Swine, Flu and Us: 3

Could it be in the end we will thank this virus for bringing us together?

The H1N1 epidemic is not much in the news anymore, but of course it’s percolating along. WHO now calls it “sneaky” because human-to-human spread is rapid and because the virus has the potential to mutate into a more virulent form. As of May 25 the number of countries affected (46) has doubled from May 6 (23). The number of identified cases has gone from 1,516 to 12,515, an eight-fold rise, and the number of deaths from has tripled from 30 to 91—which means a big further decline in the case-fatality rate, again probably due to better detection of non-fatal cases.

WHO is considering redefining “pandemic” so that it isn’t forced to go to level 6, the highest level, for a disease that is (so far) much less impressive than the seasonal avian flu. The fear is that a level 6 label would cause too much fear (we have nothing to fear but fear itself?) The upshot may be to include lethality in the definition of pandemic, which would mean there have to be a lot more deaths before it’s considered full-blown.

This seems reasonable, but it does highlight the way our language and labels arbitrarily shape our feelings—in this case, the feelings of the whole species—in a way that has little or nothing to do with the science. It also shows the power of a virus—not even alive by some definitions—to unify the species around one voice that has the power to influence if not command the anxieties of six billion people.

WHO Director-General Margaret Chan has been under pressure from Britain and other countries to choose her words more carefully, and she said she would, but she also wants to avoid complacency. On May 22, she said, “This is a subtle, sneaky virus. It does not announce its presence or arrival in a new country with a sudden explosion of patients seeking medical care or requiring hospitalization.” She went on to say, “We expect it to continue to spread to new countries and continue to spread within countries already affected.”

It’s rather amazing, and in fact wonderful, that the whole human species has rallied around one organization, WHO, and in the end really one person, Margaret Chan, to protect itself from a new and insidious threat. It’s marvelous that Mexico responded as effectively as it did, that the needed information spread throughout the world in hours or days, that so many countries have acted to get on top of this so quickly, and that even the language used to describe what is happening is subject to input from the planet’s collective wisdom so as to strike the right balance between appropriate precautions and inappropriate fear.

Still, the restless viral tide is slowly rising. H1N1 is sneakily spreading at a time of year when flu is normally not a big concern. Next fall and winter we will probably be seriously tested.

A vaccine is now ready for production and some decisions will have to be made as to how to allocate manufacturing resources, since it is going to be difficult to produce enough of this vaccine and enough of the one for next year’s seasonal flu as well. We are going to have to get used to uncertainty.

But one thing’s for sure: the human species has an unprecedented unity—of risk, yes, but also of communication and purpose. The rabbi of my childhood synagogue once gave a sermon on Noah’s flood, saying that at the moment the human race faced that disaster, it was unified as never before. He went on to say that if we ever had an invasion from Mars, we would see the nations of the world unite to face the threat.

Perhaps H1N1 is doing us a favor. Perhaps it’s episodes like this one that make our species grow in its capacity to unify, and perhaps in the end we will realize we are all in this precarious life together.

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