Los Angeles Times - 11.03.2020

LATIMES.COM S WEDNESDAY, MARCH 11, 2020A

south of Sacramento — the
third confirmed fatality
from the disease in Califor-
nia.
It was further evidence,
as many health officials ar-
gue, that the virus will not
easily be contained. From
using military might to a
seemingly hands-off atti-
tude, hard-hit states and
municipalities hope to slow
the spread of a contagion
that threatens lives and can
overwhelm health systems if
too many cases hit at once.
This week, with the num-
ber of people testing positive
growing daily, health offi-
cials across the United
States are adopting varied
tactics as they make the
switch from containment to
mitigation — a transition
mandated in part, say some
experts, by a failure to find
cases earlier as testing was
delayed by a lack of access to
kits, a problem many argue
is still impeding efforts.
“Our detection is so poor
that if we detect one [case]
we absolutely have a lot
more than that,” said Marc
Lipsitch, a professor of epi-
demiology at the Harvard
School of Public Health. “We
have failed to detect cases to
such a degree that there are
probably many, many cases
that are spreading undetec-
ted, and the only way to deal
with that problem are mea-
sures like social distancing
that don’t require tracing
cases.”
What this new phase of
fighting the coronavirus
looks like varies widely as
health officials grapple with
how to keep people away
from one another, a daunt-
ing prospect when many
Americans are unaware, or
skeptical, of the actual risks
of the disease. Mixed mes-
sages from federal, state and
local authorities have con-
fused many about the sug-
gested precautions they
should take, said Lipstich
and others.
“I don’t think that people
are grasping that it’s serious
right now,” said Harvard epi-
demiologist Michael Mina.
“And I think right now is our
last chance to prevent mas-
sive numbers of cases.”
President Trump has
shifted between sounding
skeptical about the virus to
claiming the contagion is
largely under control.
“I think we’re doing a
really good job,” Trump said
Tuesday after a meeting
with GOP leaders on Capitol
Hill. “Democrat governors
are saying we’ve done a fan-
tastic job. ... Gavin Newsom
said there’s not a thing that

he’s asked for that we

weren’t able to get him.”

But the same day, Sur-

geon Gen. Jerome Adams

said at a White House brief-

ing: “We will see more cases.

Unfortunately, we are likely

to see more deaths. We have

not seen the peak of this epi-

demic quite yet.”

Mitigation strategies at-

tempt to minimize the virus’

impact on the broader com-

munity, especially vulnera-

ble populations, through

community actions — rather

than a focus on exposed indi-

viduals.

But it carries its own

costs. When authorities urge

businesses and govern-

ments to delay events like

Coachella, as happened

Tuesday, it mitigates risks

but also affects workers, who

are losing jobs, contributing

to the chance the nation will

slip into a recession.

“In most jobs in this

country, you can’t work from

a laptop on your couch,” said

Adriane Casalotti, the chief

of government and public af-

fairs at the National Assn. of

County and City Health Offi-

cials. “We’re out there asking

real people to choose be-

tween the public’s health

and their own financial well-

being — them keeping their

jobs. For individual families,

this is complicated and

messy.”

The disparate realities of

mitigation are especially ap-

parent in California, where

Gov. Newsom has made it

clear counties have the lead

in responding to the virus.

“What we are doing is a

bottom-up process, not a

top-down process,” said

Newsom Tuesday. “I think

the local health officials

should make those determi-

nations.”

In Los Angeles County,

Barbara Ferrer, director of

the county Department of

Health, said her agency also

had a focus on slowing the

spread, but is combining

mitigation with contain-

ment.

Public health officials in

Placer and Yolo counties,

which neighbor Sacramento

to the northeast and west,

also announced a shift Tues-

day from trying to contain

COVID-19 to accepting that

the disease is spreading too

fast for widespread quaran-

tining measures. Seven peo-

ple in Placer County have

tested positive for the co-

ronavirus, including a Rock-

lin man who died last week.

Yolo County has one con-

firmed case.

On Tuesday, the United

States surpassed 1,000 co-

ronavirus cases, mostly in

Washingon state, New York

and California. As of Tues-

day, California had 157 con-

firmed cases of COVID-19,

with more than 1,075 Califor-

nians so far tested for the co-

ronavirus at 18 labs across

the state, the governor said.

Aimee Sisson, Placer

County’s public health di-

rector, said the county would

continue to do some tracing

of who came in contact with

COVID-19 patients, but only

to screen for high-risk situa-

tions, such as a person who

visited a nursing home or

came in contact with an

immune-compromised indi-

vidual.

Widespread quarantine

measures can’t be sus-

tained, Sisson said, espe-

cially for healthcare work-

ers. California already has a

shortage of medical pro-

viders, and forcing quaran-

tines on front-line staff is a

burden the system can’t

bear as the virus spreads.

