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We were all told that any virus could sneak up on us from behind while we were looking in the H5N1 direction, and yet this outbreak of H1N1 was not expected.  Not in specific terms, but it certainly was expected in general terms.  Whatever the source or the label, a pandemic is a pandemic; and preparations are necessary.The stunning speed of spread was something we were also told to expect of a pandemic virus, but when the first news reached us of an outbreak in Mexico City, and by noon of the same day it had spread to California, Texas, and Kansas, we were taken aback.  By mid-afternoon it exhibited itself in Canada and Britain.  Same day.Whether the death toll has been significant or not, the evidence of the incredible spread of a virus should make us seriously consider our vulnerabilities.  Some may say it was all a bust, we were all ramped up for a rocket that fizzled.  Others are looking at this through the experience of past pandemics and recognizing the similarity to the typical wave pattern of other pandemic infections."Pandemic," refers to geography, not to severity of the illness.  The number of countries of contagion have merited the ranking of a Stage 5 category, not the number of deaths.  The severity of the virus is limited in the first wave for two very significant reasons.  Firstly, in the northern hemisphere the flu season is typically November to April, and is coming to an end for this year.  Remember, flu viruses thrive in the cold, unlike bacteria which are killed by freezing.Secondly, it is typical of a flu virus to circulate in waves, likely two or even three.  The second wave usually is the one that mutates into the super-killer wave.  We could expect the timing of this wave to be in the fall, when the virus has had its "dry run" and has had time to adapt efficiently to human hosts, and re-visit at a time when seasonal viruses thrive and we are most vulnerable to flu viruses in general.In addition, world wide, the resources, attention and response to the H1N1 swine flu outbreak have been completely appropriate. We all know, and are likely even related to, at least one skeptic, whose voice scoffs in our ear at every mention of readiness.  Some of the other relatives, on general principle, are then yelling about the sky falling with every cloud that passes across the sun.  It's easy to lose balance on this topic, and it's even easier to take our ease and see this wave of H1N1 as a bullet missed.  We may even decide the storm has passed and put pandemic concerns back on the shelf. That, however, would be the biggest error of response because of the natural structure of viruses.  A novel virus (one humans haven't encountered before) is an alarm to our immune systems.  The immune system goes into hyper-drive and mobilizes all its defenses at once to fight it, and this effects a response in the body which can produce a "cytokine storm".  It's believed this explains the reason why many deaths will occur in the 15 - 40 year old age group.  This age group normally should be the last to succumb to a flu virus, but their more efficient immune systems are shocked into an over-reactive mode that turns the body's defenses against itself.Another lesson we are learning from this experience is that "flu", as a term, is deceptive.  Flu doesn't begin to describe the phenomenal disruption to the immune system these pandemic viruses produce.  Like the dreaded SARS, it's not just coughing, sneezing, vomiting, diarrhea, fever, and feeling like crap.  This pandemic flu produces seizures, paralysis, coma, and of course, death.The word is out about hand-washing, cough and sneeze etiquette, staying home if sick, and keeping an eye on people who might be ill at school, work, or on a plane.  The media have all pounded home the proper messages.  There may have been a few places on earth that didn't have the information, but not likely any more. So, don't toss the hand-sanitizer.  Don't alter your hygiene protocols.  Eat right.  Get plenty of exercise.  Try to eliminate as much stress in your life as you can.  Get enough rest.  We believe this is the first wave, and we hope we're wrong.  Judging by world reactions to the announcement of Stage 5 it's encouraging to see that the dust is being blown off pandemic plans across the globe.  Perhaps with this warning and heightened concern we will see subsequent waves pass as mildly as this.Stay well.  Take care.