The new Stephen Soderbergh thriller “Contagion” presents a terrifying vision of a global pandemic: a virus that kills millions of people as scientists struggle to find a vaccine. Last week, in connection with the anniversary of the 2001 anthrax attacks, ScienceNOW, the online news site of Science magazine, hosted a discussion with two consultants on the film: Laurie Garrett, who has reported on infectious diseases for 30 years and recently wrote “I Heard the Sirens Scream: How Americans Responded to the 9/11 and Anthrax Attacks,” and W. Ian Lipkin, a neurologist and epidemiologist at Columbia University who has helped identify several new infectious agents.
Following are edited and re-ordered excerpts from the conversation. The entire chat can be found at news.sciencemag.org.
Tell us about the making of “Contagion.” What’s an example of how you improved its scientific accuracy?
W. Ian Lipkin: We designed a plausible virus and showed an accurate laboratory and public-heath response scenario. I coached the actors on how to demonstrate symptoms of disease. The habitat-destruction scene at the end of the film is a powerful reminder of the zoonotic [animal-to-human] origin of many emerging infectious diseases.
Laurie Garrett: I was involved at the script level, and there were 30 — yes, 30 — drafts. In countless ways, from brainstorming on plots all the way down to very specific ways a scientist might phrase a comment, I had input, and offered critique.
About the virus you helped “create” for the movie: How probable would it be that something like that could happen naturally in the world today?
Lipkin: The majority of emerging and re-emerging infectious-disease threats arise in nature; nonetheless, synthetic biology is becoming an increasingly important field to monitor as costs go down and tools become more accessible.
Did you face any resistance when you tried to include actual science in the plot?
Lipkin: The “Contagionists” were committed to getting it right. There were only a few instances where I might have made other choices — however, none of the choices were poor choices.
How did you guys end up consulting for the movie?
Lipkin: Because Laurie and I are both photogenic.
Are we safer today than we were 10 years ago?
Garrett: Yes and no. We are better prepared for bioterrorism, or terrorism generally, because we are less naive, as Americans, and more vigilant. But most of the billions of dollars’ worth of investments in preparedness have left us no closer to safety — mainly because [the World Health Organization] has a $1 billion deficit, CDC just lost $750 million in its budget in a single month, and local health departments are getting hacked right and left.
How great is the actual risk of a bioterrorist attack vs. something potentially more impactful over a large area, like a nuclear attack?
Garrett: You ask about balancing and weighing risks — radiation, biologicals, chemical, suicide bombers. I don’t think it is actually possible to say which is more likely (or not likely), or which would be more devastating were it to occur. Risk assessment depends on intelligence, and all aspects of terrorism intel are still difficult to assess. In the end, I think “preparedness” is about infrastructure — what is in place, how well people are trained.
Would you say that the efforts made over the last 10 years have improved public knowledge about these threats? Or have they made people more fearful?
Garrett: I sympathize with your concern that “Contagion” will scare people. When we screened it at the Council on Foreign Relations, there was a lot of grabbing-the-Purell afterwards. But consider what most teens seem to love to watch: slasher monsters, vampire killers, gore and guts. Compared to that stuff, “Contagion” is mild. There is much more science in the movie than people seen dying or suffering.
Slasher monsters, vampire killers are not real. “Contagion,” being based on actual science, makes it truly scary.
Garrett: Fair enough. I personally think a movie like “An Inconvenient Truth” is scary as hell, because if Al Gore’s analysis is even 20 percent correct, we are facing a terrifying future. Does that mean documentaries and realistic films that present frightening forecasts ought not be made? No. It means that they are terribly important.
In light of the ever-present bioterrorism threat, what are your feelings about whether or not the last known stocks of pathogens such as smallpox should be destroyed?
Garrett: It has always been the U.S. government position that the smallpox stockpiles should be saved, in case of an attack that might require seed stock for some pharma effort or comparative genotyping. In contrast, many countries have argued that the most likely — if not only likely — source of smallpox for terrorist use would be those very saved stockpiles. I have personally wrestled with this conundrum for years, and have gone back and forth.
What more should be done to prevent pandemics? Would you agree that poor disease surveillance in animals and bad animal-health-care capacities in Africa, Asia and other developing countries deserve much more investment?
Garrett: Recombination events are always at the top of our concerns — right after zoonosis. “Contagion” depicts both — quite accurately, I think. The real problem is a zoonotic event that then recombines, as constantly occurs with influenza.
Fear of vaccines is a massive problem, and you will see the Jude Law character in “Contagion” deal with that. There is more mercury in a single tuna sandwich than all vaccines an individual is likely to take in a lifetime combined.
Ian, how does your research intersect with biodefense?
Lipkin: We collect and analyze samples from wildlife and people in 40 countries, searching for insights into emerging infectious diseases. We also look at the ways in which prenatal and early-life infections contribute to health and disease. This film was a wonderful affirmation of our work.
Garrett: Ian is being a bit humble on this entire interaction here. He played a critical role in “Contagion,” as he does in disease detection every day. The producers and writer Scott Z. Burns spent time in his lab and modeled one of the characters (played by Elliot Gould) after him.