Of particular interest to me were the viewpoints of the public health officials (Laurence Fishburne's CDC official, Kate Winslet's EIS officer, Marion Cotillard's WHO epidemiologist) faced suddenly with a clearly worrisome situation and working to hold back panic and deal with the uncertainty that is inherent at the start -- and to some extent throughout -- any outbreak. Was this a false alarm? Bioterrorism? What was causing it? How fast would it spread? How was it spread? At the beginning of the SARS outbreak, in 2003, it was not even clear if the agent was bacterial or viral. Reports from Mexico at the beginning of the 2009 H1N1 pandemic pegged the mortality rate at four percent -- staggeringly high for influenza. The need to make decisions in the face of so many unknowns is perhaps the most difficult aspect of public health (medicine too).
Other perspectives include the research scientist (Dr. Ally Hextail), sympathetically and beautifully portrayed by Jennifer Ehle, working tirelessly to develop the vaccine. Another virologist, the rumpled academic played by Elliott Gould (named Ian Sussman no doubt as a paean to real-life Columbia scientist Ian Lipkin, who writes today about being a consultant on the film) ignores rules and makes a breakthrough.
Despite -- or maybe because of -- how close the story was to my own work life, it seemed less entertaining and dramatic than it might have. Ticking off important teaching points like bullets in a slide presentation (human-wildlife interface -- check; handwashing -- check; deforestation -- check; conflict between professional and personal roles -- check; R0, an epidemiology 101 concept -- check) the film tries to cover too much, and at times does so at the expense of depth. Of course, cinematic license is a necessity if an audience is to want to actually see the movie, but too often single individuals serve as proxies for many. (Even in the animal roles: I chuckled when a single surviving monkey represented the success of a vaccine candidate). The filmmakers gave short shrift, I think, to the role of state and local public health specialists, who in reality would be the front line of the battle. Some might question the degree of social disruption depicted in Contagion, but one doesn't have to look much further than the aftermath of Katrina (definite, conscious echoes here) to believe it.
Finally, a disappointment to me was that the lone representative of the unofficial sector. Jude Law's blogger, (Alan Krumwiede) though at times ambiguous, turns out to be a nefarious opportunist. In real life, this sector includes organizations ranging from Medecins sans Frontieres, HealthMap, Flutrackers, to the news media, parent and provider groups, and others who play important and responsible roles. I direct an organization, the Program for Monitoring Emerging Diseases (ProMED), that detects outbreaks rapidly through careful analysis of unofficial sources and reports them widely and transparently. Our efforts led to the early recognition of the SARS outbreak, ahead of official notifications.