- Hi, I'm doctor Seema Yasmin
and from 2011 to 2013, I was an officer
in the Epidemic Intelligence Service,
so today I'm gonna match the timeline of Contagion
with the timeline of COVID-19.
[contemplative music]
Contagion starts on day two,
and we see Gwyneth Paltrow's character is sick
and then a montage of other sick civilians,
all demonstrating symptoms within one day of transmission.
Everyone we see who gets sick with this
has a cough, a fever, seizures,
and then dies within three to four days.
The virus in Contagion is fictional.
It's called MEV-1, but it is a hybrid
of two real life infections, influenza and nipah.
Nipah is a real life virus, a very serious one,
that can cause fever, shortness of breath,
swelling of the brain, coma, and seizures.
The illness caused by MEV-1 is very different
to COVID-19, where people get sick over the course
of two to 14 days.
And unlike the fictional virus in Contagion,
death from COVID-19 isn't typically so sudden.
- [Man] Honey?
Oh, Beth, Beth, hey.
[contemplative music]
- So in this scene, we're looking at day five,
which is the day that the World Health Organization
is notified of the outbreak.
- [Announcer] What we are hearing from Beijing
is that the outbreak is contained
to the Chrysanthemum Complex in Hong Kong.
- We're also looking at samples from London.
Two clusters--
- Here's the first time that they use the word cluster
and that can refer to cases that are literally
clustered together in time and place.
We still don't know who was the first person
to become infected with SARS-CoV-2
and when that was, but we do know
that Chinese officials alerted the World Health Organization
on December 31st of 2019.
Then it would be day 21 when the United States
identified its first cases.
[contemplative music]
On day six in Contagion, the CDC learns
of a cluster of cases at an elementary school in Minnesota.
- There's a cluster in an elementary school.
- And we start hearing here some very familiar language.
- We're isolating the sick and quarantining those
who we believe were exposed.
- And that's exactly what happened here in the U.S.
People who had symptoms were isolated
from others and those who were exposed to those
who had symptoms were then quarantined.
- The average person touches their face
two or 3,000 times a day.
- Two or 3,000 times a day?
- So in this scene, we have Kate Winslet
playing an officer in the Epidemic Intelligence Service,
the job that I used to have,
and she's talking to health officials
at the Minnesota Department of Health.
- I say we have to believe this is respiratory,
maybe fomites, too.
- What's that, fomites?
- This is stuff they would already know,
especially when you're looking at the fact
that it's the Minnesota Department of Health,
which is known to be one of the best departments
of health in the country.
- It refers to transmission from surfaces.
- Fomites are inanimate objects and surfaces,
things like a door handle or a light switch.
- Those things become fomites.
- One of the things that's very silly to me
about Contagion is that Kate Winslet is sent,
on her own, to investigate this epidemic.
In real life, with something of this magnitude
with a novel infection, you'd be sent with a team,
not alone.
Epidemic investigations are all about teamwork.
- For every person who gets sick,
how many other people are they likely to infect?
We call that number the R-naught.
- Her description of R-naught is accurate.
- R stands for the reproductive rate of the virus.
- R-naught is the basic reproductive number of an infection,
which means the average number
of people one infected person will go on to infect
in a susceptible population.
Once it gets to below one, meaning that one infected person
is, on average, infecting fewer than one people,
that's when you see an epidemic stop
because you're breaking the chain of transmission.
The R-naught of SARS-CoV-2 is thought
to be somewhere between 1.5 and 3.5.
[contemplative music]
- We did Pilates together.
I called her after she got back, I never heard from her.
- So you had no contact with her?
- In this scene, the Epidemic Intelligence Service Officer
is doing what we call contact tracing.
With contact tracing, you first talk to the person
who is sick and then you find out
when were they contagious.
- Did she go to the class?
- I didn't see her there.
- Then you follow up on that long list of people.
- Is there anyone else who might
have had contact with her?
