The new movie “Contagion” provokes atavistic fears harkening back to the ancient plagues that for hundreds of years devastated Europe and Asia. Until the implementation of modern public sanitation like clean water and sewers systems, infectious diseases in industrial societies ranked on a par with ancient pandemics. By the end of the nineteenth century, urban life had definitely improved. In the twentieth century, the concerted use of vaccines, sulpha drugs, and antibiotics further reduced the rates of infection and death. In the West especially, people were living longer and better.

Despite the terrors that pandemics can generate, every known contagious disease is discriminating, that is, it picks and chooses, finding its hosts in crowded tenements, military barracks, internment camps, or in socially marginalized groups, like the immigrants who bore the brunt of the 1918 influenza epidemic.[i]  It also selects for individuals whose immune systems are either permanently or temporarily impaired. Think here of the elderly, children, or pregnant women or of those who are malnourished or already weakened by other diseases or medical treatments. Think also of the vulnerability of people in developing nations, where pandemics of AIDS, malaria, cholera, sleeping sickness, and tuberculosis still ravage entire regions, in combination with the privations of wars and natural disasters. In the United States obesity, cancer, stroke and heart disease—the maladies of affluent societies—are the major health threats. Americans are finding entertainment in a movie about an imagined pandemic they are unlikely to experience first-hand. So what is the attraction?

One answer is that disaster movies offer the thrill of danger without its consequences. For dramatic effect, the vicious bat-swine virus in “Contagion” kills quickly and massively, barely distinguishing between the weak and the strong. The result is desperate, panicked crowds driven to looting hospitals and pharmacies for medical remedies, even phony ones. Some take to invading their neighbors’ homes at gunpoint. In short time, the pandemic-inspired chaos envelopes America, toppling the social order while government scientists struggle to create an effective vaccine.

“Contagion” takes its cue from over-the-top pandemic scenarios that flourished in the late 1990s, when the bioterrorism threat first became a national security concern. To persuade Congress to invest more in biodefense, in July 2001 a Johns Hopkins University think tank staged a table-top exercise called “Dark Winter,’ postulated on multiple Iraqi smallpox attacks that ultimately kill millions. It was hyperbole, both epidemiologically and from an intelligence perspective, but its apocalyptic story line gripped the imagination of high government officials (Vice-President Cheney was especially taken with it).

Instead of Iraqi terrorists, the script of “Contagion” posits a more sophisticated threat to American security: how the United States is losing out to globalization, especially Asian competition.  Hollywood’s Everyman Matt Damon, whose wife is the first “index” case, stands alone against the menace of a newly ascendant China, the source of the virus that is wrecking his society and killing millions.

Director Steven Soderbergh bolsters the film’s reality quotient by incorporating scenarios from the 2002-2003 SARS epidemic, which erupted in Hong Kong and caused an international public health crisis. Cooperation between the World Health Organization and the US Centers for Disease and Prevention in Atlanta contained the outbreak which worldwide infected 8, 422 and killed 916, mostly in Asia. Had SARS spread to sub-Saharan Africa, it would have had dire results for the already vulnerable populations there. After the 2001 anthrax letter attacks, the CDC improved its surveillance and response capability, which allowed it to better monitor and check the spread of SARS; the United States had only eight cases, none fatal. CDC officials and other scientists consulted with the producers of “Contagion,” lending plausibility to explanations of viral mutation and transmission.  (The 1995 movie “Outbreak,” in contrast, was full of howlers.)

In “Contagion,” an elite Hong Kong restaurant in a casino is suspected as the prime cause for the global disaster. The spread of a deadly contagious illness through hedonistic social contact—corporate types spend a night feasting and gambling—stands as a metaphor for the malaise that many Americans have been feeling since the 2008 economic downturn.  If only Matt Damon’s wife (played by Gwyneth Paltrow) had stayed home from that Hong Kong business trip and resisted its festive conclusion, the virus would have spared her, her family, the United States, and maybe the world. But where’s the entertainment value in that scenario?

In real life, the control of unusual disease threats, including those involving potential bioterrorism, relies on responders in two different locales. One is the high-containment laboratory setting where dangerous microbes are tested, stored, and researched. When Nature produces an unusual new disease, like SARS or avian influenza, laboratory safety and security are essential for keeping the threat under control, as well as for developing effective biomedical defenses. In 2004, a new, quickly detected SARS outbreak erupted in Beijing, after a lab worker at a virology institute was accidentally infected. The FBI’s discovery that the material in the 2001 anthrax letters, which resulted in five deaths, came a U.S. Army research laboratory points to a significant security breach, intolerable in an age when biodefense research is being conducted in literally hundreds of high-containment labs nation wide.

Instead of just a technological fix—discovering the “magic bullet” vaccine—“Contagion” could have emphasized more the other important responder, the local public health offices, which were barely given a nod. The movie also could have highlighted the known low-tech preventatives, like hand washing, coughing into one’s sleeve, and strategies for avoiding crowds. In the 2009 H1N1 outbreak, for example, high school students protected themselves and others by staying home. Instead, even the film’s basic educational messages were muddled. Acting the part of a CDC epidemic intelligence officer, Kate Winslett informs officials in Minneapolis (where the US outbreak begins) that ordinary people touch their faces a thousand times a day, increasing the chances of disease transmission. Yet later in the movie, her boss (played genially by Laurence Fishburn) defends the handshake as a gesture of peace, this after dozens of images showing lethal germs being transmitted by casual hand-to-hand contact. Not to give away the end of the film, but a simple, culturally appropriate bow in Hong Kong would have been more prudent.