If I hear one more smug, well-dressed public health expert threaten us with the Next Great Pandemic, be it swine flu, avian flu or H1N1, with its inevitable comparison to the 1918 Spanish flu that “killed millions and millions”, the top of my head will blow off.

Presented in the metaphor of war, the virus is no longer a miniscule chunk of protein that requires a living, breathing body to reproduce but a rampaging army, mowing down everything in its path. Conveniently forgotten is that just as important as the “strength” of the virus is the health and immuno-competence of the host. Which brings me to the Spanish flu.

First off, it wasn’t “Spanish” – viruses not being good with national borders (plus most of them don’t have passports). The flu began somewhere in Europe at the end of a long and bloody war which you might recall: World War I.

The Allies, however (us, I mean, aka the Good Guys fighting the “Hun” and keeping the world safe for capitalism and democracy and whatnot) heavily censored news of the flu, thinking it would cause panic and pandemonium. (As if the war hadn’t already done that.)  So news of the flu trickled in from Spain, neutral during the war, which did not censor its news. Hence, people assumed the flu came from Spain.

Generally speaking, 1918 was not a good year, coming as it did after four years marked by new weapons and a war machine the likes of which the world had not seen before  – which is why WWI was also known as “the war to end all wars”. Millions of of young men died: cannon fodder for tactics devised by generals schooled in the gentlemanly art of 19th century war in what became known as the start of the 20th century in all its technological splendour.

Faded sepia photographs are all we have left of the many who died; dressed in those ugly boiled wool uniforms that make you itch just looking at them. Boys, really, living and dying in muddy trenches: damp, mouldy underground passages where micro-organisms proliferated as did gangrene and fungus and rot. And if anyone objected they were shot as a traitor.

I don’t tend to get sentimental about war but I confess that I wept when I saw the monument at Vimy. (“Every day they die among us,” said Auden, “those who were doing us some good.”) An entire generation lost to trench warfare.

That was the context for the Spanish flu: war, rationing, weakened immune systems, shell shock, malnutrition; the constant noise of cannons, stress, and injuries too horrible to contemplate; amputees in the hundreds of thousands. As ugly a situation as it gets. And no social programs, remember – those came much later, after the next great war. Everyone suffered, not just the military.

Medicine had little to offer: no antibiotics, no ventilators, no ICU’s, no potentially life-saving surgeries. Had there been, fewer people might have died (since it is the immune reaction that kills, not the virus), though we have no way of knowing – any more than we know how many people actually died of the “Spanish” flu.

(I suspect a fair amount of  hyperbole has crept into the numbers – particularly given the sheer number of agencies, drug companies and individuals that currently stand to gain in power and prestige from the scare tactics, not to mention funding and/or profit.)

Certainly in 1918 there was no way of testing for the virus, and even today, when we can (if we do), easily half the people diagnosed with the flu turn out not to have it. Experts call it “flu like” illness because they have no idea what it is. People just get sick when the weather gets cold, some worse than others.

So you’ll forgive me if I don’t get into a lather every time this pandemic business comes up with its inevitable reference  to 1918. Today, conditions for the majority of us in the developed world are so different as to make such comparisons  meaningless. Epidemiology shows us that the risk of getting any disease is higher if one is poor, malnourished, stressed, immune compromised; if one does not have ready access to clean water and air, nutritious food and decent  living conditions, jobs and hope. This means some Aboriginal reserves  in Canada and various pockets of poverty  throughout the United States, Europe and Japan, as well as most of the developing world.

Not the rest of us for whom hardship means our internet is down.

It wasn’t really a vaccine and a multi-million dollar PR campaign we needed last fall. Particularly since the massive expense will no doubt mean future cuts in less glamorous public health programs like suicide prevention for at- risk youth and the like. What we really needed were clear-eyed, long-term initiatives to fundamentally ameliorate the conditions of those communities on our own doorstep where people live impoverished, hopeless lives, in circumstances somewhat more similar to those of 1918.

There’s a public health program I would support. But, I doubt anybody would be interested. It wouldn’t make good TV.