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…
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.
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.
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.
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.
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.
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.
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.
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, 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.