Earlier this month, the movie Contagion opened in theaters. With a star-studded cast including Matt Damon, Kate Winslet, and Gwyneth Paltrow, this action-thriller about the spread of a deadly virus is sure to attract a large audience. While Hollywood has been known to alter or exaggerate the facts to enhance the storyline, it is reported that Steven Soderbergh and his team aimed to realistically portray a pandemic. As Matt Damon stated in an IMDb interview, the movie is “scary because it’s true and could happen.”
The film illustrates how quickly and easily some infectious diseases can be transmitted, and in this particular scenario, there is no treatment protocol or vaccine, resulting in mass casualties. Such a scenario is not unrealistic and has occurred many times in history. The 1918 influenza pandemic (also known as the Spanish flu) killed 20-50 million people worldwide, and was, perhaps, the most deadly pathogen in human history to date. In a 2006 interview, Terrence Tumpey, a senior microbiologist at the Influenza Branch of the Centers for Disease Control and Prevention (CDC) who recreated the 1918 flu virus to study its virulence, stated “it is only a matter of time until the next influenza pandemic occurs.” He was right.
In 2009, we faced another influenza pandemic – the H1N1 pandemic. However, this pandemic was much milder than that of 1918 for two main reasons: (1) the strain was not as virulent, and (2) the public health response was rapid and multi-faceted. For example, the virus was first detected in April 2009, and vaccine manufacturers worked quickly to produce effective H1N1 vaccines for the fall season. While the public health response was largely successful, H1N1 did not truly test our response efforts the way a virulent, unknown pathogen would.
Over the years, we have learned a great deal about how to respond to familiar viruses like influenza. However, it is much more difficult to respond to a new contagious disease. To combat such a threat, we must be able to rapidly detect and diagnose the disease, determine what treatments and preventative measures to use, and then deliver these countermeasures to the masses. Continued investment in the public health and medical countermeasure infrastructure is essential to these tasks.
A deadly pandemic similar to the one in 1918 or to the one portrayed in Contagion is always a possibility, whether naturally-occurring or man-made. I hope that the movie heightens public awareness about the dangers of infectious disease, the importance of the public-private partnership when responding to a threat, and the need to prepare for the worst-case scenario.