A Wing And A Prayer

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Another global flu pandemic that horrific is not inevitable. "The scientists at the who and elsewhere who have been beating the drum about the coming flu pandemic are overstating the evidence," says Paul Ewald, an evolutionary biologist at the University of Louisville in Kentucky. Standards of public health in much of the world are far better than they were in 1918. There is better understanding than ever before of how a disease propagates, and how it kills. New antiviral drugs are available — though there are not enough to go around in the event of a worldwide outbreak — and h5n1 vaccines are being developed by French drugmaker Sanofi-Aventis and U.S. biotechnology company Chiron. In the wake of Hurricane Katrina, which demonstrated the high cost of complacency, the world is beginning to heed who warnings — health experts from international organizations and officials from more than 65 countries met last week in Washington to discuss a coordinated response to bird flu, and rich nations such as Britain, France and South Korea have stepped up orders for antiviral drugs that could help to protect their citizens in an outbreak. But none of these factors, alone or together, are enough to let the world sleep easy. Last month, a British study warned that the country lacked enough critical-care beds to cope with an influenza pandemic. As Time reporters worked on this story — talking to a virologist hunting for genetic clues in the muddy backyard chicken farms of Asia, a doctor in Vietnam who attends some of those who have already been infected by h5n1, and an epidemiologist in the U.S. who tracks the movement of the virus around the globe — they were left with one abiding impression. Though we have the ability to prevent or mitigate a flu pandemic, those in the front line of the battle against h5n1 are preparing for the worst. This is their story.

At his h.k.u. office overlooking the South China Sea, Guan fishes a cigarette from his pack of Mild Sevens and sighs, rubbing his forehead. A research paper he has been working on for years, a document he says will explain where the h5n1 virus came from and how it has become so entrenched in much of Asia, has just been rejected by a major scientific journal. That's part of life for any research scientist, and Guan is confident that the paper will soon be picked up by another journal. Still, he is taking the blow personally. "A paper is just a paper, but this is something that's important for the whole world," says the researcher, who was born in mainland China. "If a pandemic occurs, no matter how developed this world is, it would suddenly shut down," he says. "And I know it's coming."

Messianic complexes aren't unusual among élite medical researchers, though few are as vocal about it as Guan, who will tell listeners that his work will help save us all. But then, few scientists have Guan's credentials. It was Guan who realized that civets were transmitting the the sars coronavirus to humans, convincing Chinese officials in Guangzhou to cull the animals in January 2004. That helped to prevent a possible second sars outbreak. Guan has been just as key with h5n1: he heads the Joint Influenza Research Center, a project between H.K.U. and Shantou University in China's southern Guangdong province, that has helped to give scientists the most accurate picture yet of how h5n1 has evolved and spread. "Guan Yi is a very bright guy," says Robert Webster, a renowned flu expert at St. Jude Children's Research Hospital in Memphis, Tennessee. "He talks a million miles a minute, and a lot of the stuff you don't even understand, but he is extremely dedicated."

Guan is important not just because of who he is but where he is. With its densely packed populations of animals and humans, southern China is the traditional birthplace of influenza. The last two pandemics, of 1968 and 1957, originated there as avian-flu viruses that mutated and eventually passed into people. That's what happened in Hong Kong in 1997 with h5n1, as the virus first spread directly from sick poultry into human beings, infecting 18 people and killing six — an outbreak that was halted only when officials culled all 1.5 million of the territory's chickens. Later, Guan and his H.K.U. colleagues — including Malik Peiris, who discovered the sars coronavirus — helped to trace the origin of the new, more dangerous strain of h5n1 back to a single Guangdong goose.