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“The Fifth Wave.” A True-Life Horror Film

March 6, 2017, 8:51 PM UTC

We open on a small Chinese village. A child is sick. Mother cradling him in her arms. Then quick shots of other homes, where a middle-aged man, then a grandmother, then a young woman are clearly ailing. Feverish. Coughing. Cut to: a small chicken farm, a few dead birds lay on the ground. Close-up on the farmer who can barely stand. He, too, collapses.

Cut to a rural hospital. Superimpose the following on-screen, typed out in quick fashion as in a Jason Bourne flick:



RATE OF PNEUMONIA (tick, tick, tick)…88%



Pause for a long second on-screen. Surgeons in scrubs burst in frame, rushing a gurney into the intensive care unit. Another gurney is right behind it. And there are patients in wheelchairs behind that. Too many to treat. The panic is palpable.

Superimpose title: THE FIFTH WAVE.

Good afternoon, readers! Welcome to real-life screenwriting 101—the class where the moviemaking is hokey, but the underlying facts are as true as they come.

In the fictitious scene above, indeed, the stats—cases, ICU hospitalizations, deaths—are actual figures. (They’re drawn from the Chinese Center for Disease Control and Prevention and the World Health Organization.) And the term “the fifth wave” (or “the fifth epidemic,” as it’s often called) is the one scientists use to describe the outbreak of avian flu that began in China on October 1, 2016. So far, in this fifth wave, there are 460 confirmed human infections with this H7N9 strain—a total that, in just five months, already outnumbers those in waves 3 and 4 combined. This year’s outbreak, moreover, has spread farther geographically than the earlier ones.

While Chinese authorities have found no evidence of “sustained” person-to-person transmission, such a “spill-over” strain would truly make this horror film frightening—resulting, perhaps, in a devastating pandemic akin to what the world saw in 1918.

That scenario, unfortunately, is not as improbable as many might hope. Nor is this a “far-away” problem for Americans. We’ve had outbreaks of human infections from avian flu, in recent years, in Virginia, Canada, and last year in New York, when a strain of H7N2 avian flu virus passed from a cat in an animal shelter to a human. And there’s at least some research (sorry—this one’s behind a paywall) to suggest that certain unique attributes of H7 viruses make them more amenable to jumping species than other strains.

Bringing all of this closer to home, of course, is the news from yesterday, when the USDA announced that a strain of bird flu had been found in a Tennessee chicken firm. No humans are sick, but more than 73,000 breeder chickens will have to be culled to prevent further spread, authorities said.

So why would I use this space to scare all of my new good friends on a mopey Monday? (Shame on me!)

Well, there is method to my meanness. As frightening as this all is, it reinforces (I hope) what I said in last Tuesday’s newsletter: The spread of infection is a global problem and it demands a concerted, vigilant, global response. We can’t turn our backs on this.

On the hopeful front, it’s also an opportunity to showcase some potentially revolutionary applications of digital health and surveillance. And I’ll have more on that part of the story tomorrow.

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.