
By Jane M. Orient, M.D. -
Clusters of a dozen or so deaths may get nonstop “if-it-bleeds-it-leads” press coverage. But the lack of preparedness for the really, really big threats may be met with virtual radio silence—until panic breaks out.
The worst, possibly existential, threat is the stealthy, invisible one that multiplies exponentially—in the accurate sense of the term: 400 cases today, 800 tomorrow, then 1600, 3200, 6400, 128000, 256000, 512000, and 1.024 million after only eight doubling times. Biological threats proliferate—until they run out of susceptible victims.
In 1918, the great influenza pandemic killed as many people in 11 months as the medieval Black Death did in 4 years. Ultimately, at least 50 million may have perished. Young healthy people, especially young soldiers headed off to the front in World War I, succumbed quickly. To avoid interfering with the war effort, the U.S. government denied and covered up the threat, preventing the implementation of public health measures.