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The nightmare scenario

by GME
September 8, 2023
in World
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This is a horror story. In fact, it’s a horror story about a horror story.

I’m warning you right now that the ending is going to be bleak, and that the only “twist” is that it’s bleaker than you think. So this would be an excellent place to stop.

In 1993, I wrote a short story with a decidedly downbeat tone. It was so downbeat that the note I got back from Gardner Dozois, who was then the editor at Asimov’s “Science Fiction” magazine, was, “I rarely say this, but this is too dark.” Over at “Analog,” editor Stanley Schmidt was complimentary, saying the story was “well written and well plotted” before adding, “but our readers need a happier ending.” After that, I dropped the story in a folder and have rarely thought about it since.

The idea for it came from a friend who was then working through her residency in a St. Louis hospital. One January day, a family member brought in a man who was staggering and had slurred speech. According to that family member, the man, “Got drunk back at Christmas and never sobered up.” In the hospital, the man soon became unable to speak and his motions became increasingly feeble and uncontrolled. A few weeks later, he died.

At autopsy, it was discovered the man’s brain was riddled with the kind of openings known as “spongiform encephalopathy.” This is usually the result of the inherited prion disease known as Creutzfeldt-Jakob disease, but it can also result from transmissible diseases like mad cow disease. In these diseases, malformed proteins, known as prions, cause other proteins to fold abnormally. The mangled proteins can bond as they would normally and accumulate in the brain, causing severe plaques and associated voids.

There is no cure for any prion disease.

After hearing my friend’s story, I thought up what I considered “the nightmare scenario.” My story starts the same, with a single patient staggering into an emergency room, but he is soon joined by others. It takes some time to figure it out, but it turns out the rapidly growing number of such cases is due to an after effect—a sequela—of a flu that swept the planet several years earlier. By the time the story opens, the percentage of people carrying antibodies showing their exposure to this flu is roughly 100%.

The story ends with one of the researchers murdering an anthropologist to prevent her from carrying the disease to a previously uncontacted community in the Amazon basin. (Hey, it’s not like no one warned you this was dark.)

That’s the horror story. Now here’s that twist I promised you.

This is a pre-published paper written by researchers at Linköping University in Sweden. Its lengthy title is “SARS-CoV-2 Spike amyloid fibrils specifically and selectively accelerates amyloid fibril formation of human prion protein and the amyloid β peptide.” That probably gives you a pretty good warning when it comes to the contents, but here’s how that paper begins.

“An increasing number of reports suggest an association between COVID-19 infection and initiation or acceleration of neurodegenerative diseases including Alzheimer’s disease (AD) and Creutzfeldt-Jakob disease (CJD). Both these diseases and several other neurodegenerative diseases are caused by conversion of human proteins into a misfolded, aggregated amyloid fibril state. The fibril formation process is self-perpetuating by seeded conversion from preformed fibril seeds. We recently described a plausible mechanism for amyloid fibril formation of SARS-CoV-2 spike protein.”

So, are we doomed?

It’s probably not as dire as the story I concocted 30 years ago. First of all, the paper shows the results of in vitro (aka in a test tube) experiments. Those results often vary wildly from genuine results in people, otherwise we wouldn’t need all those stages in testing new drugs. There has been a peculiar increase in cases of CJD, but that started before the pandemic. Also, amyloid fibrils are not the same as prions, even if both trigger neurologic damage, so this is unlikely to be the airborne mad cow disease of my nightmare.

But the potential for disaster here is concerning, because there is also this from CNN: “Federal data suggests that the current increases have stayed far below earlier peaks and notable surges. But judging by word of mouth among family, friends and coworkers, it can seem like everyone knows someone who’s sick with Covid-19 right now.”

I’ve just spent over a week in a hospital sitting bedside with a sick relative. While I wore a mask most of the time, that kind of long-term exposure in an environment where viral particles can be expected to be high is … not great. I have my fingers crossed. I have them crossed for us all.

And hey, for now at least, can you leave a few communities uncontacted?

 

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