2020: Chapter 1

A/N: Happy New Year, all! I recently went down a rabbit hole for unknown reasons and re-read my old stories in rapid succession, and remembered how much I enjoyed the Cunninghams. And then I realized that my stories all ended in the year 2020, and obviously the things in the stories when I tried writing the future didn't work out too well, because, well, who could have seen 2020 coming? And that made me wonder how 2020 would have gone for Jeff and Kim and the rest of the cast of characters that they surround themselves with, and this story was born.

I'm still writing (rather slowly, unfortunately), so posting won't be all that quick, but I hope you enjoy it anyway.


19 December 2019

Captain Jeff Cunningham rushed through the doors of the Armed Forces Health Surveillance Division, barely acknowledging the officers and civilians between the doors and the Global Emerging Infections Surveillance conference room. "Sorry, sorry," he said quickly as he made his way to a chair. "Are we dialed in?"

"Nobody else is on yet," Carrie, one of the junior epidemiologists, said. She made a show of checking the time on her phone. "Also, you're not late. We still have three minutes until 8. You probably have enough time to drop your coat and bag off in your office." He waved her suggestion aside.

"You okay, Jeff?" Lt. Colonel Kevin Nelsen asked as Cunningham searched his bag for his Apple pencil for his iPad to take notes.

"Just stuff with the kids," Cunningham replied. It was always stuff with the kids; Sydney was getting in fights in school, Jack had an ear infection—again—and Pup was, well, the 13-month-old daughter of Kim. And Kim herself had just gotten home from Afghanistan around midnight, tired and cranky and hungry. "But leave starts tomorrow afternoon, so all will be good. Assuming they don't kill each other before then. Or on the plane."

"I thought you drugged your kids to take care of that?" Nelsen asked.

"Oh, I totally drug my kids to take care of that," Cunningham assured him, finally finding the electronic writing implement.

"Hey, this is AFRIMS," the conference line phone in the middle of the room announced.

"Hey, Bry," Cunningham replied. "You're the first on the line. Hopefully the others will be on soon."

"Good evening, this is NAMRU-2."

"Thanks, Romeo."

"Hey, Jeff. It's Ashley."

"Hey, Ash!" he greeted. "How's Cairo?"

"We still miss you guys. Any plans to come back?"

"Don't give Kim any ideas," he said warningly. "I heard someone else join?"

"USAMRU-G is on."

"So is USAMRU-K."

"NAMRU-6, I just joined."

"Do we have USAFSAM yet?" Cunningham asked. He gave it a few seconds, but there was no reply. "What about CDC?"

"It's Commander Deussing from CDC."

"Hey, Eric. Well, it's 8:01, so let's go ahead and get started. Hopefully USAFSAM can join. I'm here with Kevin, Moheeb, Jess, Carrie, Sarah, Katie, Chloe, Matt, and, uh—," he frowned at the Army captain at the other end of the table. "Our rotating preventive medicine resident. I'm sorry, I don't remember your name."

"Captain Shannon Roux," she introduced.

"Captain Roux," he repeated, giving her an apologetic smile. "We have AFRIMS, CDC, NAMRUs 2, 5, and 6, and both USAMRUs. Administrative updates. Two weeks from now is 2 January and we agreed last meeting that we'll postpone this meeting of the minds until the following week, which will be 9 January. Same time, 0800 Eastern. If anyone needs an updated calendar invite, shoot Carrie an email."

"This is USAFSAM, sorry I'm late," the speaker phone announced.

"Thanks for joining us, Kelly," Cunningham said. "Does anyone else have any administrative issues?" Seeing shakes of the heads in the room and no comments from the phone, he continued. "Let's move on to flu. USAFSAM, what do you have?"

Dr. Kelly Flynn, the microbiologist in the flu lab at the United States Air Force School of Aerospace Medicine, the headquarters of one of the largest influenza surveillance networks in the world, immediately launched into a very detailed explanation of the circulating strains in various parts of the world, estimates of vaccine efficacy, the status of drug resistance patterns, and just about anything else that could be remotely related to influenza, which took the next fifteen minutes of the call, and of which Cunningham caught maybe 50%, despite his frantic note taking. So far, it was shaping up to be a decently average flu season—especially compared to how bad things had been two years before—although it was still several weeks before the typical peak and really too soon to tell. "Thanks, Kelly," Cunningham said when she finished her explanation. "Kevin, what do you have for the rest of respiratory surveillance?"

