When is a nasty cold not just a cold? When is it something more sinister, the early auguries of some dire and oft-prophesied global pandemic perhaps? The ill are the worst folk to ask. If you are lying this moment, bed encircled by sodden tissues, limbs leaden, head full of cement, the world and your spouse cruelly underplaying your suffering, it is easy to believe we are approaching the End of Days.

Little wonder thousands this Christmas have besieged doctors, demanding emergency attention, only to be outraged by medical advice to go home, boil the kettle, put on your jammies and sweat it out. But then this winter it is near-impossible to evaluate how anxious we're supposed to be. We are blasted by code-reds about the worst flu epidemic in a decade, scientists “warning” - do they do anything else between November and February? - about a cunning mutant strain, impervious to known drugs. And, meanwhile, the Government's National Risk Register puts a killer bug - above terrorist plot or dirty bomb - as our No1 public threat.

In those magnified images, a spiky glob of virus looks like a death star. Could this be the year we finally get a killer of that 1918 vintage, which wiped out 50 million souls? The year already feels apocalyptic enough with economic ailments and clouds of uncertainty blowing in from across the globe. The fear of a foreign lurgy is part of our island seige mentality, a medical sister to our horror of the euro.

It's a pity then for the doomsayers that this year's bug hails not from somewhere potentially malevolent and certainly unknowable like Romania or a remoter Chinese canton. It's hard to take too gravely a health threat hailing from sunny Brisbane: after bird flu comes, er, the Killer Kangaroo Kold.

With more than 70 per cent of the elderly taking up a free flu jab this year, the vulnerable are likely to be far safer than they were in 1999 when 22,000 people died from complications. (No cheers, then, for a nifty government strategy that actually worked?) Most of those suffering are the young and fit, who are simply unaccustomed to being unwell.

With vaccines such as MMR wiping out childhood illnesses of the sort that ensured a week laid up reading old comic annuals, with your mother bringing you trays of egg and soldiers, we have come to distrust the power of bed rest. We are busy people.

Only losers loll around unwashed watching Trisha. Besides we are led to believe that through diet, exercise and attentive reading of medical pages, we can control our own health. Succumbing to a virus feels like personal weakness; even moral failure. As my father-in-law would tell his children: “There are two types of people: those who go into work with a cold and those who do not.”

Except that those who do now have a little helper. The pharmaceutical companies are enabling us to override our bodies' natural, recuperative impulses so we can stagger into work, distribute our germs to colleagues and thus expand their revenues. Coughs and sneezes are market pleasers. But the smoking ban (smokers have more colds) and the spread of the flu vaccination programme have meant the sales of “winter remedies”, a commercial niche worth £220 million a year, have flattened. The only up-side has been in the “premium market”, the souped-up high-strength pills and powders, typified by the (at least honest) slogan: “Until there's a cure, there's Beechams.”

There is something faintly hilarious about the phrase Lemsip Max: a gentle, soothing childhood brand crudely souped up, as if Mary Poppins now administered a spoonful of sugar in PVC catsuit and conical bra. And look on the packet. Besides the sundry colourings and flavourings, there is not much more than 1000mg of paracetamol and a bit of caffeine. For about 50p a sachet! A nice cup of tea and a generic pill could do the same for pennies. But we are, of course, at our most vulnerable when buying these products: we need to believe in their metallic-tasting magic. And as the brand manager of Vicks said once: “We have found that price is not a purchase barrier.” Sick people are magnificent suckers.

Personally I am terrified of any medicine that boasts it is the maximum dose, while issuing grave, capital-lettered warnings. I'm with the 26 per cent of hard nuts who get through colds unmedicated, if not entirely sober. But young folks, many who pop a mega-sized Neurofen just to take the edge off the day, regard this as added value. They are pharmaceutically less paranoid then my generation, more impatient for an instant solution. It is hard, after all, to take nothing, to trust that nature will just take its course.

Who'd want to be a GP telling an aching, self-pitying man-flu victim that, sorry, you're on your own here, chum? Tempting to steer the French course of overprescribing, send him home with a pack of unneeded antibiotics, an inhaler and maybe a suppository to serve him right.

My own local surgery has devised a clever system for weeding out the slackers from the sickly. The only way to get a same-day appointment is to wait outside the clinic until it opens at 8.30am. If you're not there by 8am the queue will be too long. In February only a properly suffering person would bother - although you may die in the cold before you get to see a doctor.

No wonder the take-up of the flu vaccine has extended beyond the oldest and most vulnerable. Perhaps we are heading towards the American model. In many states children aged between 2 and 18 are only allowed to attend school if they've received the jab. (Just imagine the hoo-hah among the MMR = autism brigade.) Certainly employers are offering it now as a winter ritual. Once this looked laughably Stakhanovite: “Yes boss, please stick a needle in me, anything to help me serve you more ably.” It seemed pitifully corporate to entrust your immune system to your employer and forgo the God-given duvet days that help us through to spring.

But if we survive the Brisbane H3N2 or the pesky drug-resistant H1N2, we will all be dosing ourselves up on Anadin Atomic and Strepsils Shock & Awe, making sure we are at our desk to fend off the most likely pandemic of all, the pitiless P45.

Times Recommends

• In the real world, the public sector must pay
• Playing politics in a land of double Dutch
• Be like the plinth people: not set in stone