Page 3 of Outbreak Protocol

CHAPTER THREE

FELIX

I've taken over the corner table at Café Liebermann, three blocks from the hospital.

The owner, Greta, keeps my coffee topped up without asking.

She's used to seeing me here during my off hours, though not usually with such a grim expression.

My laptop screen glows in the dim corner as I enter another case into my makeshift database.

The café's warmth contrasts with the chill that runs through me as I type. Three weeks since Herr Becker died. Twenty-seven cases since then. Eight deaths. The pattern is unmistakable, but I seem to be the only one connecting the dots.

I scroll through my database, colour-coded by symptom progression, geographical distribution, and suspected exposure routes. The spreadsheet would make any pathologist proud—meticulous, detailed, annotated with clinical observations that don't fit neatly into diagnostic categories.

"You look like you need something stronger than coffee," Greta says, sliding a plate of k?sekuchen beside my laptop.

"Just more hours in the day." I manage a smile that doesn't reach my eyes.

"The world won't end if you take a night off, doctor."

If only she knew how wrong she might be.

After she moves to another table, I pull up the map of Hamburg I've been marking with case locations. No clear epicentre, but clusters are forming—the port area, two schools, a veterinary clinic. Whatever this is, it's gaining momentum.

My phone buzzes with a text from Anna: "Frau Meier from bed 4 just crashed. Respiratory failure. Similar presentation to your other cases."

I close my laptop, leave too many euros on the table, and hurry back to the hospital.

"Her son says she was fine three days ago," Anna whispers as we stand outside the ICU. Through the glass, I watch the respiratory therapist adjust ventilator settings. "Started with what seemed like a bad flu, then rapid deterioration this morning."

Frau Meier makes twenty-eight.

"Did you note the bleeding?" I ask.

"Yes. Nosebleed that wouldn't stop, then petechiae appeared on her chest and arms."

"Just like the others." I rub my eyes. "Did ID consult see her?"

"Briefly. Said it's likely an aggressive influenza strain with secondary complications."

"That's what they always say." I can't keep the frustration from my voice .

"Her son is in the waiting room. Asked specifically for you—said his mother mentioned you were kind to her in triage."

I find Martin Meier hunched in a plastic chair, staring at nothing. When I sit beside him, he looks up with red-rimmed eyes.

"Will my mother die?"

The direct question catches me off-guard. I could offer platitudes, but that's not what he needs.

"We're doing everything possible, but her condition is very serious." I pause. "Has anyone else in your family been ill? Or at your mother's workplace?"

"She volunteers at the community garden three times a week. Said a few of the other gardeners had been sick recently." He wipes his eyes. "I just thought they had a weird summer cold or flu. I should have brought her in sooner."

"This isn't your fault. This illness... it progresses quickly and unpredictably."

"But you've seen it before." It's not a question.

I hesitate, weighing professional caution against the truth. "I've observed similar presentations in other patients recently, yes."

"Is it contagious? Should I be worried about my kids?"

Another question I can't properly answer. "We're still determining the transmission pattern. Wash your hands frequently, monitor for symptoms, and come in immediately if you develop a high fever."

His shoulders slump. "That's what the other doctor said too. No one seems to know what's happening."

I place my hand on his shoulder. "I promise you, some of us are trying to figure it out."

The next morning, I examine Friedrich Heinz, a 51-year-old veterinarian who came in overnight with fever, severe headache, and early signs of the rash I've come to dread.

"I thought it was just exhaustion," he says, wincing as I check his lymph nodes. "Been working double shifts at the clinic. Lots of sick animals lately."

My hand pauses. "What kind of animals?"

"Bit of everything. Three dogs with mysterious bleeding. A couple of cats with neurological symptoms. Even treated a parrot with similar issues." He coughs, a wet, rattling sound. "Probably just coincidence."

Just like Herr Becker's parrot. I make detailed notes.

"Any idea what was causing the animal illnesses?"

He shakes his head, then grimaces at the movement. "Tests were inconclusive. I was planning to send samples to the university lab, but then I got sick myself."

I order the now-familiar battery of tests, adding special requests for the infectious disease team. As I'm finishing the admission orders, Klaus grabs my wrist with surprising strength.

