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Episode 20. Plague Doctor Dispatch (3)

****

Night has already arrived.

But the disease doesn’t sleep at night, so we, its opponents, can’t go to sleep either.

I’m sick and dying. I heard something about the guest room in Lapis Castle earlier, but I didn’t have time to leave the shelter.

I only took a quick nap in a hammock-like object in the corner. Istina dozed off standing up.

It’s something I’ve always done.

Anyway, the emergency room operates on three shifts.

People keep dying next to me, so why bother leaving work? None of my patients died, thanks to the diligent efforts of making them drink alcohol.

If you think about it for a moment, it’s an unbearably unpleasant fact. It shouldn’t be the case that someone dies because the medical staff in charge didn’t give them enough water… … . It must have happened yesterday.

There’s nothing I can do. I can’t stay awake, but I can’t use the clone technique.

“Oh. The sun is up, Istina. I have to get to work.”

“, last night there was a person… … .”

Several people died last night.

Was it because she couldn’t sleep all night, or was it because she was mentally exhausted? Istina’s hands were shaking a little. I looked at Istina.

“Our patient didn’t die, right?”

“Yes.”

“Don’t think about anything else. You’ll hurt yourself.”

The hospital is a place where dying people come. People who die have no choice but to come out. I ran around like a real dog all night.

But since the sun is up, there will be some spare manpower. Now, I have to look at the number of patients coming in today, and I hope it will decrease a bit.

“I guess the number of patients will decrease today?”

“I wish it would decrease.”

I don’t know.

I hope the vodka I poured into each well yesterday had an effect, but I don’t know the results yet. We’ll have to wait and see, too.

Still, it seems like several of the patients I’m seeing now will be discharged today. If the situation stabilizes, they may be able to go home.

“Professor Asterix. Could you please come to the conference room for a moment? The Lord is looking for you.”

A plague doctor in white robes.

This time it was Hedwig again. Was there something going on? The number of patients had decreased significantly.

Hedwig’s face couldn’t be seen clearly because she was wearing a beak mask, but she was probably just as tired as we were. The relief center had practically turned into a battlefield.

“What’s going on?”

“They said they would discuss future strategies.”

“Let’s go right away.”

I nodded.

I guess I’ll have to go and check. I don’t know how much quarantine work they’ll do today. I also have to check to see if the Lapis officials have done their work.

Did you do well?

****

We quickly arrived at the conference room of Lapis Castle. This time, the conference room was bustling with people. Everyone looked haggard, as if they had worked hard last night.

For now, isn’t this a good sign?

“I’m busy.”

The dark circles under my eyes had increased overnight, but the Lord of Lapis was delighted to see me. Whatever it was, it seemed like last night had some results.

“Then let me just tell you the conclusion. We went around the streets all night long to check the distribution of patients. As the professor said, the epidemic was spreading from certain wells.”

“Yes.”

“Are we right? Cholera is a waterborne disease, caused by drinking water contaminated with feces. Clean water is the solution.”

“In my opinion, yes. The policy seems to be effective.”

The Baron of Lapis nodded.

“It all seems true. Let’s do as the professor said. How far have you come?”

I was a little worried.

When John Snow first proposed the fecal-oral route of cholera transmission, government officials did not believe the theory, although they acknowledged that Snow’s strategy was effective.

It was a stupid reason. The fecal-oral route as the cause of cholera was a concept too offensive for contemporary society to accept.

What can I do? I have to face reality.

Fortunately, the Baron of Lapis seems to believe me. I expect that the number of new patients will decrease significantly today as well.

“I poured vodka concentrate into the well, but this is only a temporary measure. I think it will all evaporate and disappear in a day or two.”

“What is the next solution?”

A multi-layered solution is needed.

“We need to find the cause of the water source contamination. We need to dig a few new wells. It would also be a good idea to tell people to boil the water before drinking, especially children. We also need to install sand purifiers near the wells.”

