A primary premise of Reason and Science is the expectation that what has happened in the past, will happen in the future. Disease has always happened in the past. Some things are different now though. There are far more people, living closer together than ever before and they travel far more. That makes the danger of pandemic disease greater now than it has ever been in human history. It is not a question of if. It is a question of when, how bad, what can we do to respond, how can we protect the civilization and institutions we rely on. It will become a question of how do we recover and how do we look at it. Do we look at it as an inexplicable and uncontrollable disaster that traumatizes us as the Black Plague traumatized the society in the Middle Ages or do we look at it as a challenge to be overcome? It is likely to happen more than once. This is the essence of morality for humans in the future, we must deal with nature rather than simply being subject to it. Our survival must also be a choice instead of only an instinct. What I am not sure is which we will face first - pandemic disease of the genetic problem. Either one will require humanity to smarten up.

Of course another event in Science is when someone asks "I wonder what would happen". That much of how this whole story started for me. Lynn Ikoma was discussing tropical diseases and I wondered what the consequence of immunization would be. What along strange trip that led to. It turned out to be more about genetics, but that is partly because we haven't had a pandemic yet.

If you ask any expert in disease, you will get the well known opinion that the world is due for a pandemic. We're overdue for that matter. Bill Gates commented about it and said that thirty million people could die. I'll take a risk and say that number is wildly incorrect. Far more than that will die.

We've come close. The World Health Organization and other groups have worked to prevent it. They watch for disease outbreaks all over the world. We have seen SARS and MERS. Luckily both seem to be manageable. There are fears of tropical diseases like Ebola appearing from remote jungle reservoirs. Luckily Ebola is a weak disease that is not very good at spreading. Really, while most recent diseases that have popped up and gained world attention, came as surprises, most experts agree that we know what the next pandemic disease is most likely to be. It will almost certainly be a flu. We have vaccines for some forms of flu. Health organizations around the world have worked to end some of the most dangerous farming practices such as raising pigs and chickens together. That was just asking for a bird flu to jump to a mammal. Poultry markets are monitored for disease like hospitals. Still, all our knowledge says it is coming. It is natural to think that our ongoing development of vaccines will keep ahead of the disease, but diseases have been overcoming defenses for hundreds of millions of years. We have learned much that will help. During the 1917 Spanish flu, only a few cities closed schools, church services and large gatherings. We know better now. The WHO has a list of best practices to prevent spread. Still, that's not enough to comfort those that know. We don't know what it will be or how bad. What if HIV has been spread by coughing as some people actually thought early on? Little of humanity might have survived. Sorry to be gloomy, but there is reason to consider how bad it could be. When a disease was released on an island in the PAcific to eradicate rabbits that were destroying all vegetation on the island, an odd effect was seen. Disease is actually something of a symbiont with it's host. It is bad for the disease if it kills the host, because then it isn't spread anymore. On the island though, the disease acted differently. In that case, what was most important for its survival was how fast it could spread. It became terrifyingly virulent. The researchers knew the disease would spread and kill the rabbits, that was their plan. How fast it spread and how fast it killed the rabbits came as a shock.

There are a lot of unknowns here including the disease, when it will happen, what medicine can do about it, who it will effect the most, and what sanitary practices can do to control it's spread.

What is less important here, but may as well be mentioned is that disease is a uniquely general selective effect. While some people may have the right immunities to any disease, every disease stresses the body. The primary way the body fights a disease is to heat up, to create a fever that kills the disease, hopefully before it kills the host. The thing is that if a person has a genetic weakness, it is far more likely that they will die regardless of their natural immunities. Also, if they have other diseases, they may already be weakened. Many of the people that died in the 19217 Spanish Flu epidemic also had tuberculosis.

If there is a pandemic where just 30 million people die, that is one third of one percent of the human population, but it is likely to have huge repercussions, socially, politically and personally. Historians repeatedly reported how the Black Death traumatized the Medieval society. Part of that would have been from a lack of understanding, but part of it would have been due to natural human superstition. Humans are less superstitious now and we have not just more knowledge, but better tools of knowing and better means of communication. The power of fear though, during a pandemic, would be overwhelming and it must be resisted. We have a society that we depend on for survival and that must be maintained. It will take more than medicine to survive pandemics, it will take moral strength. We must not panic or let it injure us. We must recognize that it is a time for strength, not the time for weakness. It will be a time for grief, but humanity must understand that it is a challenge that we must face and overcome.