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Lisa. Very bad.”

CHAPTER 42

Lisa rides the elevator alone to the rooftop. Hard as she tries, she can’t shake the mental image of Mateo Flores. And she can’t stop thinking of her visit to see him, a few hours earlier, in the children’s ICU.

Mateo wasn’t on the ventilator when Lisa arrived, although he might be on one by now. Most of his body from the neck down was already covered in mummy-like circumferential bandaging. But as the nurse reapplied strips to his arm, Lisa got enough of a glimpse of the transparent, yellowish fluid-filled sack of skin over his shoulder to understand how extensive the blistering must have been. According to the attending doctor, the rash was spreading by the hour. And Mateo had lost so much fluid through the blisters that the ICU team was having troubling keeping his blood pressure from dropping critically low, despite all the intravenous fluids they were pouring into him.

Though he was sedated, Mateo was unbelievably stoic. He didn’t cry once during the dressing change, and he even showed the nurse a shy smile. His parents, however, were inconsolable. His father, Emilio, wasn’t angry like Mia’s dad had been. He simply seemed helpless, begging Lisa for reassurances she couldn’t offer. If she had to choose, she would have opted for anger and blame over his desperation.

The elevator opens, and Lisa steps out into the rooftop bar. Nathan sits at the same high-top table as before. He appears as rattled as Lisa feels. A beer bottle dangles between his fingers as he stares glumly out toward the dark waters of Puget Sound. It’s the first time Lisa has seen him with strands of hair out of place and a shirt that’s not perfectly pressed.

“Hey,” she says as she slides into the chair across from him. “Where’s Fiona?”

He shakes his head. “She wouldn’t leave the warehouse once she heard about the latest kid to react. She’s going through the supply. Testing each batch over again, herself.”

“What does she hope to find?”

Nathan merely shrugs.

“Mia attended a vaccination clinic two days before Mateo did,” Lisa says. “And the two clinics are eight miles apart. We checked the serial numbers. They didn’t get their vaccines from the same batch.”

He takes a long swig of his beer and then asks, “How’s the boy doing?”

“Not great. Mateo’s suffering from toxic epidermal necrolysis, a more extensive form of Stevens-Johnson syndrome, involving the whole body rather than just the mouth or face. It leads to severe blistering and fluid loss. Oftentimes multi-organ failure. Even death.”

“Jesus,” Nathan mutters. “But it’s basically the same reaction as Mia’s?”

“Another manifestation of the same disease, yeah. Both caused by a delayed immune response.” She pauses. “To Neissovax.”

“So Mia’s reaction wasn’t a one-off?”

Lisa shakes her head.

“When the board gets wind of this…”

“Two kids are fighting for their lives, Nathan.”

“There are more important things at stake than money. I get it. But it’s still going to devastate Delaware. The stock price will tumble. People are going to lose their jobs. Their careers.”

Lisa can’t help but wonder if he’s thinking of himself. “This link between Neissovax and the severe skin eruption was bound to come out at some point,” she says. “Maybe this isn’t the worst way to find out.”

“How could it be any worse, Lisa?”

“We’ve already shown that Neissovax is effective against one of the deadliest strains of meningococcus where nothing else works. It might be too essential not to use, despite the risks.”

“Doubt that.” He pushes the drinks menu toward her, but she waves it off. “You’re going to suspend the vaccination campaign?”

“We’ll decide at tomorrow morning’s meeting, but we might have to. At least, until we figure out exactly what we’re dealing with.”

“Doesn’t matter much, anyway.”

“Why’s that?”

“Once word gets out about the second reaction—”

“We have to announce this one. We can’t afford to have another case leak out. We’d lose all credibility.”

“Of course. The point is, even if you do keep the clinics open, who’s going to show up now?”

“We know Neissovax works. And there have only been two reactions among six thousand doses given.”

“One in a million is enough for the anti-vaxxers to jump all over this. But one in three thousand?” He lowers his beer. “Would you vaccinate someone you love with those kinds of odds?”

“I already did.”

“Who?”

“My niece.”

“Ah.”

Lisa realizes the worry she feels is out of proportion to the actual risk, but she can’t stop thinking about Olivia. She’s already called Amber twice to check up on her niece, who’s doing fine according to her sister.

Nathan leans forward. “How are you holding up?”

“Honestly?”

“Yeah.”

“I’ve had better days. Better weeks. Better months, even.”

He smiles, and his blue-gray eyes light with their now familiar charm. “Are you going to stop at years or are we going all the way up to decades?”

“Up to you.” She can’t help but smile back.

“Things OK on the home front?”

“Very quiet.”

“That’s good, right?”

“I’m getting the silent treatment.”

“I remember that.”

Something in his sympathetic gaze releases the emotions that have been stewing inside since her call with her father and her visit with Mateo. “I feel like such a fucking failure, Nathan!”

“This isn’t on you, Lisa.” He reaches out and touches the back of her hand.

“The vaccine is just the tip of it,” she murmurs. “I’m forty-one years old and nothing in my life works right now. Professionally, I’m losing control over the worst infectious outbreak to hit this city. Personally, my marriage is crumbling. My mentor is dying, and I can’t do anything to help her. I’m estranged from my parents. My own sister doubts me…”

Nathan squeezes her hand. “Can’t really speak to your family or your marriage. Though everyone goes through that kind of turmoil at some point. But I can tell you that you are phenomenal at your job. Compassionate, innovative, and decisive. You’ve been dealt an absolute shit hand. As bad as this crisis is, it would be so much worse without you.”

She stares back at him, wondering why Dominic never offers her such reassurances, and then gives

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