If counties keep quaran-

tining healthcare workers

for potential exposure, “we

wouldn’t have any health-

care workers left,” she said.

Sisson added that her

county does not have the ca-

pacity to continue to trace

every contact because it

lacks the manpower, even

with an offer from the state

for additional help.

Casalotti said that in ad-

dition to tracing contacts,

health officials felt burdened

by containment because it

required caring for those in

isolation — a costly and

labor-intensive prospect.

Health workers often deliver

groceries to keep patients

away from busy public

spaces where they could

transmit the virus, for exam-

ple.

But Dr. Stanley Perlman,

a microbiologist at the Uni-

versity of Iowa who studies

coronaviruses, pointed out

that drastic measures in

Wuhan seem to have signifi-

cantly slowed the spread of

the new virus. China’s mas-

sive quarantine was a never-

before-seen public health

experiment.

A study released last

week in the journal Science

modeled the effects that

Wuhan’s travel quarantine

had on the rest of the globe.

Though the study found

minimal impact in stopping

the spread of the corona-

virus to the rest of China, re-

searchers found that there

were 77% fewer cases impor-

ted to other parts of the

world through mid-Febru-

ary as a result of the restric-

tions.

Because of its success, it

has become the map for how

to combat these outbreaks.

Italy’s government locked

down the nation of 60 million

people this week. But Perl-

man said it is hard to believe

that Americans would follow

such orders — the challenge

health officials will face as

they craft their plans.

“This is not an on-off

switch. It’s a dimmer,” Dr.

Nancy Messonnier, the di-

rector of the CDC’s National

Center for Immunization

and Respiratory Diseases,

said Monday of efforts to

shift strategies.

Still, World Health Or-

ganization officials have

warned against countries

giving up on containment

strategies entirely.

Staff writers Chris

Megerian, Thomas Curwen

and Taryn Luna

contributed to this report.

Shifting strategies to combat virus

[Virus, from A1]

VOLUNTEERSperform a Purim reading for residents under quarantine in New Rochelle, N.Y. The National

Guard was sent to enforce a containment zone to prevent the coronavirus from infecting more people there.

John MinchilloAssociated Press

REED BARBE, left, fists bumps with Marevie Tepora in Santa Monica. Such

gestures have replaced handshakes for people seeking to minimize contact.

Genaro MolinaLos Angeles Times

Play. Though other pan-
demic movies, including
“Outbreak” and “
Monkeys,” have also enjoyed
renewed favor in recent
months, none seems to
resonate with viewers as
much as “Contagion.”
That’s likely because the
movie’s screenwriter, Scott
Z. Burns, conducted months
of in-depth research into the
science of pandemics. He
then recruited several well-
established epidemiologists
to develop a realistic plot,
edit the script and train the
actors who would portray
health officials, doctors and
scientists.
“When I started talking
to experts, they all said, ‘It’s
not a matter of if there will
be another pandemic, it’s a
matter of when,’” Burns
said. “There’s nothing un-
canny to me about doing
research.”
Amid a growing public
health crisis, the movie’s
near-documentary preci-
sion has become a source of
alarm for some.
Some fans believe the
film’s fictional destruction
and high death toll are signs
of what it is to come and
suggest that officials are
hiding information from the
public. In the vacuum cre-
ated by how little is known
about this new virus, fear
and misinformation have
flourished.
The movie, prescient as it
is, predicted that, too.
Burns said “Contagion”
was inspired by his father,
who often worried about the
possibility of avian flu be-
coming a human pandemic.
Not wanting to make a
conventional disaster mov-
ie, Burns turned to Dr. Larry
Brilliant, an epidemiologist
who spearheaded the suc-

cessful global eradication of

smallpox.

At the time, around 2009,

the public seemed to react

strangely to the swine flu

epidemic, Brilliant said.

People acted almost disap-

pointed that it was not as

severe as health officials had

warned, he said.

“We all started talking

about the fact that moder-

nity didn’t know what a real

pandemic looked like,” he

said.

So they set out to create

one.

“Contagion” tracks the

arrival of a fictional virus

called MEV-1 that sends

officials from the CDC and

the World Health Organiza-

tion scrambling to stop the

outbreak and quell growing

fear and distrust among the

public. By the end of the

film, chaos reigns and the

disease’s death toll has

reached at least 26 million.

The fictional virus origi-

nates from a bat, then jumps

to a pig and then a person —

which reflects the fact that

75% of new diseases in peo-

ple come from animals,

according to the CDC.

These diseases include HIV,

Ebola, SARS and now,

COVID-19.

