Thirty minutes later, Gihwan arrived at the VIP ward with one of the researchers. Both were wearing lab coats and disposable gloves, with sample collection coolers slung over their shoulders.
"We'll need to collect Ms. Amira's specimens first."
Gihwan said as he arranged the kit on the table beside the bed. Three vacutainers for blood collection, two nasal swabs, two throat swabs, and a urine collection container were laid out in order.
Gihwan double-checked his gloves and approached Amira.
"Ms. Amira, can you hear me? I'll draw a small amount of blood for testing now."
Amira nodded faintly.
Conscious, but extremely weak.
Gihwan disinfected the venipuncture site with an alcohol swab. The veins in Amira's left arm were difficult to see due to dehydration.
"The veins are severely collapsed. It will be difficult like this. Shall we draw through the IV line?"
"No, let's do a venipuncture. It's more accurate."
Taeho gently raised Amira's arm to promote the vein.
"This spot looks fine. Give me a 22-gauge needle. I'll do it."
Gihwan handed him the 22-gauge needle.
Taeho located the vein precisely using his Bio Vision.
"Got it."
He drew blood into the three vacutainers in sequence. The first was for blood culture, the second for PCR testing, and the third for antibody testing.
"Next is the nasal swab."
Gihwan took out a long cotton swab and explained to Amira.
"Ms. Amira, I need to gently rub the inside of your nose. It might be a little uncomfortable."
He inserted the swab into Amira's right nostril, pushing it deep into the nasal cavity, rotated it for ten seconds to collect the specimen, then placed it in a sterile container.
"Lastly, the back of your throat."
As Gihwan took out a fresh swab, Faisal quickly opened Amira's mouth slightly. The inside of her throat was visibly red and swollen.
He rubbed the swab against the inflamed area at the back of the throat to collect the specimen.
While the specimens were being collected, the laboratory staff member labeled each container accurately with the patient's name, collection time, and specimen type, then placed the samples into the cooler.
"Three blood samples, two nasal swabs, two throat swabs. All seven specimens have been collected."
Gihwan said to Taeho as he loaded the specimens into the cooler.
"After going down to collect samples from the other patients as well, we'll begin the first round of analysis at the lab within an hour. The PCR results should be out in four hours."
Taeho said.
"The source of the infection is presumed to be ingredients from the Seoul Barakallahu Feek Halal grocery store. We need to analyze those products immediately."
"Then let's have the remaining products brought from the hotel kitchen. Sample all Halal products in the freezer and refrigerator. We'll also contact the Halal market to get a list of products sold over the past week."
Gihwan said one last time as he left with the specimens.
"I'll analyze them as quickly as possible and contact you."
A few hours later, at the Geumsan R&D Center analysis lab, Gihwan was conducting research in front of a microscope and PCR equipment. On the desk, six lamb tissue samples, four types of spice powder, and three sauces were arranged in a row with labels attached.
"As expected……"
Gihwan called Taeho as he checked the PCR results.
"Director, the results are in. The virus was detected in two of the lamb samples and in the cardamom spice. It's a variant with 89% similarity to Mr. Rashid's case."
Taeho's voice came through the phone.
—How is the treatment development coming along?
"The good news is that since Mr. Rashid's virus analysis is already complete, the timeline is shortened. I think we only need to modify three sites in the existing treatment's chemical structure."
Gihwan continued explaining as he looked at his laptop screen.
"We've received word from the Korea Disease Control and Prevention Agency that containment measures are complete. The Seoul Barakallahu Feek Halal Market has been temporarily closed since 3 p.m., and they've obtained contact information for 120 customers to monitor their symptoms. The hotel kitchen has also been completely closed and disinfected."
—You've worked hard. Now we have to endure as much as possible.
***
After hanging up, Taeho examined Amira, who was lying unconscious once more.
The monitor displayed a temperature of 39.2°C, blood pressure of 90/60, and a pulse of 110.
"Amira is strong. She will definitely pull through."
Faisal sat in the chair beside the bed, staring silently at Amira.
"Director, do you happen to have a religion?"
"I don't."
"Do you know what Barakallahu Feek means?"
"You mean that Halal market's name?"
Faisal nodded as Taeho looked at him.
"It means 'May God's blessings be upon you' in Arabic. I believe Allah will not take Amira from us so soon."
Faisal took Amira's hand and began to pray quietly in Arabic.
His voice trembled faintly.
His precious younger sister, who had protected him since childhood.
Looking back, could he have endured that pain all this time without Amira? She had always tried to bring him laughter.
At this very moment, Faisal had no choice but to cling solely to God.
Taeho looked at Amira, lying there with a pale, bloodless face.
What he, a man who did not believe in God, could do was clear.
Perform blood tests every two hours, alleviate symptoms with IV fluids and antipyretics, and buy time until the new treatment was developed.
***
When Taeho arrived at the Geumsan R&D Center, the lights in Gihwan's lab were still on.
Upon entering the lab, Gihwan welcomed him, having been simulating molecular structures in front of his computer.
"Director, you came at just the right time. I think I've found a pattern."
"That's a relief."
"Ms. Amira's variant virus is more sophisticated than Mr. Zayd's virus. And that is precisely what can become its weakness. Due to its excessive complexity, specific regions have become unstable. Here, look at this part."
Inside the hologram, a 3D model of the virus rotated with specific regions highlighted in red.
"If we target this unstable region..."
"You mean the neutralizing agent can act more effectively?"
