Contagion, the Movie: An Expert Medical Review
Paul A. Offit, MD
Editor’s Note: We thought that Medscape readers would be interested in hearing from one of our infectious disease experts about the medical aspects of the movie Contagion. So often, science is trumped by drama in popular movies — but not this time, says Paul A. Offit, MD, a vaccine coinventor in real life. The movie was filmed in part at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, so we also provide links to stories about the work being done at CDC every day.
Hi. My name is Paul Offit, and I’m talking to you today from the Vaccine Education Center at the Children’s Hospital of Philadelphia. I thought it might be fun to talk about a movie that I saw this weekend, Steven Soderbergh’s Contagion. This movie deals with a pandemic-like influenza virus to which no one in the population has been previously exposed and which has the potential to do a tremendous amount of harm. It was an interesting movie. Typically when movies take on science, they tend to sacrifice the science in favor of drama. That wasn’t true here.
The moviemakers did a very good job of illustrating how Southeast Asia can essentially serve as a “genetic reassortment laboratory” with influenza strains being created as a combination event among strains from pigs and chickens (and in this case, bats) to create a strain that the population has never seen before. They do a very good job of explaining that possibility and in showing how easy the virus can spread from one person to another. In fact, in bringing up the concept of contagiousness as “R0,” they compare the R0 of influenza, polio, and smallpox. It’s very interesting that they were willing to spend time explaining what contagiousness means.
They also do an excellent job of describing the phenomenon of fomites — that one can, in fact, transmit microorganisms very easily by shaking a hand or touching a martini glass or a door handle. The camera lingered on these different items to the point that it essentially becomes a commercial for hand sanitizer (which they actually show at one point during the movie).
They discuss how difficult it is to try and stop this virus. The heroes of the story are vaccines. In discussing how they would go about making a vaccine, they make a distinction between a whole kill virus and a live attenuated vaccine. They show how the CDC, through active case hunting, can actually figure out exactly how this virus was generated and collaborate with academia — in this case, a virologist in California named Sussman, played by Elliott Gould. You have to be able to imagine Elliott Gould as a virologist, but if you can, it really is a nice touch, showing how he is the first to be able to grow the virus in cell culture, allowing a vaccine to be made.
The movie then explores the difficulties in trying to decide who can get vaccine, given that the supply is limited. These are all the issues that we faced when we talked about the possibility of how devastating the most recent swine flu pandemic could be. The movie is quite accurate as it portrays how society breaks down in the face of potentially millions of deaths caused by limited vaccine and limited food supplies. It’s really well done.
The movie also shows the antiscience forces. In this case, it’s in the person of the appropriately named Alan Krumwiede, who is played by Jude Law.Krumwiede is a paranoid conspiracy theorist who believes that this is all just a government plot, and he is very antiscience. He has created a treatment (that he has taken himself), called Forsythia, a homeopathic remedy, which obviously is of no value because it is simply something diluted to the point that it’s not there anymore. He claims that he has been treated by this product, even though he was actually never sickened by the virus. The movie demonstrates the impact of the Internet. In this case, Krumwiede has a blog called “Truth Serum Now” that creates — or feeds into — a lot of mistrust in the general population.
In Contagion, Dr. Sanjay Gupta interviews a CDC official played by Laurence Fishburne, and he gives Krumwiede equal time. It’s interesting that what the conspiracy theorist talks about is people. Krumwiede confronts Fishburne with questions such as “What did you know?” and “When did you know it?” when, in fact, the issues are “How can we identify this virus?,” “How can we make a vaccine against it?,” and “How can we prevent its spread?” It’s an issue of science, not an issue of people. But in this movie, Sanjay Gupta, playing himself, makes it an issue about people — another example of art imitating life, because Gupta has been perfectly willing to allow antivaccine celebrities to be on his show. In another interesting example of art imitating life, Jude Law [reportedly] actually believes in homeopathy.
In summary, Contagion is an excellent movie in that it is willing to allow science to prevail over drama. It is quite well done, so I recommend it. Thank you.