- One thing that I do find strange
about the current COVID-19 pandemic
is, here in the states, contact tracing
got shifted to the back burner
almost as if officials were saying,
"There's too much spread and now it's too difficult
"to do contact tracing."
And compare that to South Korea
where there's been very thorough contact tracing
for every single person who's shown symptoms.
[contemplative music]
In this scene, the researchers are talking
about sequencing the virus in the movie.
- We've sequenced the virus and determined its origin
and we've modeled the way it enters the cells
of the lung and the brain.
- And sequencing is where you analyze
the genetic material inside the virus.
- The virus contains both bat and pig sequences.
- [Seema] Here, they're analyzing the protein structure
of the virus.
- [Health Investigator] Blue is virus and the gold
is human and the red is the viral attachment protein
and the green is its receptor in the human cells.
- [Seema] This kind of molecular structuring
rendering is accurate.
Researchers look at 3D models like this
to determine how a virus invades human cells.
- So we have a novel virus
with a mortality rate in the low 20s,
no treatment protocol, and no vaccine at this time?
- That is correct.
- It is accurate to say there are novel characteristics
because that's what you say
when you're dealing with a very new virus,
one which you haven't seen anything quite like it before.
Sequencing a virus is really important
so that you can develop a test for it.
The test that we typically use is called PCR,
which means polymerase chain reaction.
And the way it works is you take a sample
from somebody's nose, for example,
and then you are putting it through this system
that amplifies the genetic material inside the virus.
And they did this really quickly within 10 days
in the movie, which is pretty close
what we saw in real life with SARS-CoV-2,
where Chinese scientists had sequenced the genome
by January 7th.
And that's about day eight of our timeline.
And this timeline actually matches up
pretty well with the movie.
- [Dr. Cheever] He grew it?
- [Dr. Hextall] He tried antibodies
and a multilogical knockout lines like we did,
but the key was a fetal bat cell line from Geelong.
- This scene is really accurate because,
if you can't grow the virus inside a laboratory,
then you're not able to study it,
propagate it, and really understand what it looks like,
how it behaves, and how you might treat it.
- But the key was a fetal bat cell line from Geelong.
We didn't have it.
- And the scientist says they were able
to successfully grow the virus inside cells
that came from bat lungs.
In the case of SARS-CoV-2, it was also
successfully propagated early on in a lab
using a different kind of cell, though.
It used kidney cells that came
from a specific kind of monkey.
This is a really important step
in terms of developing treatments and vaccines
for a new virus.
[contemplative music]
So here's a really great question
that one of the characters asks.
- [Mitch] If I'm immune, can't you use my blood
to cure this?
- This is something we actually do in medicine.
It's a technique that dates back
to the Victorian times where, say somebody survived
an infection with a virus.
You can take their blood, separate the antibodies
out of it, those are the proteins
that helped them fight off the infection,
and give those antibodies to others to help them.
It's often a stop-gap measure that's used
during epidemics like with the Ebola epidemic of 2014.
We didn't have any specific treatments,
we didn't have a vaccine,
so while all of that stuff was being developed,
we took blood from Ebola survivors
and used that blood to treat and protect others.
For SARS-CoV-2, there are currently studies
looking into antibody treatments
where blood transfers could help sick people
fight off the virus.
[contemplative music]
On day 13 in Contagion, they report
more than 3,000 cases in the suburbs of Minneapolis.
- Over 3,000 cases have been confirmed
in the western suburbs.
- In our timeline, on March 26th, Washington State officials
announced more than 3,200 cases in the state.
And that would be day 65 since the first case
in the U.S. was reported.
Again, it just shows how different the disease is
in the movie compared to COVID-19.
[contemplative music]
Around day 13, Dr. Mears sets up a temporary hospital
in a public space.
- [Dr. Mears] I want 25 rows of 10 beds apiece,
the most febrile cases at this end.
- And they say that it needs to be operational
within 24 to 48 hours.
- [Dr. Mears] We'll need to be operational
within the next 24 to 48 hours.
- This scene actually does match up
with what we saw happen in New York City,
which quickly became the American epicenter
of the pandemic.
