Warday

At least, that was what I thought at the time.

During our prewar vacation, my wife and I traveled up and down the West Coast on a train called the Starlight, and really had a great deal of fun. California was beautiful, and the Queen’s having been there the previous spring—that was the summer of ’83—meant that the people were more than usually kindly disposed toward us English.

I have been once to San Francisco since the war, and found it quite a tattered and crowded version of its old self. But certainly recognizable. I went to call on the Mannings, but nobody in the road knew what had become of them. The family occupying their house would not talk to me.

My primary job is to identify outbreaks of treatable contagious disease and allocate appropriate Relief resources to them so that the problem will be minimized. It is not generally understood, but our main function is to supplement existing American services.

The ordinary citizen views the country as being without any internal authority, but this is not the case. There is still a strong federal presence. Certainly in health care. All surviving physicians have, for example, been recorded in a new central registry maintained by the Centers for Disease Control. Hospitals can, as of last year, report their supply needs to the Centers also, and get fairly rapid allocation of medicines and equipment. The loss of records and trained bureaucratic personnel that occurred when Washington was destroyed was certainly damaging to health care, but it has not proved fatal.

I work very closely with the Centers for Disease Control. My experience with the CDC has been very good. The Centers have grown tremendously since the war. There has been great advance in identifying the numerous mutant disease factors that have appeared among the American population. The progress with pseudomonas plague, which has become a significant cause of death in the Southwest since the war, has been spectacular. The death rate from this illness has been reduced to forty-five percent, primarily as a result of the development of nonantibiotic prophylaxis, which was done at CDC. We have helped in educating the population to identify and report plague cases so that isolation and treatment can be effected.

In the past year we have not had the continuous round of problems that were encountered at first. Certainly nothing on the scale of the Cincinnati Flu in ’90. Worldwide deaths from that disease are estimated at approximately two hundred and thirty million, twenty-one million of them in the United States and two million in Europe.

But the U.S. population is better fed and stronger now, so we expect the next pandemic to be less damaging here than was the last.

We anticipate another expression of this hybrid flu, and are relying heavily on CDC results in the development of a treatment regime.

Actually, one of our major projects at present is to teach CDC pneumonia prophylaxis, the construction of steam hats, the various means of assisting the breathing-impaired, control of circulation with hot and cold spots, and such things. CDC has really worked miracles with the very simplest materials and procedures.

The objective of their work is to develop effective medical treatment for serious disease, treatment that can be applied at home by family members and by the victims themselves. On another front, we are underwriting the medical faculties at the new University of Texas Medical School here in Dallas, and providing British doctor-professors so that local medical personnel can concentrate on hospital work.

Despite all this effort, we are not out of the woods. Frankly, however, the drop in U.S. as well as world population is also going to mean a long-term reduction in pandemic disease, if only because the remaining population groups are obviously going to be farther apart and have fewer contacts with one another. Despite this, it must be recalled that, worldwide, health systems remain frail. Supply lines are long and subject to extraordinary stresses. Fuel may be unavailable to move a shipment of drugs from the U.K. to America, for example. On the other hand, the lack of communications—a situation that is really improving fast, by the way—may simply mean that a disease outbreak goes unnoticed by us until it reaches an area where we have a permanent station.