perhaps as soon as February. The double truth that the pandemic H1N1 2009 virus was by and large innocuous in the great majority of those infected but could, in a small percentage, be severe remains the case and was predicted to be so from the outset in April 2009. A small percentage of a very large number of infected people can still lead to a sizeable and important number of seriously infected people as demonstrated by intensive care units full to capacity across developed countries beginning for example in Australia from June 2009. These admissions to intensive care have been almost entirely in people aged below 60 years of age, a large proportion of whom, perhaps a third, had no underlying medical risk factor. Herein lies another duality that is surprising to many. The main reason a new pandemic is predicted to cause large numbers of deaths is because all in the population are naive and the elderly, being particularly vulnerable, constitute by far the greatest proportion of fatalities. With the current virus, there is evidence from Australia, North America, Asia and Europe for cross protective immunity in the elderly which is especially strong in those aged in their 80s and 90s and likely to have been exposed for the first time in early childhood to an influenza virus similar to the 1918 (or the same) pandemic virus. The WHO continues to assess the impact of this pandemic as moderate and emphasize that it will not be possible to have