In March, New York governor Cuomo announced
that the Javits Center would be converted
into an emergency hospital
and the Army Corps of Engineers went in
and converted that space
into a 2,000 bed makeshift hospital.
In real life, though, it took over a week
to set that up, not the 48 hours that we see in the movie.
We call these kinds of hospitals Mobile Field Hospitals
and many states and countries will have plans
in place to make those appear quickly
in the case of an emergency.
[contemplative music]
In this scene, CDC scientists
are tracking down the index patients.
- [Dr. Mears] Are we any closer to an index patient?
- Could be your Beth Emhoff or the guy on the bus
in Japan, someone else who crawled off the grid.
- And the find out that it's
Gwyneth Paltrow's character, Beth.
- [Dr. Orantes] Emhoff is the index patient.
- Index patient is a term that you may hear used
interchangeably with the term patient zero.
When I was in the Epidemic Intelligence Service,
I was taught that the index case
is the first case that you identify,
but patient zero is the true first case in the epidemic.
In this scene, there's a health investigator
watching video footage of who they think
is their index case in a casino.
- Okay, okay.
- [Dr. Orantes] It's transmission, so we just need
to know which direction.
- With SARS-CoV-2, the investigation is still ongoing
and we don't know who the first human cases were
or where and how they became infected.
There was a lot of finger-pointing early on
at a particular seafood market in Wuhan,
but some of the genetic analysis
and the epidemiologic analysis
shows that actually, there were people infected
earlier on who may have had no contact
with that particular market.
Similarly to the casino in Contagion,
there have been outbreaks of COVID-19 traced back
to densely populated areas and places
like a church in South Korea.
[contemplative music]
So, I wanna call out something from the movie
that is pure Hollywood.
Kate Winslet's character, playing the role
of the officer in the Epidemic Intelligence Service,
dies from the very virus that she is investigating.
And as far as I know, this has never happened
in the 69 year history of the Epidemic Intelligence Service.
[contemplative music]
In this scene, the media starts talking
about a drug called Ribavirin.
- The drug Ribavirin has been shown
to be effective against this virus.
- This is a real life medication that fights viruses
and has been around for a really long time.
And, similarly, with the COVID-19 timeline,
the president of the U.S. did bring up
an existing old-school medicine
and asked if that would work against the new Coronavirus.
So the drug that he mentioned was hydroxychloroquine
and chloroquine, which are old-school malaria drugs
also used nowadays to treat lupus
and some types of arthritis.
There is little evidence that hydroxychloroquine
is a reliable treatment for COVID-19.
- There are therapies we know
are effective right now, like Forsythia.
- Jude Law plays this really sleazy character
who's saying that they cured themselves
using a kind of homeopathic treatment
and then trying to sell this to others
and profit from it.
- [Alan] This is Forsythia.
If I'm here tomorrow, you'll know it works.
I'm not the first person to make money
off the fact that our immune system
is a work in progress.
- This is really common during epidemics and pandemics.
With COVID-19, we've seen internet personalities
and people like Alex Jones, no surprise,
peddling fake cures and trying to profit off the crisis.
[contemplative music]
- Whoa, whoa, whoa.
Where did you come from?
- In this scene, CDC scientists find out
that by day 21, the virus has mutated.
- It's mutated.
- A phylogenetic analysis is basically
like creating a family tree for a pathogen
to figure out where it originated from
and how it evolved.
- [Dr. Hextall] The Durban cluster is highly divergent.
- What they're talking about there
is the virus has mutated so much
that it looks very different to the original strains.
- We have a new R-naught, Ellis.
It's not two anymore.
- And then we hear that the R-naught has changed.
It's not two anymore, and that can definitely happen
during the course of an epidemic.
The R-naught can increase and decrease.
Ideally it decreases because of all the interventions
you're putting into place, like physical distancing,
health education, development of a vaccine.
Those things drive the R-naught down.
- We tried using dead virus combined
with several adjuvants to boost immune response.
- [Dr. Cheevers] And?
