In a tiny settlement on the west coast of Greenland, 11-year-old Aleq and his best friend, frequent trespassers at a mining site exposed to mountains of long-buried and thawing permafrost, carry what they pick up back into their village, and from there Shepard's harrowing and deeply moving story follows Aleq, one of the few survivors of the initial outbreak, through his identification and radical isolation as the likely index patient. While he shoulders both a crushing guilt for what he may have done and the hopes of a world looking for answers, we also meet two Epidemic Intelligence Service investigators dispatched from the CDC--Jeannine, an epidemiologist and daughter of Algerian immigrants, and Danice, an M.D. and lab wonk. As they attempt to head off the cataclysm, Jeannine--moving from the Greeland hospital overwhelmed with the first patients to a Level 4 high-security facility in the Rocky Mountains--does what she can to sustain Aleq. Both a chamber piece of multiple intimate perspectives and a more omniscient glimpse into the megastructures (political, cultural, and biological) that inform such a disaster, the novel reminds us of the crucial bonds that form in the midst of catastrophe, as a child and several hypereducated adults learn what it means to provide adequate support for those they love. In the process, they celebrate the precious worlds they might lose, and help to shape others that may survive.