In the film, knocking

down trees in Hong Kong

displaces the bat and trig-

gers the emergence of the

virus, which shows how

deforestation and the de-

struction of animal habitats

makes such leaps more

likely. The virus’ rapid

spread, in just hours from

Hong Kong to Chicago to

Minneapolis, reveals the

way increasing global travel

can quickly turn diseases

into pandemics, sometimes

becoming impossible to

contain.

“It was not going to be

pure entertainment — it was

actually going to have some

public health messaging,”

said Dr. Ian Lipkin, a Co-

lumbia University epidemi-

ology professor who served

as the movie’s main scien-

tific consultant. “The idea

was to make people aware of

the fact that emerging dis-

eases will continue to

emerge and reemerge.”

Lipkin, who has identi-

fied hundreds of new dis-

eases throughout his career,

shared with Burns his expe-

riences from 2003 on the

front lines of the SARS

outbreak in Beijing. Elliott

Gould’s character in the

movie, a UC San Francisco

scientist named Ian Suss-

man, is a nod to Lipkin.

Lipkin invited Winslet

and actress Jennifer Ehle,

who plays the researcher

developing a vaccine, to his

lab at Columbia to help

them prepare for their roles.

He developed a 3-D model of

the virus that rotates on

screen. He helped Burns

during post-production to

ensure the whooshing and

whirring sounds of the fic-

tional labs were accurate.

In one scene, Winslet

explains the concept of an

R-naught — which refers to

how many people each sick

person is likely to infect,

essentially a measure of

contagiousness. The scene

brought a wonky epidemiol-

ogy term to the general

public, much to the delight

of public health professors

and biology teachers who

now play the movie for their

classes each year.

Watching that scene,

Brilliant said, “I thought I’d

died and gone to heaven.”

Burns said that while

filming the movie, Damon

joked that they needed to

amp up its fear factor and

add some zombies for it to

be a real Hollywood thriller.

But Burns said it had be-

come clear to him and direc-

tor Steven Soderbergh that

the film was even scarier

because it was plausible, “as

opposed to creating a mon-

ster that gives the audience

this kind of distance from

the story.”

Which brings us to 2020,

when there is seemingly

little distance between

“Contagion” and real life.

Paltrow, who (spoiler alert)

gets killed off in the first 10

minutes of the film, recently

posted an Instagram selfie

from an airplane wearing a

mask.

“I’ve already been in this

movie,” she wrote. “Stay

safe. Don’t shake hands.

Wash hands frequently.”

Paltrow isn’t the only one

drawing these comparisons.

Many have taken to Twitter

to tell people to watch “Con-

tagion” to figure out what is

really going on with

COVID-19. A commenter

wrote on the YouTube page

where you can rent the

movie for $3.99: “This movie

should be FREE due to

Coronavirus! We must pre-

pare!”

Stephen Tegethoff, 28,

said that watching “Conta-

gion” recently with friends

made him suspect the virus

is going to spread across the

globe faster than officials

have said.

“Honestly, it did make

me a little paranoid,” said

Tegethoff, who lives in Pitts-

burgh.

Burns anticipated that a

pandemic would trigger fear

and distrust in government.

In addition to the scientist

characters, the movie fea-

tures a freelance journalist

played by Jude Law who

questions the CDC’s mo-

tives, hawks a fake cure for

the virus and gains fans as

people grasp for answers

after their loved ones’

deaths.

The movie’s portrayal of

panic and scapegoating is

what Burns sees as most

analogous to what is hap-

pening today, he said.

“I had someone write to

me on Instagram and

accuse me of being part of

the Illuminati, and that I

always knew this was com-

ing,” Burns said.

For the most part, he

said, he is gratified that

people might glean public

health lessons from the

movie. But his research into

the destructive social effects

of pandemics makes him

worry about widespread

fear, which led to dips in the

stock market, countries

blaming each other, as well

as people hoarding masks

and other supplies, he said.

“What I do hope the

movie illustrated is how

misinformation and fear

cause people to behave in

ways that frequently are

going to make the problem

worse, or cause new prob-

lems,” Burns said.

Burns said making the

film showed him how con-

nected people are by public

health.

For example, it is the

responsibility of those with

strong immune systems to

not spread diseases to their

neighbors, who may be more

fragile, he said. In this way,

he hopes a pandemic would

bring people together as

they realize they need each

other to survive, he said. But

he knows that is unlikely.

He made a movie about

it. On the original “Conta-

gion” poster is the film’s

tagline: “Nothing spreads

like fear.”

How bad can an outbreak

get? Just see ‘Contagion’

[Movie,from A1]

JUDE LAW plays a freelance journalist in “Contagion,” a film that depicts misin-

formation amid an outbreak and has alarmed many fans streaming it in 2020.

Claudette BariusWarner Bros.