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Next Time, It Might Kill You

Photo courtesy Associated Press

When it comes to travel, this is a golden age for the flu virus. It’s always traveled free, of course — as far as that goes, nothing has changed — but think of the options. Two hundred years ago, a flu virus wanting to get from point A to point B was limited to sailing ships, horse-drawn carriages and people walking down roads. Now it’s got bullet trains, airplanes, cruise ships, automobiles, submarines, buses, helicopters, subway cars — all there for the picking and choosing, and all traveling at speeds unimaginable even a century ago.

In short, flu viruses can get around as never before. Which is just one of the things about the flu that has certain people in the medical community very, very worried.

Take a flu virus like last season’s Type A–Sydney, for instance. Put yourself in its place. It’s 1997 and you’re in the city of your birth, Sydney, Australia (that’s how you got your name), where already you’ve caused a fair amount of havoc. Now, Australia’s a big country, with more than enough Foster’s-guzzling mateys to go ’round, but you’ve got ambitions: You want to infect the world, every last corner of it, just like the legendary Spanish flu virus (your hero) of 1918. That little bastard infected one-fifth of the planet’s population and killed 20, 30, maybe 40 million people. You want a piece of that, and what’s more, you’ve got a chance: You were born too late for the guys in the white coats to get you into the ’97-’98 flu vaccine. How strong you are (virulent in flu-speak) you don’t know (only time will tell), but you’re free. You’ve slipped under the radar. So the obvious thing to do is get yourself to the airport and find an up-and-at-’em Type A personality like yourself who travels, takes meetings and treats a 12-hour plane trip as casually as a walk to the neighborhood store.

It’s in Departures that you find him. Six-foot-two, mid-30s, briefcase, laptop, cell phone, earring — the works. Actually, he finds you — inhales you to be precise. He’s standing by the magazine rack in a Dolce & Gabana suit, flipping through Playboy while waiting to board his flight to L.A. Silently, invisibly, you’re hanging in a cloud of what the flu docs call virions — minute viral particles deposited in a great hacking cough 10 minutes ago by someone who smokes too much and is definitely traveling economy — and the cloud is exactly level with Mr. Type A’s head. Covering his head, to be precise. He is literally standing in flu. You’re in his eyes, his nose, his throat, you’re all over his face and hair, and he breathes you in steadily for at least a minute, tapping his foot to the song playing over a hidden sound system:

You give me fever when you kiss me

Fever when you hold me tight

Fever in the morning

Fever all through the night

You give me fever . . .

L.A. (courtesy of your host) turns out to be two days of cell phones, car phones, pay phones, speaker phones and, on one occasion at least, an actual telephone. Then it’s the redeye to New York, which you’ve been looking forward to. The incubation period is over, and your host is now infectious. By the end of the flight, in your own modest estimation, all of first class will have been "seeded." Mr. Type A ends up sitting next to Ms. Type A, a movie producer with chestnut hair and a beautiful pink throat, inside which you’re already replicating (very nice). It’s quite a conversation these two paragons strike up over their glowing laptops, and it stretches deep into the celestial night, windows to the soul wide-open, germs going back and forth like Ping-Pong balls, and everything swimming along beautifully until, halfway through the flight, your host succumbs to a persistent tickling sensation in his trachea and begins to cough. Within an hour, he’s headachy, shivering, feverish, and the coughing’s gotten worse. Spotting an acquaintance three rows back, Ms. Type A tactfully changes seats.

And then — New York, New York! The Big Apple, somewhat overripe in the heat of early September, the U.S. Open going on at Flushing Meadow, tourists everywhere, and no one even thinking about the flu. You’re in so many people now, you hardly know who you are anymore. You’re dispersing, spreading out over the land, sowing the seeds of what will turn out to be the worst flu season in America in 19 years.

On a cruise ship heading north to Canada, you observe an old man in a deck chair, pink and mottled in a pool of weak late-summer sunlight. He’s not feeling well. Funny thing, but a lot of people onboard aren’t feeling well. So many people, in fact, that it’s caught the attention of the apparatchiks at the Centers for Disease Control. On September 15 a group of them board the ship, pry a culture out of some poor geezer’s throat and send it off to the lab. Four or five days later, the results come back: Type A–Sydney H3N2. You’ve been busted.

