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As they have for most of the past 87 years, hundreds of children from across the Eastern seaboard arrived in June at Camp Modin in Belgrade, Maine, carrying flip-flops, sleeping bags and swimsuits. But they also carried something new. First there was one fever, then six, then nine campers in a single day. By the end of the first full week, dozens of kids were sleeping on state-issued cots in a specially quarantined cabin, waiting out a pandemic flu virus that is barnstorming its way across the globe. Camp Modin was not alone; so far this summer, at least 80 camps in 40 states, including a full quarter of Maine's residential summer camps, have reportedly been hit by the bug known worldwide as H1N1. U.S. health officials were struck by a trend they regarded as unusual and troubling: a flu outbreak in the middle of summer.

Just a few weeks after the Modin quarantine, senior officials from across the government gathered in the basement of the West Wing to begin planning for the siege to come. On the flat-screen televisions embedded in the soundproof walls, a PowerPoint slide flashed the human toll of previous epidemic flus: more than 600,000 Americans died in the 1918 pandemic, 70,000 "excess" deaths resulted from the Asian flu in 1957, and there were 34,000 deaths after the Hong Kong flu hit in 1968. Next to the 2009-10 H1N1 pandemic, the screens showed nothing but a series of question marks. The punctuation was designed to make a larger point. As a senior official in charge of responding to the crisis later told TIME, "You are going to see a spike in deaths."

No one knows for sure what that spike will look like or how it will compare with the roughly 36,000 Americans who die each year from seasonal flu. But ever since the first case of H1N1 flu was reported in Mexico last March, the Obama Administration has been girding for a difficult fall and winter, which may see millions getting sick, overwhelmed hospitals, rolling closures of schools, disruption of workplaces, canceled public events and a death rate no one can predict. "We just don't know the magnitude of this," says Secretary of Education Arne Duncan, who has been working throughout the summer to prepare schools. "The unknown — that's what you worry about."

The good news is that H1N1 is not, so far, a particularly severe disease for those who are healthy. Through July, 353 Americans were confirmed to have died from the new flu out of an estimated 1 million infected. With the exception of certain populations — including pregnant women, children with chronic diseases and people with respiratory ailments — H1N1 tends to be no worse than the seasonal flu. A few days in bed and lots of liquids, and most patients get better. The bad news is that H1N1 is highly contagious and, unlike many other flus, is particularly hard on children and teens.

While H1N1 proved to be a manageable bug during the spring, U.S. officials are taking no chances as autumn, the traditional flu season, approaches. One pessimistic model from the Centers for Disease Control and Prevention (CDC) predicts that 40% of the nation could be struck — roughly 140 million people — with perhaps a six-figure death toll if a vaccination campaign is not successfully implemented. "To a lot of people, the flu went away," worries Kathleen Sebelius, Secretary of Health and Human Services, who received her first Situation Room flu briefing minutes after taking her oath in April. "Nothing could be further from the truth."

The Mobilization
Sebelius says the most accurate modeling for the current virus is likely to be found in the 1957 flu epidemic. Like H1N1, that flu began early in the year on foreign soil and was relatively quiet in the summer. Once school reconvened, however, it surged. As the disease peaked in October — between the launch of Sputnik and the release of the movie Jailhouse Rock — 43% of Manhattan students and 11% of New York City teachers reported absent from school in a single day. By the time it dissipated, about 1 in 4 Americans had taken ill from the disease, though the vast majority recovered without any lasting harm, according to a study by the Center for Biosecurity in Baltimore.

To better understand how this bug might move through the U.S. in coming months, officials have spent part of this summer monitoring the way H1N1 has been behaving during the southern hemisphere's winter months. It has been spreading fast, attendance has dropped at Patagonian ski resorts, and flu fears have crippled the Buenos Aires theater business. Across the region, countries are reporting that H1N1 has become the dominant strain of the flu season. But the most positive development is that the virus has so far not mutated — a fact that makes it possible for scientists to create a vaccine for it. All these developments are being tracked at the White House, where flu meetings happen usually twice a week in the Situation Room and President Barack Obama gets updates in the Oval Office every other day or so.

But with some schools opening this month, a few decisions must be made. If the virus does not mutate into something more deadly, federal officials will urge local schools to stay open unless so many children or staffers are sick that teaching becomes difficult. This is a change from the spring, when some school districts simply shut down for a week or more as students began getting symptoms. U.S. officials now believe wholesale shutdowns are unnecessary, given the fact that the bug is already so widespread, and potentially too disruptive. When schools close, many parents have to stay home from work, disabling an already fragile economy. Janet Napolitano, Secretary of the Department of Homeland Security, recommends that all families begin planning contingencies for handling a child who has to spend a week or more home from school. (Some schools may be advised to create quarantine areas for sick children whose parents cannot keep them at home.)

But the big move, which now appears likely, will be a decision by Washington to undertake potentially one of the largest and fastest public vaccination campaigns in U.S. history. Sometime in October and November, federal officials will probably recommend inoculating 160 million Americans who are most at risk of infection. Despite the fact that the shots will be free, the campaign will not be easy: last year only 40% of the U.S. population took the time to get a regular flu shot. And the H1N1 vaccine is going to require some commitment. Officials say health workers will need to administer at least two shots in the arm spaced four weeks apart before the end of the year.

