Contagion

In the movie Contagion, a business woman contracts a disease (later named MEV-1) on her travel to Hong Kong and it is not visible until days after she's infected various people on her plane ride back home. This is the beginning of a MEV-1 pandemic that arouses a wave of fear in the people of Minneapolis. The movie also follows the decisions of various government officials and how they deal with the outbreak. Dr. Erin Mears, an Epidemic Intelligence officer, is sent to Minneapolis to investigate the disease when she dies from it, Dr. Leonora Orantes, an Epidemiologist, is sent to Hong Kong to investigate the beginning of the disease when she is kidnapped for the cure, and Dr. Ally Hextall, a CDC scientist, works on a vaccine for MEV-1 which she later discovers. At the end of movie, viewers are taken back to see each step that leads to the outbreak from how the bat and the pig created the virus to when the business woman shakes the hand of a butcher that was cutting up the pig.

The first time I watched this movie, I was in High School and I was just understanding that Health is not just what you see in the hospital. This movie is one of the reasons I got so interested in Public Health, epidemiology specifically. I was really impressed with how realistic the movie was and how well it described the responsibilities of many different Public Health officials from those who work in the government to those who work in the labs and even to those who work in the field. Now that I am taking this class, I am able to understand the importance of the CDC in the event of such a huge outbreak, The first time I watched the movie, I did not know so much about what Public Health officials did and I thought the government should be the one making final decisions on the health of the public. Now, I understand that the government has it's functions and Public Health officials have their functions. In other words, the government should take a step back when an outbreak occurs and let the CDC do their job.

An outbreak occurs when the incidence of a disease (number of new cases) at a specific place and time is greater than what is expected. For example, if one case of smallpox is found anywhere in the US, it would be considered an outbreak since smallpox is not an expected disease. However, if one case of the flu is found during flu season, it would not be considered an outbreak since it is expected that some people get the flu. In the movie, MEV-1 is a new disease so no illnesses were expected, thus it was an outbreak.

An outbreak investigation is, simply put, the investigation of an outbreak. There are 10 steps epidemiologists follow that the CDC says are involved in investigating an outbreak. They are to

1. Prepare for field work
2. Establish the existence of an outbreak
3. Verify the diagnosis
4. Define and Identify cases
5. Describe and orient the data in terms of time, place, and person
6. Develop hypotheses
7. Evaluate Hypotheses
8. Refine hypotheses and carry out additional studies
9. Implement control and prevention methods
10. Communicate findings

In some or most cases, these steps can be followed in a different order and repeated as much a necessary. The epidemiologists and scientist follow different steps of the outbreak investigation as their jobs require. Dr, Mears manages to follow all the steps stated and in the process contracts the disease. Dr. Orantes is in the process of following the steps of the investigation when she is kidnapped. Their jobs are obviously very dangerous is different ways.

Isolation and quarantine are some of the ways step 9 of an outbreak investigation can be carried out. If a person has a disease that is highly contagious, they are usually put in isolation so that other people surrounding them do not acquire the disease. Quarantine is when people who are suspected of having been exposed to a contagious disease are separated from others in case they start to show symptoms of the disease. The difference between isolation and quarantine is that Isolation deals with people who are already sick while quarantine deals with people who have been exposed to a disease. In the movie contagion, Mitch Emhoff is quarantined when his wife dies from MEV-1 and he is suspected of having it. Later on in the movie, the whole city of Minneapolis is quarantined from the rest of the country when the government realizes that too many people have been exposed to the disease. Many of the sick people in the movie are later isolated when the seriousness of the disease is comprehended.

In the movie, several public health agencies could have been better "prepared" for MEV-1. When Dr. Mears was sent to investigate MEV-1, she had to work with local government officials to create a space for the infected people to be treated. However, many the people she was working with were reluctant to help since they did not fully understand what they were dealing with and this slowed down the control and prevention of the disease. They all could have been better prepared if there was more effective risk communication between the different public health agencies and the public. Since they weren't better prepared, Dr. Mears had to take the time to explain to the government officials what could be prevented with their resources when they should have already been informed of the dangers of the disease.