A pandemic may or may not be occurring as I write this column. A/H1N1, a strain of swine flu, has developed human-to-human transmissibility, and cases are beginning to crop up worldwide. The virus may have much higher lethality than previous strains, based on early reports of fatalities at the epicenter of Mexico, but it might also be a skewed sample set, with plenty of mild cases having gone by undocumented.

Still, you can’t spell “pandemic”without “panic,”so I’ve upgraded my personal Panic Status to Level 2. That means I’m using my Purell hand sanitizer a little more often than usual. At Level 3, I’ll swear off of Chipotle, Qdoba, and Moe’s Southwest Grill for a month. At Level 4, it’s facemask time. At Level 5, I’ll move from facemask to hockey-mask. Also, I’ll begin hoarding firearms and probably get to work on my novel abut a man whose editorial skills enable him to survive in a post-apocalyptic world. (Don’t ask about Level 6.)

This isn’t the first time in my 10 years on Contract Pharma that we’ve seen a potential pandemic. Six years ago, when I wrote in this space about the outbreak of SARS, I excoriated China’s leadership for denying the existence and then downplaying the extent of SARS in its country. At the time, I remarked that “you can’t hide this stuff anymore.” Information gets out.

Just as epidemiologists study the vectors of a disease as it traverses the globe, we can also see how information carries through on- and offline networks. And if I thought our communication options were advanced when I wrote that 2003 column, I had no idea what was in store. I’m obviously too prolix to function within Twitter’s 140-character limit, but that service has become the de facto method of spreading both trivial and critical information. With communications technologies like this, borders become meaningless

Until we have to close them. In an article in the NYTimes, for example, I learned that post-SARS Hong Kong “has used infrared scanners to measure the facial temperature of all arrivals at its airport and border crossings with mainland China.” That’s “all,” not “some.”

The thing is, globalization isn’t pick-and-choose (hardcore isolationists/protectionists notwithstanding). We benefit from increased trade, dissemination of lifesaving technology, and cultural cross-pollination, but there are tradeoffs.

A few days before the outbreak made the news, I was reading Plutarch’s Lives of Noble Grecians and Romans in a hotel room in Las Vegas (yes, I am the most boring person you know). In Plutarch’s bio of Numa Pompilius, the successor to Rome’s founder, Romulus, I ran across an interesting passage:

I’m keeping my Purelled fingers crossed that this isn’t The Big One, and that the global health infrastructure can weather this episode and learn some worthwhile lessons. There are pretty significant differences of opinion as to whether The Big One is an inevitability or whether advances in medical technology, communications and living standards have eliminated the possibility of a 1918-like catastrophe.

Sadly, the panic merchants only have to be right once.

Gil Roth has been the editor of Contract Pharma since its inception in 1999.

P.S.:Because this job somehow qualifies me as a “healthcare ambassador” to my friends and family, a number of people have asked me about this outbreak and how serious it is. After my caveat that it’s early days, they each followed up with, “What drugs work against it?”

“Relenza and Tamiflu seem to help,” I told them.

Here’s what they didn’t ask:

• “Who makes these drugs?”
• “Are there going to be enough doses of them?”
• “How long did they take to develop?”
• “How much do they cost?”

Here’s what they did ask:

• “How do you spell those again?”