It’s a small world after all!

When Andrew Jeremy Wakefield told us that it was his gut feeling that the MMR vaccine caused autism, I doubt that he had any idea of what he was about to unleash on the world. I really don’t think that he wanted to trigger outbreaks of vaccine-preventable diseases in places where vaccines had suppressed those diseases out of epidemic range and into sporadic range. I bet he was in it for the money. Get people to take less of the MMR and more of the vaccine that he was trying to patent. Like any industrialist, he wanted to crush the competition and give the people a reasonable alternative.

That’s my theory, anyway. The truth could be more sinister and Andrew Jeremy Wakefield really was trying to cause outbreaks of measles like the one that engulfed Wales in 2012-13. That outbreak resulted in a little over 1,200 reported cases. The true number is probably higher, since not everyone sick was tested and a lab confirmation is necessary to call a case a “confirmed case.” In a country of just over 3 million people, the incidence of measles during the time period of the outbreak was about 40 cases per 100,000 residents. If you ignore the differences between Wales and the United States, this would translate to an outbreak of 128,000 confirmed cases in eight months in the United States. Like in the US, measles was declared eliminated in the United Kingdom at the beginning of this century when the incidence rate was less than one case per 100,000 residents per year.

Because so many people decided not to vaccinate with MMR anymore in Wales after Wakefield’s fraudulent paper on MMR and autism, herd immunity against measles (a very, very infectious disease transmitted through the air) ended, bringing about the Wales outbreak. That outbreak caused a lot of people to become sick and at least one death. (The death rate from measles is about 1 in 1,000, so it stands to reason that 1,200 confirmed cases would lead to one confirmed death.) In the nightmare “all things being equal” scenario in the United States, we could expect about 128 people to die from measles.

Death is not the only measure by which reasonable people should measure the impact of a disease on the population. There are other costs as well. There is the cost of parents missing work because they have to tend to sick children. There is the cost of medical care for those sick children. There is also the cost of tracing the contacts of the cases, and the people who are quarantined because they may be infectious will miss work and school. In the years before vaccines, this all used to cost a ton of resources to our societies. In the time since vaccines, we have been able to devote those resources to other things. It’s why we are living longer. It’s why you can sit comfortably in almost any place in the world and read this blog.

Unless you’ve been living under a rock, you have probably heard about the measles outbreak that seems to have as its epicentre “the happiest place on Earth”, Disneyland. Look at this news report from the San Diego Union-Tribune online:

“San Diego County now has 10 active measles cases, all of them linked to Disneyland visits in December, public-health officials confirmed Thursday.

Six siblings, 22 months to 18 years in age, had arrived Wednesday at the Sharp Rees-Stealy urgent care center in La Mesa with rashes and other signs of measles. Shortly afterward, the county’s Health and Human Services Agency learned of a case involving an adult older than 50.”

The only person in that bunch who was fully vaccinated against measles was the adult over 50. That’s it. The six siblings are not up to date on their vaccinations and, according to the news report, they are not enrolled in any public schools in San Diego County, California. Now there’s a list of places where they went while they were infectious. (A person is infectious before any symptoms appear.) Public health officials are asking anyone who is not vaccinated and was at those places to seek medical attention in order to contain the outbreak. The outbreak now stands at over two dozen people with more cases coming, according to my sources in public health at a national level.

That’s just the tip of the iceberg, folks. This has the potential to turn into the Wales outbreak but at a scale for a country of almost 320 million people. Last year we saw the most cases of measles in a year since the disease was eliminated from the United States. There were over 600 cases and over 20 outbreak. As Ren pointed out, a drop of just one or two percentage points in the proportion of people immunized raises the number of people in an outbreak significantly:

“A paper published in the American Journal of Epidemiology looks at these outbreaks and analyzes what it would take for measles to come back and be endemic in the United States again, or, at the very least, cause sustained epidemics. The paper is titled “Identifying Postelimination Trends for the Introduction and Transmissibility of Measles in the United States” by Blumberg et al. The authors looked at the sizes of transmission chains in outbreaks of measles and developed a mathematical model for determining the infectivity of measles and what several milestones would be for sustained transmission. In the paper, the authors concluded that the average size of a transmission chain is about 2 cases and that about half of cases are imported to the United States. In other words, a case goes out and brings measles and then infects one more person here, on average. Some chains are considerably larger. Other chains are not chains at all but single cases who return to highly immune communities. This assumes that all cases are properly reported to public health, which is not always the case from my experience.

