Hide
I am currently conducting an extensive survey of the health of the refugees. This will take time, and in truth be a process that is always ongoing. The goal is to both capture the current state and needs of the refugees, and to monitor for outbreaks or growing problems. Additionally, to monitor for any successes!
Diseases associated with dehydration and malnutrition are the most common issues I observe. It remains to be seen what effect the "Haoma" will have on these issues. My primary concern is the lack of variety in diet. It is a known fact, and one we Modini are quite familiar with, that unvaried diets are almost as dangerous as starvation. I strongly urge the Legates to consider a subsidy of varied foods to supplement their diets, including fruit if at all possible. I will update the Pyramid on any changes I notice over time as a result of the Haoma.
Heatstroke is a common killer, as is violence between refugees.
At greatest risk are elderly and children. Nutrition and health are vital for children, as their bodies grow and may be permanently damaged from nutrition problems. Children sheltering from the sun and receiving poor nutrition are especially prone to rickets, which I have observed in some of the more sheltered and squalid areas of the camps. In my professional opinion, children should be the highest priority for the suggested food-variety subsidy, particularly:
Eggs
Livers
Fungi
Goat milks
Vegetables
The over-reliance on grains among the refugee population (it is not as if these poor souls have a choice) threatens to permanently damage their health and ability to care for themselves even if their housing situation improves. On a pragmatic level, surely the Legates can agree that weak, sickly refugees are unlikely to be able to take up jobs and contribute to our Well. Chronic malnutrition will permanently damage bodies and minds, and contribute to future disease spread.
I have hired a cook to provide nutrient-rich, fatty, real foods. These are being distributed to refugees and in particular the children to supplement their diets.
Hide
I gathered this information and testimony from Sister Selsi (who was most helpful) and my interviews with witnesses of a recent infection. This report is a combination of interviews with her and with those witnesses.
What is the Blood Plague?
A highly infectious, mutagenic disease which has historically been devastating in its effections.The Priory has the ability to produce a Cure, some details of which have been shared with the Pyramid.
What does the Blood Plague do?
Causes fast-growing mutations of the flesh, including but not limited to: hemorrhaging, tissue death, accelerated production of blood and pus, weakness, organ eruption, and finally explosive death leading to spread of blood and pus which furthers the disease.
How does it spread?
Currently several methods are known. Exposure to the original meteor, exposure to blood and pus, potentially exposure to a 'green gas' observed by some witnesses, and potentially mere proximity to victims even through walls.
Ease of spread and progression of symptoms until explosion and death vary greatly between reports, and it appears that the amount of exposure to infected fluids is the greatest factor.
What are the risks?
Interviews have given mixed reports on how possible it is to prevent infection. According to Sister Selsi, it is impossible, and infection is inevitable with time and proximity. According to recent witnesses and the prior Palatial Physician, infection was preventable with precautions such as helmets, goggles, etc.
Interviews with multiple subjects have confirmed that the disease itself is highly mutable and unpredictable, with differences in symptoms and experience presented each time.
In the most recent case, witnesses encountered walking corpses infected with the disease who themselves spread it via contact during combat. This incident occurred at the Echoes, where miners had gone missing and become infected. The Green Gas was observed to follow in the wake of the "fleshy meat people".
There are always possibilities for "new strains", as the disease itself changes.
And, of course, there is the risk of the Blood Plague entering our walls. In the above incident, Ephia's Well narrowly escaped an outbreak. The infected individual was kept outside of the walls and far from the camp, with runners sent to seek help. Had those runners been infected themselves, or had the party decided to bring their infected into the Well: in the words of one of my interviewees, the result would have been "catastrophic".
The refugee camp, in particular, is a dangerous breeding ground for quick spread of the disease. According to multiple interviewees it has been so in the past. Squalor, poverty, and exposure could accelerate the spread.
What can we do?
Thankfully, a cure does already exist thanks to the work of the Priory. We can do more, however.
According to the Priory, the existing cure must be used immediately after synthesis and quickly degrades. Sister Selsi has provided helpful information on the specifics of the cure, but I believe that formally open-sourcing the information to the Pyramid will be valuable in the long term. For such a devastating disease, it is vital that the Pyramid itself have the knowledge to understand how to face the problem.
I request the Legates' support in requesting that the Priory allow observation of the synthesization of this cure, and a sample. Sister Selsi has explained to me that the Seers would need to give permission, and for this reason the Legates' support is vital. Especially if the Blood Plague changes or grows stronger, this transparency and trust between Pyramid and the Accord could save lives should the worst happen and the Blood Plague returns to our walls.
The best time to prepare is yesterday. The second best time is today. I ask us not to let ourselves be caught off-guard simply because it is not at our door already.
What is already being done?
Early discussions and planning between the healers of Ephia's Well. The priest Grenth Flamebringer has agreed to partner with me to prepare protocols and quarantine locations. None are ideal or complete solutions to the potential problem, but these will keep us more prepared should this or any other disease outbreak threaten the Well. We have prepared a potential quarantine room outside the walls, though it is not ideal.
Research into the Blood Plague. Doing so without direct observation of the Plague or field expeditions to known breeding grounds is less than ideal for research, but far safer. I have a strict "no risk tolerated" policy with this disease. The primary goal of this research is not to replace the existing Cure but to seek protective measures and monitor.
Stockpiling of medical supplies observed by the previous Physician as being necessary for healers interacting with Blood Plague victims. This cost has come out of my own pocket, and includes primarily plague masks (sealed, with goggles), gloves, medical supplies, etc.
I am hopeful that in the event of an outbreak of the Blood Plague or any other disease, the Pyramid and Fourth Legion will be open to cooperation and coordinated efforts.