"Exactly. We just need to modify the existing neutralizing agent. All computer simulations showed positive results."
"Let's begin synthesis at once. How long will it take?"
"The estimated time to treatment completion is thirty hours."
Taeho's face brightened at Gihwan's answer.
Hope had emerged.
As Taeho rose from his seat, Gihwan asked.
"Are you going home now?"
"I'm returning to the hospital. The patient's condition is unstable."
Taeho walked out the door with lighter steps than when he had entered.
Gihwan tilted his head as he watched Taeho's retreating figure.
Did something change?
Gihwan shrugged his shoulders once and threw himself back into his computer.
***
The alarm on the VIP ward monitor suddenly blared. Taeho, who had been dozing in his chair, sprang to his feet.
Beep. Beep. Beep.
Blood pressure 60/30! Pulse 150! Oxygen saturation 85%!
Taeho immediately checked Amira's condition. Her face had gone deathly pale. Her pulse was rapid, and her breathing had become shallow and ragged.
She's in shock!
Taeho immediately called the duty nurse.
"Connect one liter of normal saline immediately and prepare norepinephrine!"
Through his Bio Vision, he could see the virus attacking both the liver and kidneys simultaneously. Signs of multi-organ failure were appearing.
Taeho's face hardened.
It was a new pattern that had not been seen in Faisal's case.
"Her temperature has risen to 39.8°C!"
The nurse who had rushed over reported.
Amira's breathing grew increasingly shallow.
"Pulmonary edema is starting. Give her 20mg of furosemide!"
While the nurse prepared the injection, Taeho checked Amira's jugular vein. The jugular vein was distended.
"Heart failure is progressing too."
Taeho's hands moved swiftly.
Suddenly, Amira's breathing stopped.
Beeeeep—
A long warning tone rang from the monitor. Oxygen saturation began to drop sharply.
"Respiratory arrest!"
The nurse shouted.
Taeho immediately lifted Amira's chin to secure her airway. He pressed a mask firmly against her face and squeezed the Ambu bag with his hand.
"Contact the ER and tell them to bring an intubation set! Right now!"
Taeho continued squeezing the Ambu bag to maintain artificial respiration.
Two minutes later, Chaerin Lee came running with the intubation set.
"Director!"
Taeho quickly picked up the laryngoscope.
"Dr. Lee, apply cricoid pressure."
Lee pressed precisely on Amira's neck.
With practiced movements, Taeho inserted the laryngoscope to check the vocal cords, then carefully inserted the endotracheal tube.
"It's in. Connect the Ambu bag to the endotracheal tube."
Lee removed the mask and immediately connected the Ambu bag to the endotracheal tube, squeezing it several times. After confirming that Amira's chest was rising and falling regularly, Taeho gave an order.
"Bring the ventilator!"
When the ventilator arrived, they disconnected the Ambu bag and connected the ventilator to the endotracheal tube. With mechanical ventilation underway, Amira's breathing stabilized completely.
"Breathing is stable. Now let's focus on blood pressure."
She removed the mask and immediately connected the Ambu bag to the endotracheal tube. As she began squeezing the Ambu bag again, Amira's chest began to rise and fall regularly.
Oxygen saturation began to rise gradually.
85%, 90%, 95%...
Taeho let out a sigh of relief.
But blood pressure remained at dangerous levels.
"Blood pressure keeps dropping. 50/20!"
The nurse shouted.
Taeho immediately decided to secure central venous access.
"Bring the CVL set. I'll approach via the internal jugular vein."
Lee brought the ultrasound machine.
"Let's do it with ultrasound guidance."
Taeho disinfected Amira's neck and administered local anesthesia. After confirming the internal jugular vein with ultrasound, he inserted the needle at the precise location.
"Blood return confirmed. Inserting the guidewire."
He inserted the central venous catheter with practiced movements. Now fluids and medications could be administered more stably.
"Start norepinephrine at 0.1 micrograms per kilogram per minute."
"Yes, Director!"
As the vasopressor was administered, blood pressure gradually rose.
"Blood pressure is stabilizing!"
Lema continued real-time analysis.
—Systemic inflammatory response due to the virus appears to be the main cause. There is a high probability that it is the initial stage of a cytokine storm.
Taeho was thinking the same thing.
"We need to consider steroid treatment."
"But isn't using steroids during a viral infection dangerous?"
Lee expressed concern.
"Generally, yes. But right now, the acute deterioration caused by the cytokine storm is more dangerous than the virus itself."
Taeho made a careful decision.
"Administer 6mg of dexamethasone. Monitor her condition for six hours, and let's prepare for plasmapheresis as well."
"Plasmapheresis too?"
Lee asked, her eyes wide.
"We have to remove the inflammatory mediators from her blood. It's the most effective method in this situation."
Six hours later, plasmapheresis began. Amira's blood circulated through a special machine, removing substances that caused inflammation.
At 7 a.m., Amira slowly opened her eyes.
She couldn't speak because of the endotracheal tube. Her eyes wandered through the air before finding Taeho, and she regained her composure.
Taeho took Amira's hand and spoke softly.
"Amira, it's alright. You've passed the critical moment. We can't remove the tube right now because of your breathing, but we'll take it out soon."
Amira nodded slightly. He could feel strength returning to her hand.
Taeho whispered.
"Hold on a little longer, Amira."
Twelve hours remained until the treatment would be complete.
He hoped her condition would not worsen further in that time.
In this moment, Taeho too repeated inwardly.
Amira, Barakallahu Feek.