Contagion: From a Public Health Perspective

[Eric S.]

Greetings all,

Contagion has only been out a few days and is already garnering very positive reviews. I just got back from seeing the film and wanted to take the opportunity to open this thread to people who might like to learn more about public health, the CDC, pandemics, etc. I am an MPH candidate at the Rollins School of Public Health in Atlanta, which fellow southerners might know is directly next-door to the CDC.

For one, you might not know that Steven Soderbergh and screenwriter Scott Burns worked closely with a well-known epidemiologist (among many other advisers at the CDC and WHO). Their collaboration ensured that while the film wasn't 100% realistic, it was indeed quite plausible (if *knock on wood* unlikely).

You also might not know that this movie was partly financed by Participant Media, a media company founded by Jeff Skoll (a famous social entrepreneur). It was hoped that the film might dispel some myths about public health and introduce people to what organizations like the CDC actually do... while foremost being an incredible ride. I realize that many of us work in below-the-line gigs and don't usually have as much creative control as we might like. However, if you're ever interested in making great drama that also has a pro-social impact, I can direct you to a number of free resources, topic ideas, etc.

So, feel free to ask about public health in general, topics from the movie, or ways to tell a great story while also doing some good for the public's health.

Did you learn anything new or interesting about public health from the movie?

 

[Thor Melsted]

I liked the film a lot. Kept me glued to my seat the whole time and I was pretty much unable to take my eyes off the screen the whole time.

There was one scene that really bothered me, and that was seeing a character from the CDC (played by Laurence Fishburne) suggest the CDC was looking into homeopathic remedies, when his character was being attacked on TV by Jude Law's "annoying conspiracy nut" character. I really hope that was meant to be an overwhelmed guy saying stuff he shouldn't, rather than a realistic depiction of a CDC official, because if the CDC wastes even one second on homeopathy in real life, I'd like a tax refund, seeing as homeopathy is 100% nonsense and demonstrably so.

On a side note... as I suspect many others have or will, I bought more hand sanitizer on the way home, anticipating more frequent use.


I did learn one thing... that we're pretty poorly prepared to handle an outbreak of that caliber.

Eric, let me ask you, you said it wasn't 100% realistic - were there any parts in particular where creative license outweighed the science?

 

[Lucas Hall]

I just bought stock in Purell.

 

[Eric S.]

There was one scene that really bothered me, and that was seeing a character from the CDC (played by Laurence Fishburne) suggest the CDC was looking into homeopathic remedies, when his character was being attacked on TV by Jude Law's "annoying conspiracy nut" character. I really hope that was meant to be an overwhelmed guy saying stuff he shouldn't, rather than a realistic depiction of a CDC official, because if the CDC wastes even one second on homeopathy in real life, I'd like a tax refund, seeing as homeopathy is 100% nonsense and demonstrably so.

Sure, that interview with Laurence Fishburne definitely involved some creative license; you had to have the dramatic showdown with Jude Law's character after all. I'm not familiar with any homeopathy research being conducted or funded by the CDC, but I know the NIH funded at least one study to look at homeopathic treatment of HIV symptoms (which supposedly had mild, but statistically significant results): http://www.ncbi.nlm.nih.gov/pubmed/10335412

The CDC tends to be more applied (it was founded to combat malaria during WWII) whereas the NIH tends to be more research-oriented, though the CDC does quite a bit of research as well. A virologist working on a vaccine for a new pathogen wouldn't be thinking about homeopathy, however.

I did learn one thing... that we're pretty poorly prepared to handle an outbreak of that caliber.
Eric, let me ask you, you said it wasn't 100% realistic - were there any parts in particular where creative license outweighed the science?

In terms of creative license in the film, you could certainly nitpick a few things. The development of the vaccine was rather fast, for example. By and large, however, I think it's a somewhat realistic depiction of a novel, highly virulent, highly infectious pathogen. Granted, such bugs should be pretty rare. But like a major earthquake in Los Angeles, it's more a question of when and how we prepare & respond. An outbreak like the Influenza Pandemic of 1917-1918 is likely to happen again, eventually. That's why it feels like public health is crying wolf with H1N1, H5N1, etc. It's difficult to know at the beginning of an incident how serious it might be. People are incubating disease, spreading it unknowingly before the onset of symptoms. Mortality numbers aren't immediately available, etc.

I think standard preparedness advice applies. Have some emergency food and water if you need to shelter in place. Know what social distancing is. Learn how to properly use an N95. New pathogens have a head start. If they first surface in a metropolitan area with lots of international traffic, it's tricky to contain. They can have incubation periods up to two weeks where anyone mobile could essentially be a walking, infectious time bomb. We slow down the spread and look for a cure / inoculation. But a nasty pathogen will still do some damage.

That said, I wouldn't say that we're necessarily poorly prepared, but more that a true worst-case scenario (like a catastrophic earthquake) can't be completely mitigated. It's just that this natural disaster could impact our entire species. It's a question of likelihood. I think most officials would call the movie's scenario a perfect storm, one which hopefully won't put our civilization to the test any time soon. Let's keep identifying and tracking those large Near-Earth Objects too...

Hope that answers your questions fairly.

 

[Scott Miller]

On a personal note.. and an aside..

As for H1N1.... I think you will find that in the future, it was much, much worse than we are told. Being that my wife, and many I came to know of died from it... It was not overblown.

