Peyton held the rank of full commander in the Commissioned Corps. Elliott held the rank of rear admiral. Of the 160 EIS officers, 102 were Commissioned Corps officers.
The Corps was also well represented in the group sitting before Peyton: of the 63 men and women present, 51 were Commissioned Corps officers. Like Peyton, they dressed in service khakis, the PHSCC insignia on their left lapel, their rank insignia on their right.
Peyton pulled her shoulder-length black hair into a ponytail and smoothed out her rumpled uniform. She straightened the silver oak leaf that designated her rank and walked to the whiteboard.
Sixty-three faces focused on her. She saw nervousness and excitement and, above all else, trust—absolute trust in her ability to guide them through the coming deployment, to keep them safe, and to teach them what they needed to know. She felt the weight of their trust and the burden of her duty. She was an epidemiologist, but she considered her most important job to be that of a teacher. As an EIS instructor, it was her job to prepare her students for whatever they might encounter after their fellowship. The men and women who sat before her were the next generation of public health leaders. And one day, one of them would likely be standing where she was: leading a future CDC mission, or a state or city health department, or conducting vital research for the National Institutes of Health.
Being a teacher was a role she relished, because it was so important, and because along her own career path she herself had been lucky enough to have good teachers who cared. Fifteen years ago, Peyton had been sitting in a crowd like this one. She had been one of these faces, and it had been Elliott standing before them, giving a similar talk. She remembered how nervous she was during her first deployment. She still felt a hint of those nerves. Sometimes she wondered if there was a little excitement mixed in—the thrill of the mission, the stakes, the chase to find the origin of the outbreak and stop it before a catastrophe occurred. She had come to live for days like these. Being in the middle of a crisis almost felt more natural to her than the downtime she spent in Atlanta.
Since it was a long flight and they would need to adjust to the eight-hour time difference between eastern Kenya and Atlanta, Peyton had decided to divide her briefing into two parts. The first would be background—information many of the full-time, seasoned CDC personnel knew by heart. Many of the EIS officers did too, but a refresher was prudent, and it was a great way to break the ice. This was the first foreign deployment for many of the officers, and Peyton knew they were nervous. Going over what they already knew would give them a boost of confidence.
She grabbed a blue marker from the whiteboard’s tray. “Okay, let’s get started. As you know from the preliminary briefing, we’ll be splitting up in Nairobi. Eleven of you will be assisting with operations there; the remainder will join me in Mandera and will likely travel to the surrounding areas. However, I want each of you to be versed on our PPE protocol for the deployment, and I want to share some basic background information. We’ll cover mission-specific directives once we get closer to landing.”
She quickly covered their PPE, which included gowns, coveralls, hoods, goggles, boot covers, gloves, and other items used to protect against infectious material.
“There’s a chance that each of you will come into contact with the pathogen in some way. Those of you in Nairobi may be called into the field. First, know that it will be hot inside the suits. Kenya is located in a tropical zone. Nairobi is just eighty-eight miles from the equator. Even though it’s November, the midday sun in Kenya will cook you. You’ll be sweating before you put your suit on, and you’ll sweat even more while wearing it.
“Second, you’ll likely be unnerved by what you see. Some of us never get used to the human suffering we encounter during these deployments. There’s nothing wrong with that. You’re going to witness people living in poverty and circumstances you may have never seen before. If you feel overwhelmed, it’s okay to excuse yourself. Just let a team member know, then walk away and take deep breaths. Whatever you do, do not take your suit off. Inspecting and donning your suit is important, but being careful while doffing it is even more important. After you’ve had contact with patients, you may have virus particles and bacteria on the outside of your suit, hood, goggles, gloves, and boots. If you just rip any part of your PPE off, you’re putting your life at risk. When it comes to removing your suit: take—your—time. It won’t be easy; one hour is about all anyone can stand in the suits in this kind of heat, and by the end of that hour, you’ll be dying to get free. But again, take your time. Your life depends on it.
“Okay, what’s our deployment goal here? Anybody?”
The EIS agents, most in their late twenties or early thirties, sat near the front. The permanent CDC staff on the mission were a bit older, and most had deployed for a dozen outbreaks before. They sat toward the back and kept quiet during the Q&A, giving the EIS officers the opportunity to answer and learn.
In the second row, a woman named Hannah Watson answered. Her strawberry-blond hair was tied in a ponytail, and like Peyton, she wore Commissioned Corps service khakis.
“Containment and treatment.”
“Good.” Peyton wrote the words in large block letters on the whiteboard. “What else?”
“Identification,” Millen Thomas called out. He was a veterinarian of Indian descent, sitting several rows behind Hannah.
Peyton nodded as she wrote the word on the board. “Yes, it would be nice, at some point, to know exactly what we’re dealing with here. What else?”