Not everyone will be recommended for the H1N1 vaccine. The target group includes pregnant women, caretakers of infants, adults with chronic illnesses like diabetes and asthma and every child, teen and young adult between the ages of 6 months and 24 years. H1N1 is particularly tough on these populations. Pregnant women, for example, are more than four times as likely as others to be admitted to the hospital for the flu. Because the serum, which is still being developed, won't be ready until at least mid-October, full immunity may not kick in until early December — after the second doses are administered and an additional couple of weeks pass. "In all likelihood, this flu will hit before vaccine is available for people," explains Napolitano. "We are asking people to be resilient."

Translation: Everyone remain calm. Officials are working overtime to find health-care workers and public spaces to administer the vaccines this fall — and it will be a few weeks before more is known about where and when the shots will be given. The sheer size of the vaccination task causes some of the greatest concern for public-health experts, and it has begun to hit home for people like Kevin Sherin, the public-health director in Orlando, Fla. He oversees a school system with about 175,000 students, a county with more than 1 million residents and a tourist industry that cycles through 49 million visitors in a typical year. He says he has eight nurses in the schools and 20 other nurses ready to do immunizations. But if they each spend five minutes per injection, it would take them a month and a half — working 24 hours a day — to deliver the vaccine to all the local students. "For most of the local health departments, they are not going to have the resources to do the job," Sherin says. "We are really going to be relying on volunteers to help us." In addition to turning to private-sector doctors and nurses to aide the effort, Sherin is looking into renting empty storefronts, reopening vacant schools and even using the downtown Amway Arena, home to the Orlando Magic, for mass-vaccination campaigns. "It could be a little bit of pandemic pandemonium in the beginning," he says.

Managing the public's need for reliable information may prove as big a challenge as injecting the vaccine into people's arms. For instance, antivirals like Tamiflu are recommended in some cases for family members of those already sick with flu but not for large populations, like schools, that may have flu circulating in their midst. (Officials worry that widespread prophylactic use of antivirals could deplete stockpiles for people who really need them and create more deadly flu strains in the long run.) Officials must also explain that the seasonal-flu vaccine, which is specifically recommended for more than half the U.S. population, is ready now, even though the shots for H1N1 will not be ready for months. People, officials say, should not wait to get their seasonal-flu shot.

The Federal Government has set up a central clearinghouse for flu information at flu.gov and a Twitter account with regular updates at @CDCemergency. Government officials don't underestimate the challenge of getting the word out about flu to non-English-speaking citizens and communities that are not regular viewers of prime-time press conferences or followers on Twitter. "Right in the middle of our biggest cities, where we assume everyone knows everything, there are people who don't have access to information," explains Bobby Pestronk, who directs a trade group of local health officials. "The new virus is exploiting weaknesses in the public-health system."

While Washington waits for vaccines, the government is moving toward a wartime footing. The Department of Education is encouraging schools to prepare take-home study packets so kids can continue learning if their schools close. The Department of Labor has been drafting guidance for employers who may be hit by thousands of parents who need to stay home with their kids. All of it is being done very quickly for a threat that is unknowable and, scientists say, fast approaching. "Early on, there were some folks who said you can't go out and talk about this because we don't have all the facts," says John Brennan, a former CIA official who is heading the White House flu task force. "We all agreed that we are not going to know all the facts."

The chief mantra for everyone — wash your hands, cough into your sleeve, stay home if you're sick — will be repeated endlessly over the coming months in ad campaigns, public-service announcements and the media. For instance, the current advice for healthy people who get a fever and cough without other serious complications, such as an inability to eat or drink or difficulty breathing, is to stay home and not visit doctors or hospitals, which may be overburdened dealing with people who are more severely sick. At the height of the spring flu outbreak, hospitals were overwhelmed by crowds, including large numbers of the so-called worried well, who, when they showed up en masse, had the ability to delay services for the seriously ill. But U.S. officials admit that today's guidance could change as conditions develop.

Back to Normal in the Northeast
Meanwhile, things have calmed down at Camp Modin. No child was hospitalized, even though about 1 in 5 of the campers and staffers came down with the illness. Quarantined campers were carefully screened for any rise in body temperature, and Tamiflu was broadly administered, despite federal recommendations. The pandemic was integrated into normal camp life, just another reality like bug bites and sunburn. "The kids made light of it. It was just the flu," says Howie Salzberg, the camp's director. To help pass the time, quarantined kids were given access to television, DVDs and video games, causing some healthier campers to feel jealous. "They were saying, 'How do I get sick?' " Salzberg says.

If the U.S. experience this fall mirrors what happened at Camp Modin, the virus may go down in history as a case study in preparedness. But with a once-in-a-generation bug on the loose and schools opening in the coming weeks, the drama known as H1N1 may just be starting.

— With reporting by Elizabeth Dias and Sophia Yan / Washington 

• Michael Scherer
• More than 2 billion people worldwide could get it. Hundreds of schools may shut down. And 160 million Americans will need to be vaccinated — twice