A recent conversation with Mike Leavitt keeps replaying in my mind. When Leavitt, former secretary of Health and Human Services, met with our editorial board at the end of January our lively, wide-ranging exchange took a serious tone when the topic turned to pandemic influenza.

"It's no fun to talk about this because, first of all, it hasn't happened for a long time, and people are quite skeptical about whether it will.

"But," Leavitt said, "it will."

Three months later, the swine flu outbreak is front-page news. It's the lead story on network news broadcasts. At the writing of this column, 149 deaths have been attributed to the flu, all in Mexico. There are 44 confirmed cases in the United States in five states. Utah is not one of them.

Thus far, the cases of swine flu in the United States have been mild. Most sufferers have recovered quickly.

Yet, U.S. public health officials have declared a health emergency so the government can ship flu-fighting medications from a federal stockpile to the states should they need them. At the same time, President Barack Obama says the threat of spreading swine flu infections is a matter of concern but "not a cause for alarm," according to Associated Press.

The $64,000 question, it seems, is how concerned should we be?

Concerned enough that we should step up our hand washing, avoid touching our mouths, noses or eyes unless we've washed our hands or use alcohol-based hand sanitizer if we can't wash our hands. If we cough, we should cough into a tissue we immediately toss in the garbage, cough in our elbows or, if we cough in our hands, wash our hands immediately. We should stay away from sick people. People who have flu-like symptoms should stay home from work or school. They should seek a doctor's care if they have severe symptoms such as difficulty breathing. That's what experts say.

It's essentially the same advice given each year at the start of the regular influenza season. The flu and complications of the flu kill about 36,000 Americans a year, according to the CDC. That's a big number that generally receives little or no attention.

It's one of the reasons swine flu isn't a huge worry for me. I'm more concerned about a contagion of needless panic — the sort of irrational concern that causes people to swamp emergency rooms if they have a case of the sniffles. Many hospitals across the country have had to cut patient services and lay off staff since the economic crisis began in September. It's a very real concern because many hospitals operate on razor-thin profit margins in good times.