The word which epidemiologists dread most in the entire world is "exponential" - and exponential might well be the scale of spread of bird flu. Exponential is what happens when you fold a piece of paper in two, and it is hardly any thicker than it was when it was a single sheet.
A second later, fold it in two again, and it's still not very thick. But continuing the folding, a second at a time, and two sheets will create four, four will become eight, and so on. A page which is a millionth of a metre thick is two metres thick after just 20 folds. After ten more folds, the paper is well over two kilometres thick. Another 10 folds and it will stretch across the Atlantic. This exponential origami took a single sheet of paper from Galway to New York in 40 seconds.
A disease behaving like that would cause a pandemic - and we might indeed be in the early stages of an avian flu pandemic. Admittedly, avian flu could turn out to be like genital herpes or vCJD, the pandemics which didn't occur. But doctors in this country are desperately worried, even if they aren't saying so in public, because if we really are on fold two of the sheet of newspaper ceaselessly doubling in size, then we are in the direst trouble.
The Arctic cold of Siberia has flushed millions of birds out of Asia. Far faster than anyone was predicting a month ago, the flu has traversed the steppes, the Alps and the Rhine and is now Italy and in Lyons. It has achieved a killer rate of about 60 per cent among the 169 people it has infected. This is the basic, unmutated H5N1 virus. Its vector towards human beings for the moment is the actual handling of birds.
So if the virus does not mutate, what we have is a limited occupational illness, like miner's phthisis or insulator's asbestosis. But if it mutates, as the HIV virus appears to have mutated, and as the influenza virus does repeatedly, we could have the epidemiological equivalent of a piece of paper being folded over enough times to cross the Atlantic in two thirds of a minute. And this could come to pass if the mutation which virologists fear occurs, so turning avian flu into a human-to-human disease. We are as prepared for that as much as we are for a collision with Pluto.
Our hospitals cannot cope with the minor and wholly predictable surge of mid-winter illnesses. Their corridors are already full of baffled patients on trolleys, and the scuttlebutt talk in the canteens among the administrative staff is that if avian flu mutates into human-to-human flu, they won't be turning up for work. If this actually comes to pass, it will leave the doctors and the nurses to run the hospitals.
But nurses and doctors, being for most part young and fit, are the people most likely to be fatally affected by avian flu. Avian kills those who are healthiest, sparing the infirm, the weak, and ill. For avian flu's lethality depends on it provoking the body's auto-immune system into over-reaction. A healthy, vigorous bodily defensive mechanism over-estimates the level of threat that it offers and causes the lungs to produce a protective froth which kills the patient in 60 per cent of cases. This is probably a greater level of mortality than that which resulted from bubonic plague (though not than its cousin, pneumonic disease, which was almost universally fatal).
So what plan has the Government got to deal with an avian flu epidemic? How will it cope with the possibility of the administrative staff not turning up for work, with no one to run or clean or cook for the hospitals? Yes, it is a scare story, but scare stories happen, as in Aids. So what is our national plan to cope with a plague? Is it another form of the aggressive indecision which seems to be the Taoiseach's preferred option in all matters, perhaps with Joe Jacobs promising to give us his little tablets to ward off nuclear bombs and avian juju? We know what State-run bodies are capable of when confronted with the task for which they were set up. They invariably fall into a state of self-righteous paralysis, whether trying to implement a coherent transport plan or to add a single lane to a few miles of orbital motorway, and end up producing the Red Cow Roundabout, in some form or other. So, can we expect any different when the possibility of pandemic finally arrives? Will we pioneer its epidemiological equivalent, the vaccarubracirculus, which will do to the patient what the RCB does to traffic flow around Dublin?
Brother John Clyn of the order of Minor Friars of Kilkenny in 1348 wrote one of the most haunting accounts of what it is to be living in the middle of a plague. "While waiting amongst the dead for the coming of death, I have set down in writing [ the events of the plague]. . . And lest the writing should perish with the writer and the work with the workman, I leave the parchment for the work to be continued in case in the future any human survivor should remain, or someone of the race of Adam should be able to escape this plague and continue what I have begun."
Six hundred and sixty years on, and we are about as ready for avian flu as Kilkenny was for the bubonic plague which took Brother John Clyn soon after he wrote his own epitaph.