In Britain, there was even a temporary order not to drink unboiled water, although it is questionable whether people actually did so.

There were also reports that employees working at the brewery did not contract cholera.

“You could give people beer, order them to drink boiled water, and put water purifiers in front of every well. It also makes it clear that the cure for dysentery is hydration.”

The Baron of Lapis nodded.

“Isn’t there a more fundamental solution?”

“But now that we have identified the cause and the countermeasures, isn’t it better? We still need to think about a fundamental solution… … .”

It’s a general improvement of the water supply and sewerage facilities. But if I bring this up, won’t I just get cursed at?

Mr. Pirhoh, one win today too.

Of course, Pirhoh went a step further and proposed introducing democracy, tax cuts, expanding infrastructure, and improving the road network.

So, he was driven out as a revolutionary.

I thought about my words a little more.

“Epidemic dysentery is a disease caused by multiple factors. It is caused by a combination of problems such as malnutrition, problems with water and sewage systems, contaminated water sources, and lack of sanitation.”

Lapis’s eyes narrowed just slightly.

“Yes.”

“There is a fundamental solution, but it will take a lot of time and money.”

I guess it was a story I didn’t really want to hear.

“Okay, I understand.”

“That’s a story for later. Most of the time, you can probably solve it with just a sand purifier. Don’t worry too much.”

“But what is the principle of a sand purifier? I prepared it as you instructed.”

It’s simple.

It’s filtering water through sand. Bacteria are microscopic particles, so if you let water pass through sand, will the bacteria be caught?

Get caught.

The principle of how bacteria are caught needs to be thought about a bit more. It’s a more complicated principle than you might think.

Bacteria that settle in the sand form biofilms. Ironically, bacteria cannot pass through biofilms made by other bacteria.

A perfect semi-permeable membrane is formed that even bacteria cannot pass through. Strange as it may seem, the filtration power of the sand purifier comes from the bacterial membrane.

The role of absorbing fine particles is actually played by activated carbon. If there is anyone who does not know what activated carbon is, think of it as charcoal.

anyway.

We moved to the workshop inside Lapis Castle. The sand purifier itself can be made without difficulty even with these people’s skills.

It’s not a problem that requires any special skills.

“Professor. Is it really possible to purify water with just sand and charcoal? Is it even possible to filter out bacteria?”

“It’s possible.”

I’ve already been monologuing about this topic in my head for quite some time. I don’t want to bother explaining it again.

It really seems like the government officials stayed up all night. Several sand purifiers have already been completed. If you run water on them… … .

Purified water does come out. Of course, this assumes that the bucket holding the water and the pipe through which the water comes out are not contaminated.

It’s much better than nothing.

“I think this is successful?”

“Okay. That’s good.”

It will take about a day for a biofilm to form inside the sand purifier. It is not yet clear whether the effect will be dramatic.

****

And then the next morning.

As I said before, the median incubation period for cholera is about a day. If the measures we took were effective, the number of patients should have decreased by now. I don’t know if it has. It seems much quieter than when I first came.

“Still, it’s much more deserted than before.”

“Don’t say that. The patient is coming.”

We opened the door to the relief center and-

This time, not a single person was lining up in front of the relief center. It meant that no one had come to the relief center because they had gotten sick the night before.

“What is this.”

Istina was terrified though.

It’s still too early to feel relieved. More people will come today. It’s just that the people who came early in the morning and waited for me were not there right away.

“Does this seem like a solution?”

“That’s right… … . How did you know?”

Future knowledge.

This is literally textbook content.

“Follow the logic. We hypothesize that the epidemic dysentery is transmitted through water.”

“Right.”

“We proved this hypothesis through the geographical distribution of patients. And as a solution, we purified all the water sources in the city, and this is the result.”

Istina was a bit worried.

“This is ridiculous. I can’t even count how many people have died from dysentery so far, and it was such a simple problem to solve.”

What do you mean by simple? I can’t even walk properly because I’ve been on duty for three days.