 

Still, the flu docs are way behind the curve. Two months later, in November 1997, your favorite periodical (Morbidity and Mortality Weekly Report) states: "This antigenic variant has not yet been detected in Africa, Europe, South America or in the continental United States, and the extent to which this variant will circulate during the 1997-98 season cannot be predicted." You have yourself a good laugh over that one. A month from now, there will be hospitals in America so overloaded with your victims they’ll be turning ambulances away at the door. For over 10 weeks, the flu will reach epidemic levels in 122 American cities.

Still, even at the height of your virulence, even when, half-crazy from bad Christmas music, you’re hanging out in every other bar and coffee shop and elevator in America, there’s no escaping the fact that, essentially, you’re minor-league. You’re making a lot of people ill — sometimes very ill — but you’re not actually killing many of them. Not enough, anyway.

And then there’s another problem. Just as you’re making every newspaper and news show in America, a rival flu virus bumps you right off the front page. In Hong Kong, there are reports that a deadly flu strain (Type A H5N1) previously found only in chickens has appeared in humans. Several children have died, and already there are whispers of a possible pandemic, 1918 all over again, only worse. In 1918, it took the killer flu four months to circumnavigate the world. Now 1 million people fly across international borders every day, and the flu cowboys are panicking. All the big shots from the CDC race to Hong Kong, as do officials from the World Health Organization (WHO), and in a desperate attempt to stop the disease from spreading they gas a million and a half chickens. And when supplies of carbon dioxide run out, Chinese civil servants are called upon to slit the birds’ throats as Buddhist monks and nuns chant prayers and warn of cosmic retribution.

There’s no way you can compete with that. All that’s left is to cultivate what victims you may, work on your memoirs and polish your after-dinner speech style. (Joke: What is a flu virus’s favorite poem? "Among School Children," by W.B. Yeats.) In 1998, as part of the annual flu vaccine, you will be injected into 80 million American arms. It’s a kind of immortality, after all. Most flu bugs don’t even make it that far.

On December 14, 1998, a proclamation, signed by Daniel Levanchy, chief of the Emerging and Other Communicable Diseases Division at WHO, as well as by 18 other "top world experts on influenza," hailed the Hong Kong chicken holocaust as a necessary step in "containing a fatal bird-flu virus and avoiding a global [human] pandemic." Commending the authorities of Hong Kong and China for "their decisive and courageous action on behalf of the continued health of the human race," the proclamation concludes, "We may owe our very lives to their actions."

The statement was not necessarily hyperbolic. Hundreds, possibly thousands of years after its debut on the human stage, influenza remains a puzzle. Not because we don’t know what it is — we do — but because we don’t know what it will become. Currently, three major flu strains are circulating globally, and they undergo slight changes — or antigenic drift — constantly, which is why flu vaccines are good for only one season. (Type A–Sydney is a virus that drifted.) Drifting flu viruses are worse than a nuisance — in the USA, they cause between 10,000 and 40,000 deaths a year, along with 50,000 to 300,000 hospitalizations and between $1 billion and $3 billion in direct costs for medical care — but they can be managed. They are what is meant by the term "ordinary flu." What worries the public-health types is when a virus undergoes an antigenic shift rather than drift, which is to say, changes radically. At that point, there is no predicting what will happen, because humans will have little or no immunity to the virus.

Just over 80 years ago, a virus shifted. In the ensuing global pandemic, 20 million Americans became seriously ill and 550,000 of them died. The majority of the victims were not — as is usually the case with the flu — children and the old, but healthy adults aged 20 to 40. There was no flu vaccine back then, and there were no antibiotics either, but it’s unlikely that either would have made a difference. Flu is a viral infection, and this particular virus was vicious, attacking the lungs of its victims until they drowned in their own bloody fluids, often in as little as 48 hours.

 

The flu came in three waves. It seems to have started in an American Army training camp in March of 1918, spreading across the country from there. It did not attract much attention at the time, because very few people died of it. In April, probably transported by American servicemen, it appeared in a Europe mired in World War I, and over the rest of the summer it spread slowly across the planet. But it still was not especially virulent. That changed suddenly at the end of August 1918, when, for no clear reason, a second wave appeared almost simultaneously in Brest, France; Sierra Leone, Africa; and Boston, Massachusetts. This was the worst flu strain in history. In Western Samoa it killed just under a quarter of the population, and in India — where it killed 12 million people in a matter of months — the death rate was reported to be "without parallel in the history of disease." During one week in Philadelphia, the number of deaths in the city climbed 752 times above the usual rate. The corpses, according to one historian of the period, were "gathered in carts as during Europe’s bubonic plague or Black Death epidemic," with undertakers stationed around the clock outside hospital exits. Schools and theaters were closed, citizens were ordered to wear protective masks in public, and young children found themselves at home with parents who were dead. Shortly after the second wave had abated, a third one swept through the States in early 1919. Less lethal than the second, it nonetheless made countless people seriously ill and killed tens of thousands more. All told, 20 million to 40 million people died worldwide of a virus so small that several million replicas of it could fit on the dot that ends this sentence.

