You could have said that before the 1918 pandemic, too

This much we know: At some point, we'll have another flu pandemic. Last century, there were three.

We don't know if the currently simmering H5N1 will be the influenza subtype that causes the next human pandemic. Or, if it is, when that will happen.

But as we assess the risk, we need to be clear thinkers. We need to open our eyes wide and accept the possibilities - and not use specious logic to assure ourselves "it won't happen" (or, even worse, "it can't happen").

There is considerable evidence, brought by world-class authorities, that influenza A (H5N1) is a very serious threat.

Yet some people respond with something like: "H5N1 has been around for years and still hasn't developed the ability to pass easily from person to person. The longer it goes without causing a pandemic, the less likely it will ever do so."

For example, Dr. Richard Wenzel, president of the International Society for Infectious Diseases, writing in the Richmond Times-Dispatch last fall, noted what changes would be needed in the H5N1 flu virus for it to develop a pandemic strain, then stated:

"While all are possible, none has occurred since H5N1 emerged nine years ago."

Another example: Laura Kelley, an associate of the National Intelligence Council (writing in her private capacity), commenting on the U.S. Pandemic Influenza Plan, stated:

"Remarkable though it may seem, all of this spending and activity is based on the deaths of fewer than seventy-five people, caused by a viral strain that has little or no person-to-person transmissibility."

Another example: Dr. Jeremy Farrar, working at a Vietnamese hospital which has treated about two dozen people with avian influenza, thinks an H5N1 pandemic is unlikely. In March 2006, he told the International Herald Tribune:

"For years, they have been telling us it's going to happen - and it hasn't."

[snip]

"Billions of chickens in Asia have been infected and millions of people lived with them," he said. Yet, "less than 200 people have gotten infected.

"That tells you that the constraints on the virus are considerable," he continued. "It must be hard for this virus to jump."

You know what? You probably could have said those things before the 1918 pandemic, too. Had they understood the biology the way we do, the naysayers back then could have said:

• "This virus has had little or no person-to-person transmissibility."


• "It's only killed a few people, you know."


• "It must be hard for this virus to jump from chickens to humans."


• "They've been saying this virus will cause a pandemic, but it hasn't."

Then, months later, the H1N1 virus began killing people by the tens of millions.