Chapter 183 - 137: A Race Against Death
City Eighth Hospital.
Director Kang was worried.
A resident beside him said, "His O2 levels are still dropping. Eighty-two now."
"Push propofol. Prepare for intubation..."
Following the emergency treatment guidelines issued by Elder Zhi, the department had fully implemented a protocol of extremely early tracheal intubation and a double dose of oseltamivir.
This protocol was indeed effective.
The problem was the sheer number of mild cases being sent in. They all required isolation, which placed immense pressure on the hospital’s resources.
As for the critical patient in front of him, the rate of pulmonary consolidation was just too fast.
It was happening too quickly for anyone to react.
"Guidewire."
Director Kang held out his hand.
The nurse quickly handed it to him.
He lifted the epiglottis to expose the glottis, inserted the endotracheal tube, withdrew the guidewire, and connected the ventilator.
On the monitor, the blood oxygen saturation level finally climbed slowly back to ninety.
"Director, the ER just sent up three more. All with diffuse bilateral lung lesions," the head nurse said, rushing over with a newly printed report.
"How many ventilators do we have left?"
"Two."
Director Kang was silent for half a second. "Report to the provincial department and request more ventilators. In the meantime, bring all the anesthesia machines from the surgery building over to use as substitutes."
The specific antivirals were exhausted, and equipment was running out.
Facing an original strain of the virus with an extremely high load, their defenses were still stretched to the breaking point, even with the most advanced rescue protocols.
Just then, in bed six in the corner, the ECG flatlined.
Director Kang strode over. "One milligram of epinephrine, IV push! Start chest compressions, now!"
...
On the other side of the city.
The Central Laboratory of the Oncology Research Institute.
Jiang He sat before a clean bench, his eyes focused.
He held a pipette in his left hand and a microcentrifuge tube in his right.
DRIP.
A microliter of liquid was dispensed into the bottom of the tube.
After confirming that Patient Zero was carrying a quadruple-reassortant novel influenza variant, the containment efforts on the front lines were merely treating the symptoms. The real battle was being fought in the lab.
Jiang He’s task was to complete the most central, technically difficult, and time-consuming step in vaccine development:
creating a high-yield vaccine seed virus strain.
He extracted the HA (hemagglutinin) and NA (neuraminidase) gene segments of the virus.
Then, using reverse genetics, he would carefully splice them onto a high-yield PR8 backbone plasmid.
The PR8 strain was a classic virus strain known for its extremely high replication rate in chicken embryos.
It was a bit like grafting a plant.
Giving the deadly virus a safe and easily replicable chassis.
The centrifuge stopped spinning.
Jiang He removed the tube and glanced at the clock on the wall.
It was the early hours of the morning again.
He hadn’t rested in a very, very long time.
Every life-saving attempt on the front lines was a countdown ticking in his mind.
As a clinical doctor, Jiang He knew exactly what was happening in the ICUs.
This was a race against death.
The next step was transfection.
He introduced the reconstructed plasmids into a 293T cell line.
After that, all he could do was wait for the cells to rescue the virus.
...
Affiliated Hospital No. 1.
A negative-pressure ambulance came screaming to a stop.
The taxi driver, Old Lin, was carried out.
He was completely unconscious, his face a cyanotic purple.
"Temperature 39.9, pulse ox has dropped to seventy-five!" the paramedic shouted during the handoff. "He picked up that foreign businessman from Mexico three days ago!"
"Take him to Negative Pressure Ward Two! Prep for intubation and an NG tube! Administer a double dose of oseltamivir through the tube!"
They entered the ward, connected the monitor, and intubated him.
The entire sequence of actions was performed in one smooth motion.
But Old Lin’s lungs were in even worse shape than expected. The X-ray showed large-scale whiteout in both lungs.
"Director, airway resistance is too high! The ventilator can’t push air in," a resident said, his eyes glued to the screen.
"Increase the PEEP (Positive End-Expiratory Pressure) and switch to low tidal volume ventilation," Ke Zheng said, his voice hoarse.
His vitals hovered on the brink of death for ten minutes before finally, barely, stabilizing.
From the end of the hallway, another urgent shout was heard.
"Director! Provincial People’s Hospital is on the phone! They’re almost at full capacity too!"
Ke Zheng looked out the window.
’This is going to be a long, drawn-out war.’
...
「Nine in the morning.」
Baiyun Airport.
An Ilyushin Il-76 transport plane slowly descended for landing.
The cargo door opened. Shu Yuelong, along with a dozen core team members and boxes of precision instruments, strode down the ramp.
Lin Zhenhua, Director of the Provincial Health Department, was personally waiting by the tarmac.
Lin Zhenhua went forward to greet him. "Researcher Shu."
"What’s the situation?" Shu Yuelong got straight to the point.
"A city-wide lockdown has been initiated. Preliminary screening at the Canton Fair Complex is complete, but the number of severe cases is still rising. The clinical feedback is extremely poor. This strain is just too aggressive."