The math used by the authors took into consideration vaccine coverage in the United States as reported by CDC. If they dropped vaccine coverage by 1%, the average infection chain becomes 2.8 people. Bring that coverage down to 93.9% from 95.9% (a decrease of two percentage points), and the chain jumps to a whopping 4.3 people on average. Let that sink in a little. A simple drop in two percentage points in our current MMR coverage pretty much doubles the number of people infected with measles from people who bring it from overseas, according to the mathematical model presented by the authors.”

How low is the immunization rate in the counties in California where the outbreak started? It’s scarily low:

“The trend is especially pronounced in Orange County, where the proportion of kindergartners with their full shots fell from 92.9 percent in 2003 to 89.3 in 2012, and particularly in the county’s wealthy beachfront communities.”

This is way below the threshold analyzed by the paper that Ren reviewed. It’s about 6 percentage points lower, meaning that the outbreak chain on average will be about 60 cases, if you follow the math from the model in that paper. In a civilised society where the vaccine is widely available, those kinds of numbers are nothing short of insane.

So who is to blame for all this? Is it just Andrew Jeremy Wakefield bringing his MMR fearmongering to the United States after being so soundly rejected in Britain, stricken off the medical record and regarded as nothing better than a self-righteous quack? Is it the douchebag pediatricians who for some reason kowtow to “crunchy” moms and dads who are afraid of vaccines? Is is the other douchebag pediatricians who pull “alternative vaccine schedules” out of their asses and tell non-vaccinating parents that it’s okay to “hide in the herd”? Is it the fire science graduates who bloviate about the so-called dangers of vaccines and try to make themselves sound important when they’re nothing more than warm piss flowing down the drain of the truck stop restroom that is anti-vaccine activism?

Yes, it is their fault, but there is more blame to be spread.

It’s the fault of people who think that it is a good idea for anti-vaccine loons like Sherry Tenpenny to travel to Australia and give talks about vaccines, spreading a dangerous message. It’s also the fault of well-intentioned public health professionals who want to defend her free speech right to do so. (Wink, wink, Ren.) People who know that vaccines work but don’t want to engage with the anti-vaccine nutjobs are also to blame for not speaking up and correcting the lies put out there by those hacks. Elected politicians who get a lot of money donated to them by anti-vaccine special interests are also to blame for something that reeks of corruption.

In short, everyone is responsible for this shameful chapter in public health history. We had measles and other vaccine-preventable diseases beat, but we’ve allowed them to come back because we seem to think that parents are the best judges of what is good and what is bad for their children. They’re not. They may be the best advocates for their children, people we can trust will act with in the best interests of the children 99.9997% of the time. However, if they are misinformed fools who think that vaccines are toxic or vaccines make people toxic, or cause autism and whatnot, then they will act wrongly when it comes to what is best for their children and for society in general.

These idiots are walking around with their college degrees in non-science fields thinking that they somehow are knowledgeable in science-related matters because they can google terms and read websites and blogs that confirm their biases without a shred of evidence. They think that they can skip vaccines because, hey, people survived vaccine-preventable diseases all the time. Most of the people who went to war returned from that war. It doesn’t mean that war is not deadly, painful, scarring, and costly beyond human comprehension.

So take a good look at yourself in the mirror right after you read this and ask yourself if you did everything possible to counter the lies and misinformation put out by anti-vaccine luminaries like the morons at Age of Autism or RKF Jr. and his anti-thimerosal brigade. Did you donate to organizations like Every Child By Two, Voices for Vaccines, or Immunize.org? Will you counter your friends and neighbors on whatever medium if they say that vaccines don’t work?

