Have you ever watched the sci-fi-ish thriller 12 MonkeysStarring Bruce Willis, it features Brad Pitt in a wonderful role (perhaps just a role wonderful to him) as the crazed son of a renowned virologist. Reportedly, the director was worried that Pitt wouldn’t be able to handle the role, which called for a lot of stuttering crazy-talk. How did they go about turning him into a raving lunatic?

By taking away his cigarettes. If you haven’t watched the movie, then watch it. It’s a beautiful story — more on that later. Plus, a lot of what I say here will make more sense if you watch it. Plus, you’re stuck at home anyways, so what better things do you have to do? I know, a lot.

A couple months ago, I started hearing ads on the radio about vacationing in the Florida Keys, and I thought about 12 Monkeys. (If you’ve watched it, you know why.) Suffice to say, for those of you who haven’t watched the movie, it is set primarily in a future in which humanity has been forced to move underground in the face of a plague that wiped out some absurd percentage of the population. James Cole (Bruce Willis) is sent back in time by the “scientists,” who are hoping to learn about the origins of the virus (and/or stop its spread in the first place) in an attempt to discover a cure. The story is beautiful and reminiscent of a Greek tragedy. I’ll say that much and stop there, although perhaps I’ve already given too much away!

At any rate, when I started hearing ads about the Florida Keys, I began to wonder if COVID-19, which was then called the novel coronavirus or, more commonly, just the coronavirus, would become something bigger than several thousand or tens of thousands of cases in China and its neighboring countries. Many people, I think, assumed that COVID-19, like the two coronaviruses SARS and MERS before it, would simply burn out on its “home” soil.

Much as many people assumed the Ebola epidemic that began in Guinea in 2013 would burn out, like many Ebola epidemics had burnt out before.

That Ebola epidemic is the focus of Richard Preston’s new (2019) novel, Crisis in the Red Zonewhich is a followup on his older novel The Hot ZoneI’ve read and reread The Hot Zone too many times to count; now I’ve lent it to a friend. I’m about halfway through Crisis in the Red Zone, which has proved just as gripping and, to put it lightly, gory. Gory, and the scary thing, as with true crime, is that every word is true. I highly recommend both of these books, even to those who think they have no interests in viruses. They are not technical. They are written using terminology familiar to the layman. The language is sparing, vivid, and evocative, bringing crises to light. And, in the face of the COVID-19 outbreak in the United States, the situations depicted in Crisis in the Red Zone have become all too relevant and even familiar.

This post, by the way, is not about writing. If you hadn’t noticed already. It is, however, about fact and fiction and the tenuous line between them, which every good writer knows and which many writers are willing to exploit.

What Preston has done in both of his books is search — search for the truth about the virus, about where the virus began, about where it came from — and chronicle — chronicle the actions that were taken, the actions that were not taken, and the spread. Or the non-spread, which is covered in The Hot Zone. (In 1989, Ebola virus appeared in chimpanzees in a lab in Reston, VA — very near Washington, D.C. But the virus never spread. The book gives the how and gets at the why.) About midway through Crisis in the Red Zone, he interrupts the narrative to give some thoughts:

If we look closely at this outbreak, the first outbreak of Ebola, we can learn things that may help us prepare for the next emerging virus, whatever it is and whenever it comes. It seems virtually certain that another Level 4 emerging virus, one that is perhaps far more contagious than Ebola, will cross from the virosphere into a person somewhere on earth. That person will pass the agent to someone else, and quickly the agent will move along airline routes, traveling inside air passengers, and it may be able to ignite spreading chains of infections in cities, as Ebola did. Since there will be no vaccine and no treatment for such an emerging virus, and because it may spread easily from person to person, the virus will be terrifying and will seem virtually unstoppable.

If we are going to stop the next virus, it pays to study history.

This book was published in 2019, the same year in which the novel coronavirus began to spread in China. Like SARS, MERS, and Ebola, COVID-19 likely originated from an animal source. It is currently classified as a biohazard Level 3. So while it may not represent the “terrifying” and “virtually unstoppable” virus Preston predicted, it at least represents another step on the ladder to that virus.

Many would argue that COVID-19 is terrifying in its own right, though its symptoms are mild in many individuals and though some countries have shown evidence that it’s capable of being stopped — at least for a moment. Did you know that the coronavirus family also includes the set of four viruses that cause the common cold every year? This, coupled to the fact that, seventeen years after its outbreak, no vaccine has been developed for SARS, has led some experts to speculate that creating a vaccine for COVID-19 will be no easy feat. It may in fact be impossible without a serious scientific breakthrough of some kind.