"Alright, I understand."
The group quickly boarded a minibus.
On the bus, Shu Yuelong spread out a stack of documents. "We will be taking over the virus isolation and vaccine development work. Prepare for a long fight."
"Mm."
Lin Zhenhua looked out at the streetscape rushing past the window, his expression grave.
"Vaccine development requires co-culturing the wild-type virus and a high-yield strain in chicken embryos to allow for natural genetic reassortment. The process is full of randomness. We have to screen for a perfect seed strain that retains antigenicity, can reproduce to a high titer in chicken embryos, and is non-pathogenic. If we’re lucky, it could take two months. If we’re not, it could take half a year."
Shu Yuelong nodded. "This is the most grueling stage. Without a seed strain, any subsequent mass production is out of the question."
"Indeed."
"In any case, no matter how difficult, we have to crack it. Let’s go straight to the Oncology Research Institute. For Jiang He to have completed the sequencing at a time like this is already an incredible contribution. The rest, we’ll take it from here."
In Shu Yuelong’s mind, for a third-year university student like Jiang He to complete the virus’s genome sequencing overnight was already a heaven-defying feat.
As for vaccine development?
That was a massive, systematic undertaking.
It required a huge team and a long period of time.
It was absolutely not a field one person could even touch.
「Central Laboratory, Oncology Research Institute, Affiliated Hospital No. 1.」
The minibus stopped in front of the building.
Shu Yuelong and Lin Zhenhua led the way, followed by a dozen researchers.
After they walked inside, they saw Jiang He standing at a lab bench.
"Jiang He, thank you for your hard work," Lin Zhenhua said.
"Director." Jiang He recognized Lin Zhenhua, then his gaze swept over Researcher Shu and the other experts behind him.
"This is Researcher Shu Yuelong from the National Disease Control Center," Lin Zhenhua introduced.
"Researcher Shu." Jiang He nodded.
Shu Yuelong looked at the young man before him, a mix of complex emotions welling up inside.
This was the third-year student who had sounded the alarm for the entire nation.
"Student Jiang He, thank you for your hard work."
Shu Yuelong said,
"The sequencing data you ran is perfect. Now, leave it to us."
The researchers behind him were already preparing to step forward and take over the equipment.
But Jiang He simply put down the marker in his hand and picked up a rack of microcentrifuge tubes he had just organized.
Inside them were minuscule amounts of a clear liquid.
Jiang He said, "Experts, there’s no need to blindly guess at natural reassortment in chicken embryos anymore."
Shu Yuelong froze. "What do you mean?"
Jiang He handed the tubes over. "These are the completed HA and NA recombinant plasmids. I’ve already constructed and sequence-verified the eight-plasmid system based on the PR8 backbone."
A dozen of the nation’s top virology experts stared in unison at the rack of small tubes in Jiang He’s hand, utterly dumbfounded.
Shu Yuelong even wondered if he had heard him wrong.
He asked again to confirm, "What did you say?"
Jiang He said, "I’ve already knocked out the pathogenic polybasic cleavage site. Two hours ago, I transfected this system into the 293T cells. All you need to do is wait for the cells to rescue the virus. In about forty-eight hours, you can just collect the supernatant and measure the titer. It will absolutely be a perfect seed strain for large-scale production."
A researcher in black-rimmed glasses stepped forward, his brow furrowed. "That’s impossible. Building an eight-plasmid system with reverse genetics... just figuring out the primer design and the annealing temperatures for fragment amplification can’t be done overnight!"
Although the other experts didn’t speak, the skeptical glances they exchanged spoke volumes.
Biology is a rigorous science.
One person, in a standard lab, completing foundational work in a dozen or so hours that should have taken months to overcome?
It sounded truly absurd.
Faced with their doubts, Jiang He didn’t argue.
He just felt exhausted.
At the same time, he was also worried about his wife, who was at the hotel.
So, Jiang He turned, took off his sterile suit, and said,
"The records of all the failed attempts, parameter adjustments, and the final successful sequencing data are all on the D drive of that computer."
"I’ve already finished the most time-consuming part, the genetic reassortment, and I’ve knocked out the pathogenicity."
"I can’t do the subsequent chicken embryo amplification, purification, inactivation, and mass production by myself."
"I’ll have to trouble you experts with the rest. Thank you for your hard work."
After saying that, Jiang He walked straight out.
As the door closed, the lab fell into a profound silence.
A dozen of the country’s top virology experts looked at each other, speechless.
’Did that young man just casually drop something that could shake an entire city on the table, and then turn around to go catch up on sleep?’
’An eight-plasmid reverse genetics system... overnight? For real?’
The silence lasted for a full half-minute.
Shu Yuelong was the first to break it.
"What are you all standing around for?"
"Old Li, check the raw sequencing data and charts on the computer! Professor Zhang, take over the incubator immediately and closely monitor the status of the cell transfection!"
"Verify it, now! I need to know, as soon as possible, if what he gave us is actually usable!"