The ball is in your court. It really is, no matter how much or how little you think you influence the world. Eradicable diseases like measles are not being eradicated because the most infectious thing, fear, is being allowed to spread without countering it with the most effective thing against it, knowledge.

To understand autism, you need to understand incidence and prevalence

In 2012, the CDC put out a prevalence study of autism in the United States. It changed the prevalence number from “1 in 110” to “1 in 88”. There were many who were alarmed at this statistic. They thought that the chances of a child being born with autism increased from 1 in 110 to 1 in 88. Well, they didn’t. This was only a rise in prevalence, not a rise in incidence. While the two are related, they are not necessarily tied to each other. That is, if one rises, the other one doesn’t have to. One can rise and the other can fall. Why?

It’s a little complicated, but I’ll try to explain it.

Let’s look at the definition of incidence. Incidence is the number of new cases in a population, per unit of time (usually a year), divided by the number of people at risk in that population. So, if your population is 100,000 and 100 people get the disease in one year, then your incidence is 0.001 or 0.1%. But what if we’re talking about cervical cancer? In a normal population of 100,000, only half of the people in that population — the women — would get cervical cancer. Men don’t have the right equipment for that. In that case, 100 cases in an at risk population of 50,000 is an incidence of 0.002 or 0.2%.

If you fully recover from the disease, then you move over to the “at risk” population again. If you don’t — because it stays with you forever or because it kills you — then you stay out of the at risk population. You could have 100 cases each year, no more and no less, and the incidence would continue to rise if no one recovers or your at risk population is not replenished by new births fast enough. In the example I just gave you, the population at risk for year two is 49,900. If you get another 100 cases, then your incidence is 0.00200401 or 0.2004%. It’s a small increase, but it’s an increase nonetheless.

So, remember this: If the disease is not curable (because it is chronic, pervasive, incurable, or deadly), then the population at risk dwindles if it is not replenished by births or immigration. Lower the denominator in incidence, and you will get a higher number. To decrease incidence, you either increase the number at risk or you decrease the number of new cases.

Now, let’s move on to prevalence. Prevalence is the number of existing cases in a population, per unit of time, divided by the total number of people in that population. That’s total population, regardless of whether or not they have the disease. So, if you have 100 cases of cervical cancer on year one, your prevalence will be 100 divided by 50,000, which is 0.002 or 0.2%. Year two, you get another 100 cases, and you will now have 200 existing cases divided by the same population of 50,000, which is 0.004 or 0.4%. Your prevalence doubled!

This assumes, of course, that no one died of the disease or that the total population stayed static through some means. In real life, population levels change.

In year three of the above scenario, you get another 100 cases, making it 300 existing cases in a population of 50,000, for an overall prevalence of 0.006 or 0.6%.

So, remember this: If a disease is not curable, then the prevalence will increase as long as there are new cases. Prevalence will decrease if the increase in population outpaces the new number of cases or the number of existing case decreases because of death or recovery.

Now, onto autism.

As far as science and medicine can tell us, autism is not curable. It is treatable. With the right interventions and depending on the level of severity of the autism signs and symptoms, autism is treatable. Plenty of people with autism go on to live happy and fulfilling lives. Again, it is not curable. Not at this time. So any new cases of autism will pile-on to existing cases and… Prevalence will increase.

Not only that, but the number of new cases per year can go down, but there will still be all those previously-diagnosed cases of autism which are still being added on to even if the incidence falls. Incidence would have to reach zero, the number of new births would have to continue (some countries have a negative birth rate), and people with autism would have to start passing away before the prevalence of the condition decreases.

Here are some theoretical numbers, as an example:

Note that there was a successful intervention in this example.

The column headings are self-explanatory, but let’s just go over them again for clarity.

  • New cases – Number of newly diagnosed cases that year.
  • Existing cases – The number of new cases for the year plus the number of existing cases the previous years. (Let’s pretend that there were no existing cases in 1999.)
  • Incidence – The number of new cases for the year, divided by the population at risk.
  • Prevalence – The number of existing cases (new cases plus existing cases) for the year, divided by the total population.
  • Population – The total population.
  • Population at risk – The total population minus the number of new and existing cases.

