The Flu

1. We dodged a bullet last year.

Look at official statistics, and you’d be forgiven for thinking that so-called influenza pandemics are no worse than garden-variety flu. After all, the seasonal influenza virus kills hundreds of thousands of people around the globe each year, while the World Health Organization’s official death toll from 2009’s H1N1 ("swine flu") stands at just 18,366. But that tally counts only laboratory-confirmed cases, thus vastly understating the threat. In Africa and Asia, millions of transmitted cases and thousands of deaths weren’t picked up by developing-world health-care systems; whether the true number of dead is five or 100 times greater is impossible to know. What’s more, many people born before 1960, when a virus similar to swine flu disappeared, had significant immunity against it.

2. Prior outbreaks tell us little.

Influenza pandemics are nothing new. Even Hippocrates noted the occurrence of the disease as far back as 412 B.C., and there have been at least 11 documented pandemics in the last 300 years. The nature of the influenza virus, one of the fastest-changing organisms in existence, makes its spread inevitable: Not only can the virus jump species directly, but when two different influenza strains infect the same cell, they can create a new hybrid by reassorting their genes. The H5N1 ("bird flu") virus first jumped directly from birds to humans in 1997. Since then, it has killed 60 percent of the more than 500 people it has infected and shows no signs of disappearing. A more severe influenza pandemic could strike tomorrow, or not for another 50 years.

3. We’re still not ready for the big one.

After years of planning and billions of dollars spent preparing for a severe outbreak, we’re better off than a decade ago but still a long way from home. Western investment in vaccine manufacturing technology will pay off soon — but making enough vaccines for the developing world will remain a problem. In February, 95 countries told the World Health Organization that they had no vaccine at all. In June, the U.S. government trashed 40 million expired flu vaccine doses worth an estimated $260 million. Moving vast quantities of stockpiled medicine from countries where flu seems to be waning to those where incidence is on the rise is still difficult. And cuts in public-health spending are reducing governments’ ability to handle a surge of patients, while millions of dollars are being wasted on ineffective measures such as airport screening of arriving passengers.

4. Panicky governments make things worse.

Swine flu was a serious threat, but many countries overreacted to the point of irrationality. Egypt, for example, slaughtered its entire pig population; Singapore warned citizens that violating a quarantine order would result in jail time. Mexico, where the 2009 outbreak began, was punished harshly for its transparency: France demanded that the European Union cancel flights to the country, and some U.S. commentators wanted the border shut. In total, the Mexican economy lost nearly $3 billion. This kind of overreaction only encourages governments to keep quiet the next time a virulent flu strain hits.

5. Tech geeks don’t have all the answers.

Because flu travels so fast, early detection is a priority. But forget about containment. For all the hype over Google’s discovery that rising numbers of search terms like "flu remedy" predict spiking sickness rates weeks ahead of government reports, in a pandemic they actually measure alarm, not disease. At best, this information is of little value: Once individuals show symptoms, they’re already contagious. A new "micro-needle" bandage being developed at Emory University and the Georgia Institute of Technology might be more helpful; if it catches on, governments could simply mail citizens their annual shot. Until then, wash your hands and stock up on tissues.