"MERS in Saudi Arabia, nothing new there," LTC Nelsen announced. He frowned. "ProMED is reporting human cases of avian flu in China. AFRIMS or NAMRU-2, do you have anything?"

"This is Colonel Soltis at AFRIMS," Bry chimed in. "I saw that ProMED post. H9N2 in Fujian and Anhui, right?"

"Where are Fujian and Anhui?" Chloe Sharp asked. Cunningham glanced around the conference room, wondering if any of the several maps hanging there was China. Nothing in enough detail for him to see from his seat.

"Across the strait from Taiwan," COL Soltis chimed in. "I don't think it's anything to worry about. Two cases, both with known livestock exposure, no evidence of person-to-person spread. China has a few of these kinds of cases every year."

"NAMRU-2, anything to add?" Cunningham asked.

"I read the same posts Kevin and Bry did," Commander Romeo Galang said. "We'll keep our eyes open for more information."

"Great, I appreciate it. I know we don't have a presence in China, but does CDC still have an office there?"

"It's a lot smaller than it used to be, but they do have one," CDR Deussing confirmed. "I've gotten the same information as AFRIMS and NAMRU-2, but I'll reach out to the country director to see if she knows anything further."

"Thanks, Eric. Everyone, keep me posted about this. Kevin, maybe touch base with our friends at NCMI and see if they have anything they can share. I hope it's nothing, but I'd rather know sooner rather than later if this turned out to be a pandemic-potential flu. Kevin, anything else in the respiratory program?"

"That's all I've got," the Army physician confirmed.

"GI?"

"Cholera in Somalia and Yemen. Nothing new," Commander Matt Petersen said. "NAMRU-6 is doing their usual vaccine trials."

"We have nothing new to report on that, either," Lt. Commander Yvette Song said from Peru. "Negative results on the last E. coli run, and we're not starting a new one until January."

"Okay, great. Vector-borne?"

"There's still dengue everywhere," Lt Col Moheeb Zara commented.

"Don't I know it," Cunningham muttered.

"There's an Australian team that is modeling outbreaks based on weather patterns in Bali," he continued as if Jeff hadn't said anything. "They're still working on historical data, so nothing really to report from that. No new updates on Dengvaxia, or any vaccine candidate. There's also yellow fever outbreaks in Nigeria and Mali."

"Any vaccine issues?"

"No, sir, supplies are good. I think they've started vaccination campaigns in both countries." Cunningham nodded absently as he made a note of that.

"Zika?"

"Nothing new," Zaza said.

"Peru?"

"Nothing to report on either dengue or Zika," LCDR Song confirmed.

"And high consequence pathogens?" Cunningham asked.

"Ebola still happening in DRC," Major Sarah Ross said. "We are up to 3346 cases with 2213 deaths. Vaccination campaigns have started, with 1890 people vaccinated to date. CDC is involved with this outbreak, no request for DoD assistance at this point."

"Thanks, Sarah. Let's go down the list. AFRIMS, anything further to report?" The various labs and surveillance locations gave their usual short reports, everyone seeming a little bit eager to get into the holiday 'breaks,' which for disease surveillance, wasn't really much of a break, and Cunningham understood the feeling. He was already mentally preparing for leave, and the thought of having to put in two more days of work at the office before he got to get on a plane to take him to the other Washington—the very cold, very windy high deserts of Washington State, where he would be surrounded by his wife's very loud and very energetic family for almost two weeks—was almost more than he had the mental energy for.

"Any alibis?" he asked after the last unit—USAMRU-K, the United States Army Medical Research Unit-Kenya—finished their updates. He gave it a few seconds, then said, "Hearing none, we will reconvene in three weeks, on 9 January. I will be on leave starting tomorrow night through the third, but will be available via email and phone. Please keep me posted if anything new pops up. Thanks for dialing in, everybody. Have a good night and happy holidays, and let's hope for good things in 2020."