As you can see, we had a steady increase in the number of new cases from 2000 to 2009. From 2009 to 2015, the number of new cases declined. Appropriately, the number of existing cases continued to increase throughout because the condition is not deadly. (Again, this is theoretical. People with autism die from other causes, like the rest of us.) As you can see, incidence climbed along with the number of new cases until 2009/2010, then it began it’s decline. On the other hand, prevalence started its increase in 2000 and continued increasing to 2015. Also note that I increased the population every five years or so in our theoretical place (city, county, state) because that’s what populations in the United States have been doing. We don’t have a negative birth rate.

So, as cases dropped and population increased, incidence dropped. Because cases didn’t die, and the new number of cases outpaced the population increase, prevalence continued to increase.

On a side note, one of the criticism someone mentioned about HIV/AIDS treatment is that prevalence continues to increase. In their mind, HIV/AIDS treatment is not working if that particular measure of disease continued to increase. Can you see now why they were wrong?

Can you see why the prevalence of autism increasing from 1 in 110 (0.9%) to 1 in 88 (1.1%) is not a clear indicator that the number of new cases each year is rising? It’s only an indicator that people with autism are living and that the number of existing cases each year is outpacing population growth. For prevalence to decline, you would have to drop the new number of cases per year to zero and wait for the number of existing cases to drop on their own as people with autism get old and die.

That right there is what puzzles me when certain groups say they want the prevalence of autism to plummet. And their ranting and raving about an increase in autism signaling an “epidemic” of autism is also puzzling. Hopefully, it will be puzzling to you as well, now that you have seen how incidence and prevalence work.

Of course, this assumes that all things are equal when it comes to autism surveillance. But they are not. But that’s for another blog post at a later time.

By the way, here is the graph of the information in the table above, for those of you who are more visual:

Even with a theoretical, successful intervention in 2009, prevalence continued to increase. Why?

Books You Should Read: "When Germs Travel" by Howard Markel

Anyone who knows me knows that one of the big things I detest about Public Health as it is set up today is the interference of people who don’t know better into the things that we – the peons working the daily outbreaks and looking for cases of stuff – need to do without restrictions. Of course, I’m talking about politicians. The one issue that has painfully brought this to the forefront in my professional life is immigration. Time after time, I’ve seen politicians at all three levels of government call for the denial of basic health services to immigrants and their children. They reason that it is a waste of resources that could go to Americans.

It’s as if they think that viruses and bacteria know the difference between Pablo, the young apple picker from Oaxaca, and Paul, the corporate up-and-comer from Omaha with the dashing good looks. Pathogens don’t give a crap about who they’re infecting. To them, we’re all just sacs of growth media. The sooner we come to understand this, the sooner we can let go of the stigma that we cause to people based on their ethnicity and/or nationality and move on with what needs to be done.
The book “When Germs Travel” does a great job at telling us all about what happens when germs cross international boundaries and come to a new population – or society – and the kind of craziness that they cause. It covers six epidemics that were triggered by immigrants (or returning travelers) and the stupidity that ensued. For example, an outbreak of bubonic plague in Chinatown causes the authorities to cordon-off the area and not permit people who look Asian from interacting with the other ethnicities. Any epidemiologists worth his weight in salt will tell you that such an intervention by itself is useless.
You can’t quarantine or impose social distancing on just one group of people. You need to do it with all who are susceptible, regardless of race, ethnicity, gender, sexual orientation, disability, etc.
The book also covers the mistreatment of Jewish immigrants as they arrived in New York Harbor from Eastern Europe. They were screened for Chlamydia trachomatis, the causative agent of trachoma, which is an infection of the eyes. In that time, the infection was not treatable with antibiotics, for there were none. People were screened and told to go back to their country if they were found to be infected. On the other hand, if they had the right amount of money or the right connections in New York City, they were allowed to go on through.
A lot of help that screening did.
Not only that, but the screeners – medical doctors –  did not practice good hygiene. A high-ranking government official inspecting the intake points noticed this. That official? The President of the United States. Bo-yah!
I won’t spoil the rest of the book for you, but you know where this is going. You know of the treatment of Hatian immigrants because of HIV/AIDS. You know of the treatment of other immigrants because of Tuberculosis. Oh, you don’t know?
Everyone should.
One thing that resonates throughout the book is the hypocrisy of the decisions taken by politicians and the public health officials influenced by them. That’s right, not all public health workers are infallible and incorruptible. Many of them can be bought or intimidated into taking the wrong course of action when they need to protect the public’s health. And that’s one main reason why I will never, ever become a politician or play the politicians’ games.
I never want someone to write a book about how wrong I was in letting the next big epidemic or a small outbreak of diarrhea associated with a diner get out of control. That’s just plain embarrassing.