"Doctor, I've been a vet for twenty-five years. When multiple species show similar pathologies simultaneously, it's never good news." His eyes are fever-bright but lucid. "Whatever this is, it jumps boundaries."

The words follow me through the rest of my shift.

"You wanted to see me, Dr. Müller?" Hartmann's voice carries the perpetual note of impatience he reserves for clinical staff.

"Yes, thank you for making time in your schedule." I've rehearsed this conversation for days. "I've documented twenty-nine cases of what appears to be the same illness over the past three weeks. The presentation is consistent and concerning."

I slide a folder across his desk. He doesn't open it.

"And you've compiled this... report... on your own time? "

"Yes. The pattern suggests an emerging infectious disease with concerning transmission rates and mortality."

Hartmann sighs. "Dr. Müller, we've been through an unusually severe influenza season which appears to have extended into the summer months. Combined with late spring allergic respiratory infections, what you're seeing is unfortunate but not altogether unexpected."

"Sir, with respect, influenza doesn't typically cause the hemorrhagic manifestations we're observing. Nor the specific pattern of neurological deterioration."

"And you've consulted with infectious disease specialists about your... theory?"

"I've tried. Dr. Vogt believes it's a particularly virulent influenza strain. Dr. Bauer suggested possible bacterial co-infection. Neither has reviewed all the cases collectively."

Hartmann finally opens the folder, flipping pages with obvious disinterest. "You've included a recommendation to contact the ECDC and implement enhanced infection control measures."

"Yes. The clustering and progression rate suggest we're dealing with something that requires broader expertise and resources."

He closes the folder. "Do you understand what happens when hospitals raise false alarms about disease outbreaks, Dr. Müller? Tourism drops. Conferences cancel. The economic impact is substantial. And careers are on the line, if and when the alarm proves to be false."

"And if it's not a false alarm?"

"The Mayor's office has specifically requested that healthcare facilities avoid creating unnecessary public concern during the upcoming international trade conference.

" His tone sharpens. "Your emergency department is currently running at 127% capacity.

Perhaps your energy would be better spent treating patients rather than playing detective. "

He stands, signaling the end of our meeting. "Focus on your actual responsibilities, doctor. Leave public health policy to those qualified to make those assessments."

The folder remains on his desk as I leave.

The familiar scent of Anna's apartment—cinnamon and vanilla from whatever she's been baking—greets me as I climb the three flights to her door. The building's old radiators clank and hiss, a comforting soundtrack I've grown to associate with refuge from the hospital's sterile urgency.

"Uncle Felix!" Emma's voice carries through the thin walls before I even knock.

The door swings open to reveal Anna's daughter bouncing on her toes, dark curls escaping from hastily assembled pigtails. Her school uniform is wrinkled and paint-stained, evidence of a day well-lived.

"Mum said you were coming for dinner! I made you something!"

She grabs my hand, tugging me through the narrow hallway lined with Emma's artwork and Anna's collection of medical conference photos.

The apartment isn't large—a living room that doubles as Anna's study, a galley kitchen, and two small bedrooms—but it radiates warmth that my sterile flat lacks entirely.

"Let me guess," I say, allowing myself to be dragged toward the kitchen table. "Another masterpiece for my refrigerator?"

"Better!" Emma releases my hand to retrieve a folded piece of construction paper from the counter. "It's a get-well card for Herr Weber. Mum told me he had a heart attack yesterday."

Anna emerges from the kitchen, wooden spoon in hand and flour streaking her scrubs. "She insisted on making it after I mentioned you saved someone's life."

"We both saved him," I correct, accepting Emma's card.

The front depicts a stick figure in a white coat—presumably me— standing next to a hospital bed where another stick figure sports an enormous smile.

Inside, in Emma's careful second-grade printing: Feel better soon! Uncle Felix is the best doctor!

"This is perfect, Em. Herr Weber will love it."

"Can you give it to him tomorrow? And tell him I hope his heart gets strong again?"

"Absolutely." I fold the card carefully, slipping it into my jacket pocket. "But first, what smells so incredible in here?"

Anna wipes her hands on a dishrag, leaving additional flour streaks on her faded jeans. "Emma chose the menu. Spaghetti with meatballs and garlic bread."

"My favourite!" Emma announces, though this changes weekly. Last month it was schnitzel, before that it was Anna's lentil soup.