One Second After

“Only thirteen deaths yesterday,” Doc said, and there was a murmur of approval, the lowest number since they had started to keep count. “Two were heart attacks; two, though, were our dialysis patients. I think that is the last of them. Everyone in our communities who was on dialysis is now dead.”

No one spoke.

“We also lost one of our diabetics.”

Again no one spoke, but John felt eyes turning towards him. Of course they knew. He stared straight ahead, saying nothing. “And we had a birth.”

“Who?” Kate asked.

“Mary Turnbill. A healthy six-pound baby girl. Named Grace America Turnbill.”

“Damn, that’s good,” Tom said out loud.

“Eight births so far, and only one lost child and mother. Not much of a statistical base yet, but still it’s better than average compared to a hundred and fifty years ago.”

“Good work, Doc,” Charlie said.

“Well, I better go from that to the downside of things. In one sense we are in what I would call the grace period right now, the calm between storms. Our initial die-off in the first days, those needing major medical intervention, the first round of food poisoning, those woefully out of shape, as you know, approximately twelve hundred deaths out of ten thousand, five hundred total here in Black Mountain and Swannanoa. We still don’t have an exact figure on those who got in the first few days, but it had to be well over a thousand, so let’s put our total number at twelve thousand, now back down to roughly ten thousand or so.”

“That doesn’t count the casualties from the fighting at the gap, and refugees dying outside the barrier,” Tom interjected.

“No, I’m only counting those who died of natural causes at the moment. What I’m saying is that those who would die quickly have pretty well died off. Across the next fifteen days or so the numbers should be fairly low as long as we keep the community stable and nothing exotic sneaks in on us, but then, I hate to say, it’s going to start sliding up again and within thirty days be far worse than anything we’ve seen so far.”

Kellor hesitated, looking at John for a moment. Kellor knew his secret regarding the stash of insulin.

“Nearly all our type one diabetics will die this month. The pharmacies, in general, allocated one bottle of a thousand units per person. That supply is now running out for them. So we can expect all of them, approximately a hundred and twenty in our communities, to start dying.”

No one spoke.

“Other deaths in the coming month: severe asthmatics running short on their rescue inhalators, severe heart arrhythmia patients running out of beta-blockers, so I expect we are in the middle of the lull before the next wave hits.

“There is another issue as well, though, that I don’t think many of us thought of, but Tom, you better start gearing up for it and we might have to start thinking about taking over a building as another isolation ward.”

“What for?” Kate asked.

“Severe psychosis.”

“You mean insanity?” Tom asked. “Hell, we’re already seeing enough crazies coming in at the gap. And the suicides as well over the last month. I think we’re all half-crazy now.”

“Well, it’s going to get a lot worse within a matter of days,” Kellor said.

“Why within days?” Tom interjected.

“About a quarter of the population was on antidepressants or antianxiety agents. Prozac, Xanax, Lexapro, even just plain old lithium. Most of those people rushed to the pharmacies and stocked up, but even then, on average a person got at best a thirty-day supply.

“They’re running out now. Withdrawal for some won’t be too bad; for others symptoms will be quite severe, including hallucinations. Compound that with the stress we are under already. As an old-time doc I’ll be the first to tell you quite a few on these meds were just mildly neurotic, living in a very pampered society where it was almost obligatory to have some sort of disorder. But seriously, roughly five percent of the population do have severe disorders, and one to two percent dangerous disorders that include severe paranoia and potential for highly aggressive behavior.”

“In other words, expect a lot of insanity,” Tom said.

“You’ll be the one dealing with it,” Kellor replied, “and I think your people better be briefed on it. Not too long ago in our past families suffered with it, keeping their crazy uncle Louie restrained or locked away, or shipped them to state hospitals which were indeed snake pits. Where do you think the word ‘bedlam’ came from? It was the hospital for the insane in eighteenth-century England and, if you saw the old prints, a true hellhole.

“We haven’t dealt with this ever since all the modern meds started coming out in the sixties and seventies. That and the changing of laws that pretty well stopped involuntary commitment except in extreme cases emptied the hospitals.