The "Contagion" Is Fear, Politics, Misinformation, And A Virus

The movie “Contagion” opened with great fanfare in the United States not because it is yet another “blockbuster” by a well-known director, but because of the questions it raises about the relationship between the government-led public health authorities and the citizenry. You only had to look at the comments in the YouTube trailer for the movie to see what kinds of emotions this movie would bring with it…

Here is one set of comments:

I’m not lying to you when I tell you that there is a distrust in the government and whatever its response would be to a public health crisis. But that wasn’t the only part of the movie that the scriptwriters and the director got right. Spoilers ahead…

THE SPREAD

In the beginning of the film, we see a sickly Gwyneth Paltrow talking on the phone as she is waiting for the plane to leave. She it talking to her unseen lover from Chicago, Illinois. She had a layover there, so she decided to take – how can I say it? – a leave of absence from her marriage. Paltrow’s character then jumps on a plane and goes home to Minnesota. Once there, she feels and looks worse. Meanwhile, in other parts of the world, other people are becoming sick with a flu-like illness: fever, cough, sore throat, malaise, nausea… the works.
Not only do we get to see that the virus is spreading, we get to see how the virus is spreading. Each sick person in the movie is shown touching things, breathing close to other people, grabbing handrails and doorknobs, and sharing drinks, napkins, and cellphones. These are all things that we do naturally, and the director and cinematographers caught it perfectly. Fomites – inanimate objects that transmit infections –  are everywhere, and and Kate Winslet, who plays an epidemiologist, tells us all about it.
Winslet’s character also tells us a little bit about viruses and how they spread. The dreaded “R0” (pronounced “R – nought”) is shown as a way to calculate an attack rate, or how many people exposed eventually are infected. She tells us – and I haven’t checked this because it’s late at night and I’m just doing a massive brain dump – that the flu has an R0 of 1, meaning that each person with the flu infects one other person. Smallpox has, according to the film, an R0 of 3. The “contagion” being dealt with has an R0 of 2 at the beginning and then 4 when it mutates later.
This means that 2 people are sick and then 4 people were sick from those, and then 8 from those, etcetera until – as Dustin Hoffman told us in “Outbreak” – we’re all fucked. When the R0 went to 4, it meant that 4 people would give it to 16, those 16 to 64, and so on and so forth, etcetera. The science was there, and it was spot on, in my humble perspective.
THE EPIDEMIOLOGISTS
Here’s one of my pet peeves about how epidemiologists are portrayed in films: They’re not all medical doctors. Yes, it’s medical doctors who are the lead epidemiologists at health departments at all levels of government, but most of the epidemiologists running into – oh, I don’t know – a hotel full of kids with influenza are not medical doctors. They have a Master of Public Health or a Master of Science or a Master of Health Science degree. In the film, the main protagonists who were epidemiologists were MDs.
Whatever.
That didn’t take away from the work that they got done on screen and how closely it matched reality. Winslet’s character travels to Minnesota to try to stop the contagion from spreading, gather case information through interviews at hospitals, and to deal with the politics of the local/state health department. That is exactly what an epidemiologist does. It’s part detective, part virus hunter, and part politicking. Actually, there are a lot of politics involved.
I won’t tell you how Winslet’s character fares through her assignment. I will tell you it had me almost in tears.
THE WOO-MEISTER
Jude Law is a good actor. He’s not as good as James Franco – on whom I totally admit having a bit of a crush – but almost as good. In the movie, Law’s character is a mix of conspiracy-theorist, overzealous blogger – aren’t we all? -, and profiteer. He is also public enemy number one, though the public doesn’t know it. See, Law’s character initially blogs to his “millions” of readers that the new virus is just a bioweapon gone wrong or some other sort of government conspiracy.
