- 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.
