A minuscule space separates health from disease and peace from pandemonium. It can be readily and rapidly crossed by a weapon of mass destruction that is invisible to the naked eye but possessing of a means of delivery that is ubiquitous and virtually unstoppable. The weapon is a virus and its weaponry human beings. It is by touch, breath, cough and sneeze that many a virus is transmitted: we put our hands to our face as many as 3,000 times a day -- after touching countless door handles, counters, dishes, and papers. The body count from a highly virulent strain depends upon what is called R-1 (or 2, or 4, or 8), the rate of its spread among its victims. Flu spreads at R-1, Smallpox R-3, and Polio R- 4-6. At a rate of R-4 the virus can infect 1 in 12 people on the planet (!) in a matter of months.
Pandemics, or epidemics of infectious diseases that impact very large numbers of people across great distances like countries or continents, are well known. Swine flu (H1N1), avian flu, SARS, smallpox, and polio, to name a few, can raise our emotional temperatures at the mention of their name. The so-called Spanish Flu of 1918-1919 killed 50 million people, more deaths than attributed to World War I. Their unpredictability is unnerving and their medical, social and economic costs can be incalculable. The telling of this macabre story in film is what "Contagion" exposes us to. When there is no known treatment and no vaccine, that's a potential body count in the hundreds of millions. That beats about any other scary movie I have seen.
This link will take you to a 2-plus minute animated video of how a "Virus Changes the World." Buckle your seat belt, and don't touch anything.
"Contagion" also packs a punch with its ensemble cast who are viral in their capacity to infiltrate the movie going public. There is Gwyneth Paltrow as the business woman/wife returning from Asia transporting the deadly disease; Matt Damon as the immune but bereaved husband determined to save his daughter; Laurence Fishburne as the Center for Disease Control and Prevention (CDC) chief on the case and Kate Winslet as the dedicated epidemiologist field officer sent to investigate the outbreak where Gwyneth released it; Marion Cotillard is dispatched from the World Health Organization (WHO) to Asia where the virus was born de novo and the contagion likely began -- actually called Ground Zero (and this film comes out immediately before the 10th anniversary of 9/11); Jude Law as the despicable blogger out to exploit whatever he can; and even Elliot Gould as the indomitable, salty scientist who no bureaucracy will deter.
Directed by Steven Soderbergh ("Traffic," "Erin Brockovich", "Ocean's 11" and its mutations) this film advances as fast as its subject. We are taken on a pandemic ride that churns up fear and will not be likely to forget. Which is, in part, what the film aims to achieve. Participant Media (see "Company with a Conscience") added its imprimatur and capital to this production to raise awareness of pandemics, identify and support the good guys, and help us all understand what can be done when faced with an enemy so powerful and merciless.
The war against a pandemic is waged on two fronts: the disease itself and the panic that ensues. Principles of containment for an infectious disease are well known: isolate the exposed, quarantine the sick and engage in a set of behaviors that prevent spread such as hand washing, covering coughs and sneezes, not touching just about anything, and the like. Then figure out what is causing the illness and how to treat and prevent it. Panic is another matter because it can give rise to primitive, mob behaviors where the rules of civilization and law seem also to have been destroyed by the disease. Still, social control can be achieved and most people will find the humanity at our core. We are a resilient lot, in body and mind.
It is a good thing we have science and government, one has to believe, at the end of this film. Where would we be without the CDC, the WHO, irascible and irrepressible scientists and a disciplined military used to preserve humanity, not destroy it? Where would we be without the National Institutes of Health to fund the basic research these medical (and military) soldiers need to do their job? Where would we be without responsible media that does not exploit human disaster but does what it can to help us all reach a higher moral ground? I just wish the filmmakers had been kinder to bloggers.
The opinions expressed here are solely my own as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.
***** Originally posted on the Huffington Post on September 9, 2011
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