Later in the movie, Law’s character starts using a homeopathic remedy in front of his webcam to prove that it is effective. True to the nature of woo-meisters and snake oil salesmen, he presents his anecdote as data, and the people believe it all. People riot to get at the remedy he is promoting. An acquaintance of his who happens to be pregnant begs him for the stuff. All the while, even with the knowledge that he is doing more harm than good because he is doing no good – as homeopathic remedies do -, Law’s character continues his crusade for the “truth”, accusing the governments of the world of being in collusion with Wall Street and Big Pharma.
Sound familiar? I’ll refresh your memory…
Toward the end of the movie, when a vaccine is developed for the contagion, Law’s character encourages his readers to not take the vaccine because, according to him, they just don’t know what the vaccine will do. It was rushed through trials and into production, so he assumes that the science is not there to support its safety. Sound familiar? It should, because we heard the same arguments from all sorts of online sources when the vaccine against the 2009 H1N1 virus was developed.
THE FEAR
As the movie progresses, so does the deterioration of society as more and more people are sick and dying. Granted, not all the people infected in the film die, but enough are sick to make basic services stop. You see trash piling up on the street, riots going on at stores and banks, and the armed forces being pressed into doing police work. That aspect of the film is presented through the eyes of Matt Damon’s character and his daughter, who are the husband and stepdaughter – respectively – of Paltrow’s character.
By some weird fluke that had to be in there to move the plot forward, Damon’s character doesn’t contract the virus. His stepson does, and he dies early in the film. But his daughter and him live through the ordeal, experiencing the return of mankind to its simian roots. I write that because it is true that we are just hominids who will revert back to mob mentality and all sorts of mayhem when the shit hits the fan. That’s a sociological fact.
That is also the big, huge gorilla in the room when we have discussion about public health problems. How the hell do we keep enough from the public in order to not cause fear but give them enough to take action? It reminds me of the stuff we went through in the early 80’s with HIV and AIDS. You had to tell people to not have unprotected sex, especially if they belonged to the gay community. At the same time, you couldn’t say that most of the cases were homosexual because – as we know now –  the heterosexual people would think they were safe and also shun homosexuals as being “unclean”.
Yeah, we failed miserably on that one.
And that’s where Lawrence Fishbourne’s character comes in. He is a head honcho at the Centers for Disease Control and Prevention (CDC) who has to balance his responsibility to not scare the public but also warn his loved ones of what is happening. It is implied in the movie that a little indiscretion of his that is discovered by a janitor, spread by his wife, and picked up by Law’s character leads to even more panic in the population. Social networking is said to have a hand in that. 
That is very true. Social networking is a whole new world when it comes to not only government but also to Public Health. There are those who are convinced that people still have chats with their health care providers on a regular basis and don’t believe anything they are told elsewhere. Nothing can be further from the truth as we have seen through the spread of fear of the MMR vaccine by blogs, tweets, and celebrities. Because of the indiscretion, Fishbourne’s character is forced to stay away from the media and even threatened to be put up before Congress, thus endangering his career as well.
He had to do what he felt was right in his heart, and his bosses didn’t care much for it.
MAJOR SPOILER
If you don’t want to know where the contagion came from originally, look away now. Go watch the movie and then come back. You’ve been warned.
At the end of the film we see how the contagion came to be. Throughout the movie, we saw that an epidemiologist from the World Health Organization (WHO) traveled to Hong Kong, where Paltrow’s character visited. Once there, the epidemiologist traces Paltrow’s steps backward to figure out where the virus first infected her. We see from surveillance tape at a casino where others who were sick were also present that Paltrow came into contact with all of them. This scares the Chinese into a campaign of misinformation to hide that fact. Other Chinese kidnap her to secure vaccines for themselves once they see that she has figured it all out.