Could it happen again? If, as Woody Allen once said, 90 percent of success in life is just showing up, then the answer is probably yes. Unlike more exotic and Hollywood-ready viruses like Ebola, the flu shows up seven days a week, 365 days a year. There have been two pandemics this century since 1918, both following antigenic shifts: the Asian flu of 1957 and the Hong Kong flu of 1968. Both were far less virulent than the 1918 pandemic, but between them they killed 104,000 Americans. "The thing we tend to ignore about the flu," says Dr. Robert Larsen of the Infectious Diseases Department at USC, "is that it happens every year. It doesn’t skip. It’s going to be here every year. It’s going to kill people every year. And then we will have a pandemic. The Hong Kong flu last year was a shift, and none of us would have had protection against that virus. Fortunately, it wasn’t a very efficient virus, and it self-extinguished. The CDC has been on the alert for that strain, and it’s gone."

Has it really gone? Or has it just gone into hiding?

Dr. Larsen chuckles. "It’s hard to decide whether it’s in hiding or if it’s always there."

If he had to rank the flu against all the other diseases that could cause a medical apocalypse, how would he rank it?

"The flu," says Dr. Larsen, "would be numbers 1 through 10."

Dr. Keiji Fukuda, chief epidemiologist for the CDC’s influenza section, and one of those called in to deal with the Hong Kong chicken flu last year, is not exactly brimming with optimism either on the subject of a pandemic. "It has happened in the past, happened this century, and there’s no reason to suspect that it won’t happen again," he says, adding tersely: "If it does, the consequences will be severe."

Dr. Fukuda is slightly more optimistic when asked if a future pandemic might be even worse than the one that some historians credit with finishing off World War I (people were too sick to continue). "It’s unlikely to be worse than 1918. [That] was a peculiar pandemic. The intrinsic virulence of that virus and the combination of events going on in the world at the time made it devastating. Having said that, because jet travel is much [more prevalent], a virus could be distributed much more quickly than in the past. We know our medical-care system has much better ways of caring for patients now, but these systems can get swamped."

 

As for the Hong Kong chicken virus, Fukuda says: "Since the end of ’97, we have had no other H5N1 viruses isolated either from poultry or from people. We’re hopeful we won’t see it, but we know these viruses are circulating in wild birds somewhere."

On December 15, 1998, one day after the Hong Kong proclamation, Dr. Shirley Fannin sits behind her desk on the second floor of the county’s Health Services Administration building on Figueroa Street. Outside, a Santa Ana wind is blowing, hot and dry, flooding the streets of downtown Los Angeles with sudden disorienting warmth. Flu weather? Hardly, but given that this is mid-December, who knows what viruses may be incubating in the temporary quarantines of millions of cars, or already floating in moist, translucent clouds through coffee shops and buses and Dil bertian blue-and-gray office cubicles? Dr. Fannin doesn’t, and she’s the director of disease-control programs for L.A. County.

Dr. Fannin is a stout woman with short gray hair and the no-nonsense manner of a person who has been interviewed on the same subject, and asked the same questions, for many, many years. Ask her if a pandemic on the scale of 1918 could happen again, and she’ll say, "Any Thursday." Mention that the next global pandemic could be incubating right now on the corner of Figueroa and Temple, and she’ll warmly agree with you. "Exactly. We do not have any control over that. And we would not be any better prepared than in 1918." But then Dr. Fannin corrects herself. "Ah," she says, flashing the sarcastic smile of the veteran bureaucrat. "We would be better prepared in one way for the next pandemic: We could study it to death. But it would be after the fact, and the people doing the studying would be the survivors."