- No protective antibodies, lot of dead monkeys.
- So here the researchers are failing in their attempts
to produce protective antibodies to the virus.
A live, attenuated virus is a virus
that's still alive, but one that you've tweaked
so it can't be as potent.
- Combined with several adjuvants, adjuvants.
- Adjuvants are chemicals that we add
into vaccines to stimulate your immune system
so the vaccine works.
At this point, with SARS-CoV-2, it's way
too early in the vaccine trials
to say whether any of those experimental vaccines
actually work and produce protective antibodies in people.
[contemplative music]
By day 26, the world is staying at home.
[suspenseful music]
This scene just shows a bunch of places
that have emptied out.
Which kind of feels a bit overly familiar
with what we're going through right now.
[contemplative music]
- [Announcer] As the death toll in the United States
is now believed to have reached 2.5 million,
the president issued a statement today
from an undisclosed location.
- By day 29, in the Contagion timeline,
MEV-1 has killed 2.5 million people in the United States.
But, in real life, by day 29 of the COVID-19 pandemic,
there hadn't been any reported deaths
from the virus in the U.S.
And the current projection is that the virus could kill
between 100,000 to 240,000 Americans.
Some early models suggested that COVID-19
could kill more than 2 million Americans in a year
if no measures were taken to stop the spread of the disease.
[contemplative music]
- If we even had a viable vaccine right now,
we would still have to do human trials
and that would take weeks.
- So the movie here portrays quite well, I think,
the disconnect between scientists and the government.
- Then we would have to get clearance and approval
to figure out manufacturing and distribution.
That would take months.
- You see scientists working tirelessly
to develop a vaccine while government officials
just don't understand that it takes a really long time
to develop new vaccines.
- Homeland Security wants to know
if we can put a vaccination in the water supply
like fluoride, cure everyone all at once.
- I'm going home now, Ellis.
- And I have never heard of a vaccine
being put in a water supply.
We are seeing that, with this emergency of COVID-19,
that with some expirimental vaccines,
that whole testing in animal stage
is being skipped and we're going straight
to phase one trials in humans.
[suspenseful music]
In terms of a researcher acting as a human test subject
for a vaccine, it could happen,
it's pretty unusual, though.
In the movie, the FDA fast tracks the approval
of the new vaccine.
- [Reporter] The Food and Drug Administration
is accelerating approval of the MEV-1 vaccine,
currently in production at five secret locations
in the U.S. and Europe.
- This can definitely happen in real life,
both with a new vaccine or with new treatments.
If the FDA believes there's a real need to,
it can fast track approval.
In the movie, and this is very Hollywood,
the timeline jumps from day 29,
when the researcher is acting as a test subject,
to day 131 when magically this new vaccine
is being distributed to many people.
And I think this creates a lot of false expectations
and false hope around the development
of a COVID-19 vaccine.
There are ones being developed now,
even some that are being tested in humans,
but it's still too early to say
when a vaccine would be available.
[suspenseful music]
I love how they end the movie.
I think, to me, it's the most prescient part,
showing the transmission of this new virus
from a bat to a pig and then to humans.
This is probably really close
to how we're thinking about the transmission
of SARS-CoV-2, probably from bats
to some intermediate animal, maybe a pangolin,
and then from that animal to humans
and then, of course, from one human
to another until it's spread around the world.
[contemplative music]
In the end, there is a lot of truth, I think,
in the Contagion movie in terms
of how a pandemic might play out
across the world and in the U.S.
But, as you can see from watching this video,
there's a fair amount of Hollywood liberties
taken as well.
I think some of the things that the movie
did not predict were the lack
of personal protective equipment
available in developed nations like the U.S. and the U.K.
And, of course, the movie, like so many,
focuses entirely on the United States,
doesn't give us a really good grasp
of how the pandemic plays out
in different parts of the world.
So did I miss any scenes that you're confused about,
or do you have any questions for me
about what it was like doing that job?
If so, please leave your questions here
in the comments section or reach me on social media.