A cold ache was in my fingers before I even finished locking the door to my apartment. I hunched over and bent my neck to keep it warm within the collar of my winter coat. I trudged through the snow to my car, and decided that although I was the only person on the street at six o’clock in the morning I should really be wearing my facemask. My frozen fingers fumbled with the elastic band as I lowered it into place behind my ears, effectively sealing my mouth away from the virus. I hoped.

The warm moisture of each breath was strangely comforting as it reflected back onto my face . There was hardly any traffic. Many people were either sick or hiding. I passed several store windows that had been shattered by looters.

Eventually I arrived at my office. Half of the front desk staff had stayed at home, citing runny noses, bad coughs, and general terror. The other half was present but similarly masked. With muffled voices and darting eyes they dutifully answered the riotous phones as quickly as they could.

“You can’t come in with those symptoms. We suggest you go to the hospital right away… except that all the hospitals are full.”

“Are you sure you’re just coming in for a sinus infection?”

“No, we ran out of flu shots two months ago, and we only had enough for our sickest patients anyway. Tamiflu? No, no one has that either. Only the CDC is able to dispense that to select hospitals anymore… I know! It’s crazy! The U.S. only had enough to treat 1% of its population… It makes us sick too. We’ve been told the new vaccine won’t be ready for six months.”

“Mrs. Walker, you sound horrible. I think you should call 9-1-1… I know they might take three hours to get to you, but with that cough you sound… well…”

I saw fifty patients that day. Almost all of them were wearing masks, some as rudimentary as handkerchiefs. One came in with a sprained ankle. Another showed up to discuss her diabetes. The other forty-eight came in with panic attacks, frayed nerves, stories of people they knew who were dead or dying, and questions galore. But it was the quiet ones, the ones with headaches and muscle aches and low grade fevers that terrified me the most.

Over lunch I scanned my emails from the state department of health, the CDC, and from my friends asking for advice. By now everyone knew that the overdue influenza pandemic had arrived. It first appeared in Southeast China as a mutated variety of bird flu and finally gained the ability to transmit itself between humans. Initially the quarantines, the local disbursements of antiviral medications, and the somewhat effective H5N1 vaccine seemed to contain the monster. But the illness was difficult to distinguish from the “regular flu,” and soon outbreaks occurred in Los Angeles, London, and Hong Kong before going global. The Western European countries faired relatively well, having stockpiled antiviral medications and funded their vaccination infrastructures for years. Only a few tens of thousands died. Elsewhere the world tally was approaching 100 million people dead.

Those persons who had received the regular flu shot in the fall gained a slight protection against the new pandemic strain of the flu. The year’s supply was exhausted quickly, however, and counterfeit vaccines were selling for $100 on the internet. Despite the government’s warning people still paid for them. A five day course of antiviral medication was selling for $5,000, even though it was only weakly effective by February.

The US government had a few protocols in place, but due to under-funding of public health and skewed priorities many people died unnecessarily. Most other countries looked upon us with pity and confusion that was reminiscent of the twin hurricanes of 2005.

By the end of the day I had developed scratchiness in the back of my throat and a runny nose. I started to worry when my temperature read 100.2 degrees Fahrenheit, and I felt the first twinges of pain in my head. I guess I knew that sooner or later I would inevitably contract the virus, and that it would be a roll of the dice whether it killed me or not. I couldn’t tell if the beads of sweat on my forehead were from a worsening fever or simply from a growing panic. I had already given away my stash of antiviral medication to a family member (who turned out to have been just sick with a cold). I closed my eyes behind the mask and tried to calm down. This couldn’t be happening.

Could it?

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Aidan Charles is the pseudonym of a practicing family physician whose writings regularly appear on his blog, The Examining Room of Dr. Charles (