One of the stranger things about the 1918 pandemic is that a remarkable number of people know almost nothing about it or have never heard of it. In America’s Forgotten Pandemic: The Influenza of 1918, the historian Alfred Crosby points out that the amnesia set in almost as soon as the pandemic was over. In the works of all the great American writers of the ’20s — Hemingway, Fitzgerald, Dos Passos et al. — there are virtually no references to a global catastrophe the writers had themselves lived through, and were fortunate to have survived. Even when the pandemic was raging, response to it was curiously muted. "Perhaps the most notable peculiarity of the influenza epidemic," a New York Times editorial noted in November 1918 (at the end of a two-week onslaught during which 9,000 New Yorkers had died), "is the fact that it has been attended by no traces of panic or even of excitement."

It’s hard to imagine the same lack of excitement today. In 1918, World War I was coming to a close, death from childbirth or scarlet fever was still common, and as Dr. Fannin points out, "People were more knowledgeable and expectant of death as a part of living." For all but the poorest Americans, this is no longer true. Were 9,000 Angelenos, most of them in the prime of life, to die of the flu during a two-week period a month from now, with hundreds of thousands of others dangerously sick and still more not yet sick but already contagious, it is unlikely — to put it mildly — that people would take it calmly.

Mike Davis, whose latest book, Ecology of Fear, examines the impact of environmental catastrophes on California, suggests, "Just as Americans are not ready to accept casualties in warfare now, they would not be prepared to accept the mortalities that would occur in a pandemic. I think we are totally disarmed for the return of mass mortality — particularly when it’s not targeted at a social group that’s a minority — where you would have an egalitarian impact on the population. The great pandemic was the last time the American middle class had to deal with something on this scale. None of the old religious and authoritarian structures are there today. Ordinary lifetime experience has changed so greatly since 1918. Then the average American family would have lost a child to illness. Americans were a lot tougher and inured by experience."

Dr. Fannin, when pressed, is equally pessimistic about how the populace would respond to a pandemic today. "Fear is contagious," she says. "If fear is limited to a group of four to eight people, it’s one size of problem. But if fear is being shared by 15 million people simultaneously, what kind of impact, what kind of aberrant behavior, could derive from that? Fear of the unknown very rapidly becomes fear of strangers or xenophobia, which very rapidly becomes fear of your neighbor, which very rapidly becomes siege mentality."

 

Some people, like Dr. Ralph Frerichs, chairman of the Epidemiology Department at UCLA, believe our current state of all news all the time would help us. "Our ability to get information to people now is remarkable," he says. "There are very few places in the world that we can’t reach. Communication is so rapid that deadly problems should be contained fairly quickly."

Others, like Dr. Larsen, are less optimistic. "Historically, the media are not responsible," he says. "When the hantavirus re-emerged several years ago, it was called the Navajo flu by much of the lay press in New Mexico. They had Indians from New Mexico who were insulted, refused boarding passes at airports, there were people who wouldn’t go into meetings with them. The public-health department had already said that it wasn’t a communicable disease, yet the media acted as if it was."

But even if the media behave responsibly, there’s not much you can say to comfort a population under attack from a deadly airborne pathogen. "What’s your option?" Dr. Fannin asks sarcastically. "Quit breathing?" When I ask her if L.A. County is developing a "pandemic preparedness" plan, as are WHO, the CDC and other groups, she waves my question away impatiently. "Oh, please!" Fannin says scornfully. "What plan? The only thing you would be able to do is a day-to-day assessment of what your problems are, and then ask people to cooperate by staying away from huge crowds."

"Do you think the pandemic is going to come?" I ask.

"You know, the possibility is there. And I cannot as an epidemiologist say always or never. Because it happened once before, and we do not know why it happened, and we do not know how to prevent it from happening again. Period. So I don’t feel like misleading people into thinking that technology has all the answers, or that medicine has all the answers, because it certainly does not. And this is one of the areas I’ve been very curious about, because while a few people have been interested in influenza, I learned nothing — nothing at all — during my medical career about the 1918 influenza pandemic. That’s what I think is so odd! That something so devastating and so awful could be pushed away from people’s consciousness!"

This is something Dr. Fannin has touched on several times during the interview — our strange lack of preoccupation with a disease that shows up every year and occasionally kills, or seriously endangers, vast numbers of us — and she remains puzzled by it. Her own parents never talked to her about the 1918 pandemic when she was growing up, even though some members of her family had been seriously stricken by the flu and others had taken part in house-to-house searches in the small rural Kentucky community they lived in, looking for, and finding, the disease’s dead victims. I decide to give Dr. Fannin my own theory of why people forget the 1918 flu. In the context of serious illness, I suggest to her, the flu is a kind of cuddly domestic cat, and every 30 or 100 or 400 years it suddenly turns into a lion and rips its victims to pieces. And then, there it is — it’s that cute, cuddly cat again. And the thing is, we need cats. We need to have some common sicknesses that we survive.

