"Contagion" was the No. 1 box-office movie on the 10th anniversary of Sept. 11--and with good reason. The New York Post's Lou Lumenick called the Steven Soderbergh-directed thriller about a killer virus "easily the scariest of the disaster films" since Sept. 11, and the film keeps viewers squirming and in suspense until the revealing and harrowing final shot.
One of the reasons the movie is so frightening is that it is so realistic, and verisimilitude clearly is something the filmmakers were striving to attain. The film thanks the Centers for Disease Control and Prevention and the Department of Defense for their assistance, suggesting that those entities did not have significant disagreements with the way the film portrayed the government's earnest but not always effective response to the film's fictional MEV virus. Nor should they. For the most part, the film shows U.S. officials to be smart, hardworking, dedicated and self-sacrificing, and the government plays a key role in the creation of an anti-MEV vaccine that helps humanity fight back against the deadly viral threat.
Based on my experience with U.S. biopreparedness efforts, the U.S. government's role is depicted fairly accurately in the film. At the same time, even though the government comes off pretty well in "Contagion," the scariest part of the film is the vulnerabilities the film highlights in our current system. Despite spending $60 billion in biodefense efforts since the 2001 anthrax attacks, we still are not fully prepared for a full-on bioevent, whether it be made by man or by nature. The film identifies at least four biopreparedness weaknesses, all of which could be addressed by smart government planning:
Other countries may not cooperate.In the film, rogue Chinese government officials kidnap a World Health Organization (WHO) scientist to extort doses of the MEV vaccine. Earlier in the film and more realistically, some of the same officials resist the WHO scientist's tentative conclusion that the disease began in Hong Kong. In real life, Indonesia has been reluctant to provide disease samples to Western health officials. In addition, Mexican officials were slower than at least one private-sector detection company in identifying the public-health flash point that signaled the start of the swine flu outbreak. U.S. and WHO officials need to plan for possible incompetence and a lack of cooperation from foreign governments in case of some kind of bioevent.
Public-sector workers may be ineffective. "Contagion" has at least two references to union troubles that prevent crucial front-line workers such as nurses from performing necessary duties. In real life, postal union representatives have questioned government plans to distribute needed countermeasures via the Postal Service, making the unrealistic demand that each countermeasure carrier be accompanied by a public-safety official. In addition, many public-safety officials did not show up for duty during Hurricane Katrina, complicating the government's response efforts. These types of problems suggest that going forward, government officials should emulate President George W. Bush's insistence on limiting unionization at the nascent Department of Homeland Security. In addition, plans for a response to any bioevent should anticipate the potential for higher-than-expected absentee rates by first responders.
Creating a vaccine is one thing, distributing it is another.Even after the virus is identified and scientists create a vaccine, the government officials in the film somewhat unrealistically distribute doses by lottery, although they appear to save some doses for senior government officials. In real life, the government has priority lists for countermeasure distribution that favor both first responders and vulnerable populations. Even so, the government had both distribution and supply troubles with the swine flu vaccine, as it overpromised and underdelivered on the number of and schedule for the availability of vaccines. To address these problems, the government must first and foremost be very careful to make sure pronouncements about countermeasure availability are clear, accurate and realistic. In addition, the government needs to work on developing a variety of distribution mechanisms, including the postal method mentioned above, but also using distribution centers and pre-stored, sealed medkits to reduce the pressure on any one mode of distribution.
Irresponsible talking heads could exacerbate public-health challenges. One blogger in the film causes all kinds of trouble by warning people against the government-created vaccine and pushing an ineffective homeopathic remedy. In real life, talking heads such as Bill Maher and Jenny McCarthy have challenged public-health efforts with irresponsible warnings about purported dangers of vaccines. Even though there is no evidence that these celebrities are motivated by profit, as in the film, government officials need to build in strategies to deflect these criticisms in their communication protocols.
The bad news from "Contagion" is that it exposes these holes in our system. The good news is that by highlighting some of these gaps, the film is giving us an opportunity to address these problems before a real-life MEV-type virus strikes.