So how did the contagion come to be and how plausible is it? The virologist in the movie who first isolates the virus describes it as being a “chimera” of “bat, pig, and human” viruses. Well, at the end of the film, we see that Paltrow’s company is taking down a forest where there are plenty of bats. These bats are seen eating bananas then going into pig pens to sleep. Some of the bats’ food is seen falling onto the ground and being eaten by the pigs. The pigs are then seen being taken to the kitchen at the casino, where a cook is seen stuffing something into the pigs’ mouths. The cook doesn’t wash his hands before he is taken to meet Paltrow’s character, who holds his hands.
Plausible? Absolutely. It is believed that the 2009 H1N1 influenza virus came about because someone with the seasonal strain of H1N1 had close contact with pigs, leading to a mutation in the virus – a genetic reassortment, if you will. Pigs are great incubators for viruses, especially influenza. There is also evidence that SARS came about from people who were in close contact with civets – ferret-like animals – in Southeast China. Anthrax can be found in the hides of cattle and sheep. That is why people who normally handle those animals are given the opportunity to be immunized against anthrax. HIV? Monkeys.
What I’m getting at is that humans contract diseases from animals all the time, and vice-versa. That leads to genes being mixed and mashed together, giving rise to new strains of viruses and bacteria that we – and our immune systems – have never seen. That gives way to outbreaks and then pandemics.
ANYTHING FAR-FETCHED?
Of course, because it is a movie, the science behind how the vaccine for the contagion is developed was not well-explained. We see scientists at CDC injecting monkeys with dead and live viruses. Then we see a scientist who injects herself with the vaccine that seems to be protecting a (one) monkey. And then we see vial upon vial of the stuff being produced and distributed. Finally, we see people getting the vaccine in their nose, though the discovered vaccine was a shot.
Walberg’s character’s natural immunity against the contagion is also somewhat troubling because it’s not something that you see everyday. Yes, it’s been seen with some cases here and there, but it’s not something that happens the way it was portrayed. People still get symptomatic and still shed the virus and infect others. But, again, it was a movie.
GREAT MOVIE
Nonetheless, it was a great movie. Like “Traffic”, this movie will go down as a “must see” if you want to get many different points of view of what the problem is. In this case, the problem was a contagion of fear, politics, and the virus. If people obeyed the instructions laid down by scientists, the outbreak would have been over quickly because the incubation period for the disease was short. But they didn’t. Instead, they all collided at grocery stores and in lines to get aid.
If politicians let scientists do their work without intervening, the message about social distancing – staying away from each other – would have been out to the public immediately. Although it would have caused a panic, it is still a message that is worth giving, like telling someone to take their medicine even if that someone won’t. Information is a great tool in preventing outbreaks of disease if it is given out the right way and to the right people.
We also got to see Jude Law’s character embody greed, mistrust of the government, and what happens when you convince yourself that your remedies and your theories are the right ones, evidence be damned. His character was truly an amalgam of what we are seeing today when talk show hosts, adult actresses, and non-scientists put their own spin on science. 700+ cases of measles in Quebec this year (2011) and 200+ cases of measles in the US (the highest since 1996) are an example of what misinformation about the MMR vaccine has done.
THEN AGAIN…
Then again, there are 7 billion of us on this planet, and that number continues to grow. We continue to take down forests and come into contact with animals that don’t normally come into contact with humans. We travel the world by plane and come into contact with each other no matter how far away from each other we were born or live to begin with. And we stand in the way of each other over petty things like power, money, prestige, and authority. So maybe the contagion isn’t all those things I mentioned above.
Maybe we are the contagion.