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October 7, 2011

Contagion: the Reality behind the Movie

http://www.jewishjournal.com/blog/item/contagion_the_reality_behind_the_movie/

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I’m usually here to remind you not to panic about whatever everyone is panicking about. Early in the H1N1 flu epidemic and in the Fukushima nuclear plant disaster I explained that everything was going to be OK.

But there are some scary germs out there. The 1918 flu pandemic killed between 50 and 100 million people, which at the time was between 3% and 6% of the world population. Ebola virus causes occasional outbreaks of hemorrhagic fever in Africa. It kills two thirds of the people it infects. There is no specific treatment. Hantavirus also causes hemorrhagic fever but is endemic in the US, causing a few dozen cases annually about a quarter of which are fatal. I could go on.

I saw the movie Contagion this week. It’s terrific. I promise I won’t give away any of the plot. The basic premise is the emergence of a novel viral epidemic. The story follows scientists at the Centers for Disease Control and the World Health Organization as they try to isolate the virus, track the epidemic, and find a vaccine, all while the illness rapidly spreads. As far as I could tell everything about the epidemic was entirely realistic. The screenwriters worked with the CDC to learn how pandemics are investigated, and it shows. The movie isn’t terrifying because the devastation is wildly exaggerated as in most apocalyptic fiction. It’s terrifying because it’s restrained and completely plausible.

The CDC’s website has a page about the movie and a page highlighting how their epidemiologists track down new mysterious diseases. Epidemiologists gather information about each patient to figure out if the disease is infectious, how it spreads, and what the incubation period is. Microbiologists isolate the germ, grow it in the lab, and figure out how to prevent, treat or cure the infection. Meanwhile doctors have to use constantly updated information to learn to diagnose and treat new cases, and counsel healthy people on avoiding infection.

The direct effects of a global pandemic would be terrible enough – the many sick and dead. But the societal effects could be even worse. Los Angeles County has a population of about 10 million. Imagine if one percent of them all (that’s one hundred thousand) went to emergency rooms on the same day. There would be pandemonium. The danger from the pandemic would be compounded by the fact that people with even more dangerous conditions like heart attacks or car accidents could not receive prompt care. A recent study of LA County hospital and ER capacity found that in a severe flu pandemic hundreds of thousands of patients presenting to ERs in Los Angeles would not be evaluated due to insufficient capacity. The toll from the disease might be small compared to the harm from the collapse of many basic public services. Civilization might dissolve for a while, and you and your family would need to be self-sufficient.

So as I’ve urged before, make some prudent preparations for a disaster.

And go see Contagion. And wash your hands.

Learn more:

CDC Responds to Contagion

CDC Features: Contagion Movie: Fact and Fiction in Film

CDC′s Disease Detectives: Global Health Sleuths Battle Contagion Worldwide

Contagion (the movie website, and check out the red link at the bottom “learn more about viral pandemics”)

Disaster Preparedness (my post in March)

News Nincompoops Narrate Nuclear Nonsense (my post in March about the Fukushima nuclear plant disaster)

Swine Flu: Unlikely to End the World (my post in 2009 about the new H1N1 flu)

Important legal mumbo jumbo:
Anything you read on the web should be used to supplement, not replace, your doctor’s advice.  Anything that I write is no exception.  I’m a doctor, but I’m not your doctor.

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