Rather, COVID-19 might join the realm of the many viruses that circulate through human populations each year, usually in the winter. Akin to a fiercer cousin of the common cold, if you like it that way, which has never been known to kill a person alone. In fact, since viruses need living hosts to survive, the viruses which kill the least — over the longest amounts of time — are the most successful ones. The ones that mutate the most, making it near-impossible for scientists to pin them down, are often the ones that last the longest, wreaking havoc among the ranks of the young, elderly, and immunocompromised.

Here are some other respiratory viruses that go around every year: influenza virus, parainfluenza virus, adenovirus, rhinovirus, and enterovirus. Many of these can result in complications such as pneumonia. It is likely, though not certain, that COVID-19 joins this list.

It’s best to keep calm and as stress-free as possible in this time. COVID-19, like many other viruses, can create a “cytokine storm” in patients, in which the immune system goes haywire. White blood cells create cytokines, which create inflammation, and inflammation summons more white blood cells to the scene, which then create more cytokines, and a patient’s condition can quickly become untenable. Research suggests that stress may play a role in triggering cytokine storms, which may have been the leading cause of death in young adults during the 1918 influenza pandemic.

Meanwhile, there’s a lot of fiction floating around. Books and movies about viruses gone wrong are at a premium. Various drugs and chemicals are being touted as “the cure” or at least a potential cure, when in fact most of them would be given only to severely ill patients who might benefit from strong antiviral drugs. Today, I read on the New York Times about a man who died after taking a fish tank additive containing chloroquine phosphate as its active ingredient. Chloroquine phosphate is commonly used as a preventative measure against malaria, and tests are underway worldwide to see whether it might aid patients in fighting COVID-19. But there’s no proof of anything yet. Most recently, a cocktail of HIV drugs failed to assist patients’ immune response to the current virus.

This, for me, is one of the most intriguing stories, a story which for me illustrates the spread of this virus and a community’s reaction to it. Westport, an affluent Connecticut suburb, has become a focal point of COVID-19 in Connecticut after “Party Zero” — a soiree — half of whose attendees were infected. Only one source of the virus at that party has been confirmed: a man who had traveled from Johannesburg, South Africa. Thus Richard Preston’s vision is coming true. Spread by wealth, the virus is traveling along airline routes. It has “[ignited] spreading chains of infections in cities,” such as New York, which now contains more than 5% of cases worldwide.

How did the citizens of Westport react to news that the virus had infiltrated their town? With fear, with apprehension, with paranoia. Some demanded that the authorities make public the names of the party hosts and party goers. Others questioned whether to make public the news of their own confirmed diagnoses, fearing social stigma.

I heard that in one country — and as a fact of the time, I can’t say whether this story is fact or fiction — they are painting a mark on the forehead of everyone who receives a positive test result for the novel coronavirus.

At this point in time, I myself may have been exposed three times over. My neighbors have been tested, but have been waiting over a week for their test results. My brother returned home from college with a fever and a cough, though he has not been tested and is recovering now. My boyfriend’s mother was exposed to a woman whose husband tested positive for the virus. We received information that by now, in the state of Massachusetts, there is hardly anyone who has not faced first or second-hand exposure.

In other words, in certain locations, the probability of becoming infected has become extremely high, despite government precautions, despite personal precautions. This isn’t to say that these precautions should be flouted. Rather, while they may not wholly “flatten the curve” as the New York Times endlessly suggests, they may elongate it into a series of lesser peaks which will eventually plane out and reveal to us our new reality.

I, personally, hope that Preston will write a book about it. I think that the Westport soiree would make great inspiration for a fictional story about this virus (or a fictional one). I also hope someone will make a documentary chronicling the spread and the tireless efforts of governments and especially of health workers around the globe, who have risked their own lives and in many cases paid with their own lives in an attempt to stop this disease. We get our best look at the human spirit through suffering.

New York Times review of Crisis in the Red Zone by Richard Preston

IMDb page on 12 Monkeys (1995)

NYT coverage of the Westport soiree, “Party Zero”
CDC COVID-19 homepage, for scientific and medical information
Wikipedia article on SARS-CoV-2 (the virus that causes COVID-19)

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