Next Time, It Might Kill You

Antibiotics are also useless against viral pneumonia, which may have been what killed people in 1918. It may have had repercussions even for those who survived it. "Flu can cause serious things later on," I’m told by my own doctor, Israel Levavi, who refers to a new theory that heart disease can often be traced back to a patient’s bout with pneumonia, sometimes decades earlier. "In 1918, the people who got meningitis with the flu and survived all became Parkinsonian in their sixth and seventh decades. They were fine until then, but the flu left tracks. What tracks does it leave now?"

Two antiviral drugs, Amantadine and Rimantadine, are quite effective against the flu in its early stages, but, as Dr. Fannin points out, in a pandemic they could cause more problems than they solve. "There are not enough doses to handle panicky people," she says, "and can’t you just imagine how people would line up for the available doses? There is nothing worse for increasing panic than a short supply."

Still, if we appear to be more or less defenseless against the emergence of a new pandemic "superflu," we may be winning the fight against the ordinary flu. A company called Aviron, in Mountain View, California, has come up with a live-virus vaccine that is delivered as a nasal spray. Early test results suggest that it may be more helpful than standard vaccines in preventing flu, and that it can shorten its duration when it is already present. Like the standard injectable vaccine, however, it takes far too long to produce to be of much use in a pandemic. Other, even more promising drugs, which attack flu viruses directly, may be on the market within a few years. Who knows? Twenty years from now, an office worker may call in sick to work pretending to have the flu, only to be told: "There is no flu anymore, and you’re fired."

It doesn’t appear likely, however. The flu has been around a long, long time, and shows no signs of disappearing yet — a point made by Charles Creighton over a century ago. "What kind of infection is it," he asked in 1892,

which has outlived so many changes in the great pestilences of mankind, has seen the extinction of plague and the rise of cholera, and all other variations, most of them for the better, in the reigning types of epidemic sickness? To have lasted unchanged through so many mutations of things, from medieval to modern, and from modern to ultra-modern, and to have become more inveterate or protracted at the end of the 19th century than it had ever been, is unique in this history. Influenza appears to correspond with something broadly the same in human life at all times. Or is it rather a thing telluric, of the crust of the earth or the bowels of the earth? Or is it perhaps cosmic, affecting men as the vintage is affected by a comet, or as if it came from the upper spheres?

"Lovely," says Dr. Fannin, smiling with pleasure, when I read this passage out to her. It appears she does not find it entirely off the mark. Which is to say, though Dr. Fannin is quite certain that influenza does not originate in "the bowels of the earth," she’s not convinced that the current theory — that all pandemic flu strains originate in China — is necessarily right, either. "Hey," she says cheerfully, "a new flu virus could happen in L.A. too, and so the next virus could be called Type A–Los Angeles, which would mean we’d have to wait until the next year for a new vaccine."

As I’m leaving her office, Dr. Fannin suggests that if a real killer flu comes around again, a typical reaction might be a disbelieving and paranoid "This isn’t the flu!" It made me think of Creighton’s questions about the flu: "Is it a thing telluric, of the crust of the earth or the bowels of the earth? Or is it perhaps cosmic, affecting men as the vintage is affected by a comet, or as if it came from the upper spheres?"

Or is it (so the contemporary version might run during a pandemic) a thing terroristic, of the crust of the CIA or the bowels of Baghdad? Or is it perhaps something dropped in a subway by overweight Japanese terrorists with confused politics and drugged, puffy eyes? Is it Ebola? Is it airborne AIDS? Is it what they say it is on the Internet? Is it germ warfare?

This isn’t the flu!

Actually, for the time being, it still is. Perhaps it always will be. Perhaps none of our cherished apocalypses will ever amount to anything: Y2K will fizzle, comets will politely decline to hit the Earth, the Big One will never happen, and the flu will remain the ordinary flu.

Which isn’t to say it won’t cause trouble. Take Type A–Sydney, for example. Put yourself in its place. You’ve been around for a year and a half now, and you’re deep into your second World Tour ("Type A–Sydney, ’98-’99"). This season, you’re making headlines in Europe. In early January, you even make the front page and editorial page of the London Times on the same day. You’re nothing but an ordinary flu strain that’s now in the vaccine, and even so, English hospitals are swamped. It’s not a pandemic, it’s not even an epidemic, and still, people are panicking — ignoring their doctors, calling ambulances like they were taxis and filling hospital emergency rooms to such an extent that truly sick people are waiting for hours to be treated. "Despite the best efforts of hypochondriacs, the current outbreak of H3N2 Sydney flu is nowhere near epidemic proportions," thunders the Times on its editorial page, urging its readers to stop clogging up the hospitals and "take a hot, sweet drink, find a good book or programme, and go to bed."

Yup, there’s no doubt about it: People are soft these days. They scare easily. If only, you think to yourself, you had it in you to give them something to really be scared about.