The real hummdinger will be if H1N1 which so far appears to be a "wild mild" flu, with few deathly implications, picks up H5N1 bird flu genes allowing it to spread human to human and kill 60% of its infected. If it kills fast and furiously, it may not spread widely, as is the case in very virulent strains.. usually. As pathology models predict a flu reaches its most moderate when it reaches its widest spread, for mathematical reasons. In fact when 1918 Spanish flu had reached global dimensions, despite its reputation for ferocity, it was probably at its least deadly. It had by that time infected 97.5% of the population as 1920 statistical antibodies tests confirmed. If you put it in that light its kill ratio so to speak was really only 0.65%.
Its actual mortality despite the inexorable and frightening progress of the more virulent "cytokine storm" or severe pneumonic cases, was listed at 2.5%, as it was stated that only 28% of the population got it. However the antibody statistics do not bear this out. In fact many people had it who probably never even knew they had it. Why the young and healthy tended to die was probably because of some feature of that flu that triggered an excessive hostile reaction of the healthier immune system. Or so goes the theory. Some people died from secondary pneumonic infection, and others died from direct flu "lung consolidation" i.e. phlegm fill up, from the flu itself. The extreme condition of that lung consolidation, it is theorized, came from a reactive cytokine build up to the deep lung virus replication.
The other feature of the 1918 flu was how fast it got serious. People were healthy one day and literally dead that same day often.
This is a very unusual flu. Some people die who are in their mid age, 20 to 50. It is a summer flu. It has spread worldwide, from a single source. So it is a pandemic. It's kill rate is really unknown, but may be below 1%. It will mutate. They all do. It will come back in the fall, probably, and mutate. The only questions are, will it mutate to a lesser form, or a more serious form? Will it cross with H5N1 and get deep lung genes?
We can only wait and see. In real time so to speak, death by death.
Can we slow its spread if we act before it gets too serious? Yes.
"In Japan, 257,363 deaths were attributed to influenza by July 1919, giving an estimated 0.425% mortality rate, much lower than nearly all other Asian countries for which data are available. The Japanese government severely restricted maritime travel to and from the home islands when the pandemic struck.
In the Pacific, American Samoa and the French colony of New Caledonia also succeeded in preventing even a single death from influenza through effective quarantines. In Australia, nearly 12,000 perished."
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