Contagion: A Dialogue

We Dodged the Bullet With SARS.
The state of the universe.
Sept. 9 2011 10:15 AM

Contagion: A Dialogue

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Matt Damon in Contagion
Matt Damon in Contagion 

Thanks Carl, for injecting some calm and virological learning into this discussion. I agree with you that the filmmakers are to be commended for talking to scientists and making some effort to get the scientific and deliberative procedures right. And I don't deny that a quick-moving pandemic on this scale is possible.

The film reflects an increasing cultural awareness of the actual peril and unpredictability of viruses; clearly Hollywood has absorbed enough of our real-life experience with these critters to make Contagion rather than another version of Outbreak (1995). The genre for these germ movies has shifted from pure sci-fi to something more like social commentary. (Not that Dawn of the Dead was lacking in social commentary.)

As you say, the film's handling of the vaccine process is a bit fantastic. Not so much the self-injection; there is a fine tradition of scientists trying out their drugs and vaccines on themselves, as chronicled in Times-man Larry Altman's Who Goes First?. When you talk to the parasitologists at Walter Reed you learn that they tested vaccine after failed vaccine by sticking their arms into cages full of malarial mosquitoes.

I'll accept that for the purposes of telegraphed pipe-laying, the lovely and talented Dr. Hextall does everything from analyzing MEV-1's phylogeny and modeling its structure to developing and testing the vaccine. We all know they work hard at CDC, but this is one busy lady. And not a hair out of place.

I didn't catch whether the filmmakers indicated the time lapse between Dr. Hextall's successful self-jab and the rollout of the finished vaccine, but I'm sure it was ridiculously short. The question is, are we to compare Contagion's vaccine-production schedule with the delay and vexation of making an actual vaccine or previous fictional ones?

In Arrowsmith, which Sinclair Lewis wrote in 1925 with the assistance of scientist and science writer Paul de Kruif, the Rockefeller boys cook up a plague vaccine in a few weeks. Then again, vaccine-making was streamlined in those days: 1) Grow bacteria; 2) Kill with formaldehyde; 3) Inject into children. Nobody quite knew how to make a modern viral vaccine until the 1940s. Interestingly, the process has gotten longer as the science progresses. 

The H1N1 vaccine set a modern record for speed. The virus was detected in April 2009, its structure doped out within weeks, and by the end of May, Doris Bucher and colleagues at New York Medical College had created vaccine seed stock for the pharmaceutical companies. Trials were on by early July, and the first vaccines arrived in September—after a delay caused by difficulties creating a reagent to test the vaccine's efficacy.

The novel H1N1 was a fairly easy flu virus for the vaccine companies to work with. The H5N1 "bird flu," on the other hand, has been extremely troublesome, in part because it's so deadly to fowl eggs. There's still no human vaccine against West Nile fever (but there is a horse vaccine). Not to mention dengue fever. More money would help. But even pouring money into research is no guarantee of success against a novel agent. Just look at the billions spent on HIV vaccines, with little of clinical value to show for it.

We dodged the bullet with SARS, as the virus burned itself out or mutated into something harmless. I don't think it's clear how quickly a vaccine against SARS would have been ready, but I'm sure it would have been a question of years, not months.

If the next bad thing is a new flu, our decades of experience making vaccines against this virus should speed the availability of vaccines, most likely. If it's some freaky new virus that comes out of bats or pigs or wherever else—a subject on which you must have lots of scary knowledge to impart, Carl—then forget about it.

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