“Contagion” is filling movie theaters and topping box offices with its thrilling tale of how an international team of doctors stops the spread of a deadly disease that kills millions around the world.
The film’s stars, including Matt Damon, Gwyneth Paltrow, Jude Law, Marion Cotillard, Laurence Fishburne and Kate Winslet, share the screen with the work of the Centers for Disease Control and Prevention, whose senior officials consulted with the film’s producers to present what critics consider “a thinking man’s horror movie” and a generally realistic portrayal of how the agency might investigate the origins of an outbreak.
(In a nod to the CDC’s help, the film’s producers hosted a screening for agency employees at its Atlanta headquarters last week.)
Winslet plays Dr. Erin Mears, a member of CDC’s Epidemic Intelligence Service who is deployed to probe the origins of the fast-moving disease.
In real life, Douglas Hamilton heads the 160-member EIS, a corps of public health and medical professionals who serve two-year terms and travel around the world to assist public-health agencies with their investigations. Most EIS officers are physicians, but some are also Ph.D.-level scientists, veterinarians, dentists and nurses, Hamilton said.
We spoke with Hamilton this week about his elite unit. A transcript of the conversation — edited for length and complete with spoiler alerts — appears below:
Q. What qualifies someone to work for EIS?
Hamilton: It’s a two-year postdoctoral fellowship in applied public health in epidemiology. Basically they’re CDC’s “disease detectives.” When CDC needs to put somebody in the field, it’s typically an EIS officer who goes along with other people.
One thing you have to realize is that health is under the jurisdiction of the states, not the federal level. When our guys go out, it’s to provide technical assistance and to help local authorities, and it’s very much a collegial arrangement.
The main focus of an outbreak response is to find out the extent of the problem, the number of people affected, the common symptoms they may share. And then once that’s identified, you have to work on limiting the disease or stopping the epidemic.
If you look at a dissertation written by candidates for a master’s of public health, the last sentence they usually write is, “Further research is necessary.” Here, EIS officers can’t do that: They have to come up with the control measures needed to help the public. It’s about applying the science to solving a real public-health problem.
Q. Who pays for an EIS’ services?
A. I’ve got a [federal budget] line item for epidemic investigations where I can send officers into the field. I literally can have somebody out the door in two hours. I don’t have to wait and put in a request for the funds. And it’s an important part of CDC’s capability to respond. Since 9/11, CDC has developed a robust operations center and do a great amount of work to get people into the field. [Editor's note: EIS officers earn about $75,000 annually, far less than they might earn doing private clinical work, Hamilton said.]
I’ve got several people, five, seven people dealing with the famine in Somalia right now. Those people are living in really austere conditions. In some cases, they hike into areas to do their investigations. I’ve got more volunteers than they need people right now.
Q. How true to form is the movie?
A. I was surprised: It seemed to do a pretty credible job of depicting what an EIS officer would do in the field. It’s a movie, so everything is a little compressed. The other thing is that EIS officers are very much the point of the spear when CDC responds, but in something as significant as the disease being described in this movie, CDC’s response would be much more response than just sending one officer into the field.
When we had the H1N1 problem, which had the potential of being a huge pandemic, we were fortunate that the virus was not as deadly as other forms of H1N1, but CDC responded as soon as the first two cases were identified in San Diego. For those two cases, we sent about five EIS officers in the first wave with other support staff.
Q. SPOILER ALERT: The plot line in the movie suggests it could take months to develop a vaccine — is that a realistic time table?
A. I’m not a vaccinologist, but my understanding is that it takes months to develop a vaccine. The H1N1 vaccine, produced after just a few months, was an amazingly fast schedule. Typically we prepare the next flu season’s vaccine six months in advance.
Q. SPOILER ALERT: Have any EIS officers ever been sickened by the diseases they were tracking?
In the entire history of EIS, only one officer has died in the line of duty. They were doing an investigation of refugee problems in 1968 in Biafra, and their plane was shot down.
My greatest fear isn’t the diseases they’re investigating, it’s traffic accidents or random street violence.
Q. Are there other disaster or deadly-disease-themed movies that are inaccurate?
A. The one that people most compare “Contagion” to is “Outbreak,” and at the beginning — where Dustin Hoffman and Morgan Freeman nuke a village — we probably wouldn’t do that.
With this movie, I was impressed that they really spent time learning about the science. It really had a significant scientific credibility.
Q. What do most EIS officers do after they leave the unit?
A. When we look at our trainees, about 75 percent of them stay in public health. A lot of them stay at CDC, others with state or local health departments or with international groups like World Health Organization, or non-governmental organizations. Probably 10 percent go back to clinical medicine. Some go back to academia.
Q. And considering your line of work, I’m curious: When was the last time you got sick?
A. Gosh, I don’t remember. I’m careful — not paranoid — but I’m careful.