Dr. Fannin laughs — the slightly condescending laugh, it seems to me, of someone who has never called in sick to work pretending to have "the flu." "You may be on to something there," she says. And then she adds: "The one socially positive thing about influenza is it’s not a great respecter of person or position. You are not protected by being rich, you are not protected by being handsome or the reverse. It’s a great leveler."

"Unlike tuberculosis."

"Yes. It has become a very fascinating subject to me."

Where does the flu come from? And when will it go away? A street song popular in 1918 had an answer to the first question:

I had a little bird

And its name was Enza

I opened the window

And in-flu-enza.

Oddly, the words were wiser than their author could have known. Avian influenza was not recognized until 1955, and was not isolated in wild birds until 1961, but since then birds have been found to play an essential role in spreading the flu virus, particularly if they spend time in China. Dr. Larsen explains it this way:

"All flu strains are found in migratory birds, like ducks, and they seem to be the source of all new flu viruses. You and I are not going to have a lot of contact with ducks, but in China they do. It turns out that the viruses that come from ducks have trouble getting into people. We don’t have the receptors in our throats to receive those viruses, but pigs do. Pigs also have receptors to receive human viruses. In China there are millions of ducks and pigs living with people on farms. The pig picks up the duck virus, then the human virus, they mix and match, the human gets the virus from the pig, and away we go — we’ve got a new virus against which humans have no protection. That’s how we believe pandemics start."

 

Older explanations of the flu were more fanciful. The Italians came up with the word influenza, meaning influence, in the 14th century. The influence they were referring to came from the stars, whose constellations were believed to provoke the disease. Other names for the flu have included the "new acquaintance," the "strange fever" and, in the German trenches during World War I, "Blitzkrieg Katarrh." In 1557 an English minister dubbed it "the gentle correction," explaining to his congregation that the flu "is one of those rods, and the most common rod, wherewith it pleaseth God to brake his people for sin." In 1580, there was a flu so fierce that, according to the 19th-century English epidemiologist Charles Creighton, "In the space of six weeks it afflicted almost all the nations of Europe, of whom hardly the twentieth person was free of the disease, and anyone who was so became an object of wonder to others in the place . . . Its sudden ending after a month, as if it had been prohibited, was as marvelous as its sudden onset . . ."

That the flu was pretty much then what it is now is attested to by the historical record. No one understood how it happened (Noah Webster, the American lexicographer, suggested, "The causes most probably exist in the elements, fire, air and water, for we know of no other medium by which diseases can be communicated to whole communities of people"), but they knew what it felt like. In 1562, an English letter writer described how Mary Queen of Scots

. . . fell acquainted with a new disease that is common in this towne, called here the newe acquayntance, which passed also throughe her whole courte, neither sparinge lordes, ladies nor damoysells . . . It ys a plague in their heades that have yt, and a soreness in their stomackes, with a great coughe, that remayneth with some longer, with others shorter tyme, as yt findeth apte bodies for the nature of the disease. The queen kept her bed six days. There was no appearance of danger, nor manie that die of the disease, excepte some olde folkes.

Aside from the fact that the author of that passage didn’t know that influenza was a viral infection — the flu virus was first isolated in humans in 1933 — there isn’t much difference between his description of the flu in the 16th century and the description of flu on the CDC’s Web site in 1999 — even down to the observation that not many people die of it "excepte some olde folkes." In fact, in many ways we may not be much further advanced in our battle against the flu than we were in 1918. We have antibiotics to fight bacterial pneumonia, which is what usually finishes off seriously ailing flu victims, but antibiotics are no longer as effective as they were during the smaller pandemics of 1957 and 1968 — which, taken together, killed 104,000 Americans alone — and Streptococcus pneumoniae bacteria are far more resistant than they used to be.

"In 1957 and ’68 we saved a lot of people with antibiotics," says Dr. Larsen. "We’d have a much more grave situation on our hands now. In ’57 and ’68, none of the pneumococcal bacteria were resistant to penicillin. In certain cities in the U.S., like Atlanta, though not L.A., we now have a situation where 80 percent of pneumoccocal bacteria are resistant to penicillin, and 15 percent are resistant to almost all the antibiotics we have."

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.


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