LONDON European scientists and health authorities are facing angry questions about why H1N1 flu has not caused death and destruction on the scale first feared, and they need to respond deftly to ensure public support.
Accusations are flying in British and French media that the pandemic has been "hyped" by medical researchers to further their own cause, boost research grants and line the pockets of drug companies.
Britain's Independent newspaper this week asked "Pandemic? What Pandemic?."
In their response, scientists are walking a fine line.
They say that although the virus is mild, it can still kill, and that the relatively low fatalities in Europe are in part the result of official response to their advice.
On suggestions of "hyping" the threat to boost research funding, they point out that while we know enough to start to protect the vulnerable, we need to know a lot more to conquer the virus, and funding for new research and drugs is vital to be equipped for future pandemics.
H1N1 is hitting a younger population -- adults in their 20s and 30s and children -- and the global death count so far is more than 6,000, according to the WHO.
While seasonal flu attacks about 20 percent of the population in an average year, experts estimate that even in Britain -- the worst-hit country in Europe so far -- fewer than 10 percent of people have had H1N1 swine flu.
Fred Hayden, influenza research co-ordinator at the Wellcome Trust and a former World Health Organization (WHO) expert, said early planning is paying off, but added:
"I wouldn't characterize this as a "mild" pandemic at all. We are seeing some very unfortunate loss of life. I think it a bit early to make that judgment."
Yet the word "mild" is used so often to describe H1N1's impact in most people that it is prompting skeptical publics to ask what all the fuss is about. Why they should care? And why take a vaccine?
France's Le Parisien newspaper ran the headline: "Swine flu: why the French distrust the vaccine" and noted a gap between the predicted impact of H1N1 and the less dramatic reality.
"Although some 30-odd people have died....the disease is not really frightening," it said. "Dangerous liaisons between certain experts, the labs and the government, the obscurity of the contracts between the state and the pharma firms have added to the doubt."
SCENARIO REVISED DOWN
In Britain, health authorities' original worst-case scenario -- which said as many as 65,000 could die from H1N1 -- has twice been revised down and the prediction is now for around 1,000 deaths, way below the average annual toll of 4,000 to 8,000 deaths from seasonal winter flu.
A group of eminent scientists who called a media briefing in London this week to announce 7.5 million pounds ($12.4 million) of new funding for British research into H1N1 found their plans hijacked by reporters asking why the pandemic was so weak.
Scientists say the truth is they can't win.
The WHO has been urging countries to prepare for a flu pandemic since 1997, when H5N1 avian flu infected 18 people in Hong Kong and was stopped only after a mass slaughter of birds. The re-emergence of H5N1 in China and South Korea in 2003 fueled the urgency to get ready.
Now that it has arrived, the apparently low impact of the H1N1 pandemic so far may show that the planning is paying off, the Wellcome Trust's Hayden said.
British officials repeatedly said the nation was well-prepared for a flu pandemic. It had high stocks of antivirals and orders for enough vaccines to cover its population in place very early.
Hayden said comparisons with earlier flu pandemics like the one in 1918, which killed an estimated 230,000 people in Britain and up to 50 million worldwide, were skewed by the fact that there were so few effective treatments at that time.
"We didn't have antivirals then, and we didn't have antibiotics for the high frequency of bacterial complications," he said. "We have these kinds of interventions now and they are making a difference."
At the funding briefing, Peter Openshaw, director of the center for respiratory infection at Imperial College London, dismissed suggestions that scientists were enjoying the fruits of a pandemic in the form of big grants to keep them in work.
"This is not something that we are licking our lips and welcoming," he said. "But there is certainly an enormous outbreak of scientific information that has greatly enriched our understanding of flu."
(Additional reporting by Sophie Hardach in Paris and Maggie Fox in Washington, editing by Sonya Hepinstall)