Sep 2 2011
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Contagion The Movie: A NewPublicHealth Q&A with Barbara Reynolds

file Image courtesy of Warner Bros. Pictures

Pandemic crisis communication is coming to a theater near you. Matt Damon and Kate Winslet star in the new movie Contagion, where the spread of a deadly infectious disease and the spread of fear go hand in hand. The movie, directed by Steven Soderbergh, fictionalizes the investigation and emergency response to a pandemic disease outbreak.

Some of the movie's scenes were filmed at the Centers for Disease Control and Prevention (CDC) headquarters, and Winslet's character is partly based on one of CDC's real-life virus hunters. In advance of the movie's release on September 9, NewPublicHealth spoke with Barbara Reynolds, Ph.D., CDC Crises Communication Senior Advisor in the Office of the Director about the CDC's role in the movie, communicating in a public health crisis, and myths about panic.

file Barbara Reynolds, CDC Office of the Director

NewPublicHealth: What’s the premise of Contagion and how realistic is it?

Dr. Reynolds: We understand the premise of the movie to be a fast-moving emerging infectious disease sweeps the world, and it’s a race to find some way to contain, perhaps treat and ultimately prevent the disease. Everything I’ve heard about the movie and the level of subject matter experts who’ve been involved as consultants makes me believe it’s going to have a real dose of realism. Of course, we know it is fiction and not a documentary. People who do anything for a living, when they watch it unfold in an entertainment format are probably looking for those things that don’t quite fit right. But I think if you take it in its entirety, you start to see some of the truths in the fiction.

NPH: What was the CDC’s role in informing the scientific basis of the movie and in some of the filming – was the filming in CDC’s labs?

Dr. Reynolds: The filming wasn’t at the labs, you’d have to have lots of training and numerous vaccinations to get into any of our labs. There was filming at the CDC in some general sites to give a sense of presence for the film. CDC had some of its epimiologic investigative services staff, otherwise known as disease detectives, interviewed by some of the cast to get a sense of the work we do. Obviously, CDC is there 24/7 protecting America from health threats, and that would include infectious diseases, so it was a natural place for them to come to get an idea of exactly how is it done by the CDC, and what are the steps in protecting people. Part of it is our field-work, part of it is scouring the data to get the clues to answer the questions, and a big part of what we do in protecting America is our laboratory work.

NPH: Why did the CDC decide to get involved in this project?

Dr. Reynolds: We’re always interested in opportunities to educate the public about what they can do to protect themselves and about the nature of health threats. We’ve also consulted on other projects out there. Where we can, we will involve health messaging in TV programs, for example. So it’s not unusual for us to make that bridge between a science organization and an entertainment entity.

NPH: Are there any examples you could share?

Dr. Reynolds: I don’t do that work specifically, but I can tell you we have consulted on, for example, soap opera story lines and we have interjected health messaging into some popular medical shows. We have also been involved in what are some pretty exciting pieces on Animal Planet.

NPH: How can we as public health professionals do a better job of communicating the value of our field?

Dr. Reynolds: I think we have to do it on two levels. Public health is a means to keep America secure from health threats. Sometimes when we’re thinking of the threats that are out there, we skip that beat. We don’t think about health threats as something that could harm the security of our nation, including the productivity of our workforce. My work around pandemic preparedness made me very aware of that. When we look back historically at the 1918 pandemic, we were suffering at that point only between a one and two percent case fatality rate. We had enormous numbers of people who died and of course that was tragic. But we also learned that a severe pandemic could threaten the very core of our economy and our infrastructure. If you didn’t have people who could go to make sure that the utilities were on, that would be a problem. I think there are times when we have an opportunity for the public to get a glimpse into what we’re doing to protect them, but not often. And frankly, if we can do it through fiction and do it effectively, that’s a nice way to do it because when it’s really happening is not the time to remind people.

NPH: You were recently featured on a CDC blog talking about managing fear and avoiding panic. How do you see this movie fitting into risk communication efforts?

Dr. Reynolds: It’s interesting, the trailer alone got me excited because they talked about fear, which is very natural and of course would happen in a crisis situation. But I’d like to correct the myths around panic and what people will do when faced with risks. It’s important to make the distinction [between fear and panic]. Most of us in our lives have said in one situation or another, “Oh, I panicked!” So we ascribe the feelings of fear or anxiety or terror to this word “panic.” From a psychological perspective, on a societal level, when we talk about panic we talk about it in terms of behavior. More often than not, what we see are most people going into fight or flight mode and doing something they believe will protect themselves. However collectively, when we’re all doing that fight or flight, and that’s not being directed in a positive way, things can break down and social order can seem disrupted.

But what we’ve learned in the research, and you can go back to decades of events where you would think people would panic, is that they don’t, oftentimes. It’s because they had some level of self-efficacy – they believed there was something they could do to protect themselves. In situations where there’s a great level of uncertainty, there’s no direction, and if there’s no trusted source for information, you have a greater chance of what we would call panic behavior occurring. At CDC we care very much about being sure that we’re perceived as a credible and trusted source of information. We also have to recognize the stressors, emotionally, people are feeling when a crisis occurs, and have to alter the way we talk to accommodate that. You have to give them a good message in a simple way that they can understand when they’re under stress. That message also has to come from a credible and trusted source. All of those things go into the mix when we’re looking at how to talk to people in a crisis situation.

NPH: How does social media impact crisis communication?

Dr. Reynolds: We’re talking about an age where information flows very quickly, and from lots of sources all at the same time. The reaction time for giving people direction is getting shorter and shorter before misinformation can be out there, and I think that this movie will show some of that, including the challenges, the pluses and minuses of social media.

We employed a number of social media tools during the H1N1 outbreak in 2009 and found it to be extremely helpful in managing misinformation when it would occur, and also having that two-way exchange, that respectful collaboration with people out there in the world. What we have found is that it did indeed work for us, and that people were appreciative of our desire to share information quickly and our willingness to hear back from them, [whether the feedback was] good, bad or indifferent. It was a really exciting real-life experience, and I think that’s also reflected in the movie that social media is an incredible tool, and we need to be prepared to communicate in a world where communication happens very quickly, in lots of different ways, and our relationships with the people we’re reaching are even more important.

>>Find more about the movie, and get immersed in the world of disease hunters and how you can protect yourself in the Contagion: Are You Ready? social site from CDC, the American Public Health Association and other partners, and on CDC.gov.

Weigh in: How does fear play into your communication efforts? Will Contagion the movie help?

Tags: Public health, Infectious diseases, Centers for Disease Control and Prevention, Infectious disease, Preparedness