Sadly, although it appears to be an interesting film, my experience would not allow me to see it.

(This was not meant as a personal affront to the others comments, just clarifying the reality of something most are already forgetting)

 

[Vince Doran]

Greetings all,



So, feel free to ask about public health in general, topics from the movie, or ways to tell a great story while also doing some good for the public's health.

Although I have never seen the movie and possibly wont until it is released on DVD (I live a few hundred miles from any cinema) I wish more research was done on Chrohn's disease and Ulcerative Colitis. I have had a battle with both for quite some time and not sure how much longer I might live, trying to sell my house so I can get back into underwater documentaries....with an Epic. My next doco will be about trying to stop the mining of coal seam gas and the method called hydraulic fracturing to recover it, they are trying to get access to my family's farm, we have a pristine river that is the source of many peoples lively hoods that they want to destroy for a few bucks....check out "GASLAND" the doco produced in USA.

 

[Steve Sherrick]

On a personal note.. and an aside..

As for H1N1.... I think you will find that in the future, it was much, much worse than we are told. Being that my wife, and many I came to know of died from it... It was not overblown.

Sadly, although it appears to be an interesting film, my experience would not allow me to see it.

(This was not meant as a personal affront to the others comments, just clarifying the reality of something most are already forgetting)

Scott, I remember you posting about this and even recently when I saw you commenting in another thread I was wondering how you were doing. I can't even begin to imagine how difficult that situation is for you. Life is so fragile. It can be taken away in an instant. I may not be able to see Contagion as it seems like it might be a bit too depressing for me. As it is, I'm already working on a documentary that is centered on this subject matter.

 

[Eric S.]

On a personal note.. and an aside..

As for H1N1.... I think you will find that in the future, it was much, much worse than we are told. Being that my wife, and many I came to know of died from it... It was not overblown.

Sadly, although it appears to be an interesting film, my experience would not allow me to see it.

(This was not meant as a personal affront to the others comments, just clarifying the reality of something most are already forgetting)

Thank you for sharing that with us. I'm terribly sorry for your loss. People sometimes forget how many friends, relatives, and loved ones are lost to influenza every year, both seasonal and the zoonotic strains (like H1N1). If it's any consolation, accounts of personal loss are often the inciting incident in many public health professionals decision to pursue the field.

Although I have never seen the movie and possibly wont until it is released on DVD (I live a few hundred miles from any cinema) I wish more research was done on Chrohn's disease and Ulcerative Colitis. I have had a battle with both for quite some time and not sure how much longer I might live, trying to sell my house so I can get back into underwater documentaries....with an Epic.

I know the CDC is heavily researching the epidemiology of Inflammatory Bowel Disease (e.g. what's causing the disease and upward trend so we can prevent it). Looking for better treatments or cures would probably fall under the NIH mission. IBD is one of the five most prevalent gastrointestinal diseases in the United States, so it's definitely on the radar. Sadly, even medical research takes a hit in a down economy.

 

[Eric S.]

i mean.. even though the movie was a pure propaganda CDC, WHO, FEMA infomercial...

it was entertaining..

but couldnt help but laugh at quite a few things..

Did the depiction of the CDC detract from the entertainment value for you? What did you find questionable or amusing?

(Don't worry; I won't bite)

 

[Thor Melsted]

I know the NIH funded at least one study to look at homeopathic treatment of HIV symptoms (which supposedly had mild, but statistically significant results): http://www.ncbi.nlm.nih.gov/pubmed/10335412

How can what is essentially a placebo (with zero active ingredients) have statistically significant results?
Considering this was published in the British Homeopathic Journal and was conducted by the Central Council for Research in Homoeopathy, I think it's safe to say the results should be questioned - or at least taken with a grain of salt.
But I don't want to derail this thread by going down the road of debunking quackery, so...

I read that the virus in the film was based on the Nopah virus, which spread from bats to pigs to humans but was decidedly less lethal. It makes me happy when filmmakers go out of their way to get science right - given all the nonsense people are fed through the various CSI/NCIS shows, like the infinite enhancement of QVGA resolution security camera footage to the point where you can see a license plate reflected in a water bottle.

Thanks for taking the time to answer my question.

 

[Eric S.]

I read that the virus in the film was based on the Nopah virus, which spread from bats to pigs to humans but was decidedly less lethal.

The Nipah virus is very nasty, but luckily does not spread too rapidly (at least at first). Unfortunately, Nipah virus does actually have a very high mortality rate (between 40-70% depending on the incident). Nipah outbreaks usually start out as point source outbreaks (i.e. not human-to-human) with pig farmers (who handled the pig tissue) or people who eat fruits that have been contaminated by infected bat saliva. It can, however, eventually become propagated (i.e. transmitted from person-to-person), which is when the societal danger increases dramatically.

Nipah would probably have to undergo a few key mutations that raise its infectivity to pose a serious global pandemic threat. Influenza, on the other hand, would probably be a more likely candidate for our next major bio-disaster. It mutates frequently and is already highly infective; so all it needs is more virulence to pose a serious global threat. Fortunately, influenza and its many mutations are very high on the radar for the CDC and WHO.

You can read more about Nipah here: http://www.who.int/mediacentre/factsheets/fs262/en/