicines worked, she returned to her prior research with her father and inspected the potions she knew and worked with. The ones that were effective in treating the illnesses classified as bacteria, fungi and viruses all worked similarly to how they were expected to according to their respective treatment pathways. The answer was right in front of her, she just didn't know what to look for!

The mana sense is truly a wonderful piece of magic. Every mage is essentially gifted access to all the knowledge in the world, except it remains indecipherable until the mage learns how to process it. Gaining further insight into the microbiological world was a great revelation for Jean. Though it wasn't so revolutionary to induce a breakthrough, as she was knowledgeable about it from before (but only to a limited degree).

Jean could run blood tests purely with her mana senses now since she knew what to look for. With fluids extracted from those already infected (pus fluid, blood, marrow, etc.) she managed to identify the exact mechanism through which the disease affected its victims. Scale-wise, it was much smaller than bacteria, which already narrowed it down to a virus. The aberrant particle coopted the natural division behaviour of cells to produce more of itself and quickly hijack the immune system of the body. The virus targeted the blood specifically to achieve this.

Identifying the epidemic as caused by a virus provided Jean with a rough idea of what she needed to do to combat it, macroscopically. But knowing the theory and being able to apply it are two different things. Jean realised that although she had a massive stockpile of relevant knowledge floating in her mind, she had very little specialised practical knowledge in medicine and healing. The little she did have was extremely trivial, such as curing common diseases. It was equivalent to going from drawing only straight lines to completing portraits. The gully was massive and impossible to overcome with theory alone.

Jean couldn't rely on magic for this because she didn't know any spells that could work in this instance. Neither hers nor Josie's control over mana was precise or distributed enough to attack the virus particles directly (there were far too many and sub-microscopic in scale). She knew she had to let the body heal itself naturally since it has subsystems highly optimised for that specific purpose. However, to nudge the body towards the path of healing she needed to provide a catalyst. She could not throw random and generic potions at this problem and expect it to work. It was also most likely an exhausted avenue by better healers which was why this horrible quarantine was warranted. She wanted to believe that no one was so evil as to relegate a large population to their deaths without even trying to save them.

But how was she to go about developing medicine to specifically target this virus?

This completely stumped Jean. She stared at her journal for half an hour, hoping that something would jog her mind into action and churn out a feasible solution. When nothing made itself known, she stood up in frustration and walked out of her tent at a brisk pace.

The world outside was filled with pain-filled moans and groans. The process of sequestering everyone stuck inside the quarantine was tiresome. Two days had passed since Josie killed the creature. After that, she moved all over the quarantined area and guided those that could move in this direction and carried in those that couldn't. The process wasn't easy, there was some pushback from the population who had grown jaded with mages in general. But the allure of healthcare overcame all those inhibitions.

Furthermore, Jean remembered to drag in the cart of supplies she'd stockpiled before leaving the capital. Food and clean water were just as important as shelter, if not more, during triage. After all, without proper nutrition, the body cannot heal itself. The quarantine was largely barren - the epidemic had put the working population out of commission, so the farms and orchards were all destitute. Therefore, the stockpile Jean brought mostly contained preserved food items that wouldn't spoil quickly. She also carried a storage disk with a stockpile of perishable goods. Since there weren't any others to manage the area, Jean had to distribute her time between research, treatment and serving food. All in all, it was extremely hectic.

Jean approached the large tent labelled "2" and took a long breath. She was adorned in her personal protective attire (a fresh set after burning the one she wore earlier). Pulling apart the canvas hanging in front, she entered the tent. She let her eyes scan over the people laying in a gridlike fashion on top of floor mats. Everyone looked exactly as she left them, which was a positive sign - the infection usually took just less than a day to rear its head.

Her eyes eventually landed on the little girl named Kili. Ever since she regained consciousness, she'd remained detached and emotionally distant - sulking in one corner of the room and leaning against the tent's frame. Jean allowed the girl to perform the last rites for her mother and cremate her body (from a safe distance). But the shock of seeing one's mother die such a cruel death was never palatable for a child - Jean should know, after all.

'Two days have passed, and she hasn't exhibited any symptoms,' Jean concluded. 'Odd... The virus is unusually infectious, especially if a victim is exposed to pus fluids. The girl's entire face was practically coated with it...'

While Jean pondered on that thought, she missed the critical signs exhibited by the man laying beside the girl. Like a high-pressure pipe bursting, the man descended into a coughing fit that immediately devolved into a devastating projectile vomit, evicting all the contents of his gut with a slurry of crimson blood in the mix.

Jean immediately rushed towards the man and tilted his head to stop him from asphyxiating on his own vomit. Once the man's violent vomiting subsided, Jean released a wavering sigh and looked up, only to see the girl drenched in blood.

"Oh no!"