Ordinarily, if someone we’d spent some time with refused to shake our hand when we parted, we’d be offended. Or think they were Luis Suarez. But when that person was Dr. Ian Lipkin, we could totally understand. He’s the professor behind the science bits in medical disaster thriller Contagion, and had just spent half an hour explaining why he never shakes hands and why WE MIGHT ALL DIE TOMORROW.
Does your knowledge of infection and disease make you extra-cautious?
It does. It absolutely does. There are a few things… I don’t know if you’ve ever traveled through Asia, particularly Japan, but during winter months you see people wearing masks on public transport – we don’t do that in the west.
Shaking hands... this is something I put into the movie. When the kid shakes hands with Laurence Fishburn, I told Scott [Scott Burns, writer of Contagion] to put that in because I don’t shake hands with most people. If you go to the east, people don’t shake hands very much – they bow. There’s been this evolutionary aspect of culture where they’ve sort of found ways to distance themselves, to decrease their risk of transmission. So I don’t shake hands as much with people as many other people do.
You saw that line where Kate’s talking about the number of times that people touch the face [between 2,300 - 3,000 times a day]. I try to avoid touching public handrails, unless I absolutely need to do, and I wear gloves when I do that.
I can’t afford to get sick, and I rarely get sick. Since I’ve been taking these kinds of approaches – that's fifteen or twenty years – I can count on one hand the number of times I've had colds. I just don’t get sick.
Contagion is pretty frightening stuff, but none of that stuff could that really happen, right?
I would say that 99% of the film is spot on. There are some aspects of the film that might have been done a little bit differently, but nothing that’s critical. Whereas, take a look at other films in this genre - Outbreak, I Am Legend, The Warning Sign - and there’s all sorts of things that don’t make sense.
That’s not really what we wanted to hear…
The virus is plausible; the concept of a vaccine lottery is plausible – after you vaccinate the first responders – people who have to go out and maintain the city, and so on – you would have to have some fair way to do it, and a lottery is a perfectly reasonable way to do it. That’s the way we’ve done drafts for the military in the past, so there’s a precedent for that. So I think the film’s quite accurate.
And is there a high risk of a pandemic like that occurring?
Well, it’s quite high. Every few years we have a flu scare. In 2003, I was in Beijing during the SARS outbreak. While I was there, there were people committing suicide, and the city came to a complete shutdown. As you probably know, any major city in the world only has a couple of days of food and water. So if everything shuts down, which is what happens when people become ill, you would have chaos in the streets. We tried to portray that message, and we did a good job of portraying that. What you see in the film is not at all unusual – that’s what Beijing looked like; you know, with deserted streets and so forth, so I think that it's perfectly plausible.
Now, could we have another flu pandemic that would look like this? Yes we could. Part of what we’re trying to do is to make people aware of what the risks are, so that we continue to invest in science and public health.
Could we be better prepared to prevent or deal with such a situation?
We could. We could have better drugs for preventing diseases. We could advertise more broadly about ways in which you can reduce the risk of contaminating other people. The major issue, I think, is that our surveillance is not what it should be. Most infectious agents originate with wildlife and move to people. We need to do surveillance on wildlife populations, and people who come into contact with wildlife, so that we can interdict these before they move into the mainstream population. In addition, we need to come up with newer and faster ways to make more efficient vaccines. They have to be cheaper, and we have to find ways to deploy them.
Is the risk getting worse?
There are a number of factors that come into this issue of increasing risk. One is the growth of the megacity – the fact it’s so difficult to provide basic services to people. London is the home of the first sewer system; we have huge problems right now with handling clean water, worldwide. And whenever you have political unrest, and you have people who are forced to migrate, they travel with their diseases and so forth, so you have the risk of them taking something local and making it global.
The last scene of the film where you see the transmission from bats, to pigs, to people – that’s a classic story; we’re seeing more and more of that.
As you begin to move into wildlife areas, bringing wildlife into contact with domesticated animals and people visiting these areas – that increases the risk.
Then you also have the issues associated with international travel and the globalisation of food production. All of this means that whatever is over here is rapidly over there. It’s only 14 hours from any part of the world to any other part of the world. So there is no longer any sort of sequestration of disease, or poverty, or anything – we are a flat world now.
Are these increased dangers outstripping advances in technology and medicine?
Well it wasn’t doing so, but now with the global recession, and the withdrawal of support for science and for public health and some of these other things, the risks are increasing, and the science is not keeping pace.
This is one of the reasons I was interested in doing the film – to highlight the vulnerability of the world to these problems.
One thing that nobody ever really talks about, which is also important, is the impact of these infectious diseases on the economy. We have a monoculture in the world. Most places you have lots of pigs over here and lots of cows over there, and one type of crop over there – well if you have a disease that starts here, it can spread like a fire and literally wipe out billions and billions of dollars worth of investment. The impact of BSE on the British economy was billions of dollars. The same tools that we use to reduce the risk of human disease are also important for protecting agriculte and the economy.
So we're not ready to deal with an outbreak of this nature?
You know, it’s a Catch 22. If I say we’re there, and we don’t get ready for it, then it becomes a fait accompli. I think there’s a high risk that we will continue to see more and more emerging infectious diseases, but we’re trying as a field to develop a universal flu vaccine. If we’re successful in doing so we’re going to eliminate a large risk that’s associated with that.
If you look back at the history of the 1918 flu, 1% of the world population became infected and died. If you look at H5N1 [avian influenza, or 'bird flu'], which appears to have a much higher per-case fatality rate, it could be worse yet. So if H5N1 becomes capable of sustained transmission, human-to-human, instead of just rare instances of bird-to-human via intimate contact, then we could be in for a very bad situation.
In terms of wiping out 100% of mankind – probably not. Could we lose 100 million people? Sure. Or more. Which is a big number.
I think it’s a big risk; that’s why I do this work, to try to identify risks when they’re still sitting in an animal population; when they’re just in a small segment of the human population, before they can generalise and cause much more damage.
What are you doing to save us?
I was really the first person to use genetic methods to identify infectious agents.
These methods are not only useful for tracking the emergence of infectious diseases, but also looking at diseases that you wouldn’t necessarily think of as being infectious, like certain types of cancer and immune diseases like rheumatoid arthritis.
Over the next few decades, I think we’re going to find the role of viruses in cancer is going to be larger than people anticipated. A few years ago there was a Nobel prize awarded for this, to a German scientist who found a relationship between pethalonical virus and cervical cancer. Now women are getting vaccines against pethaloma virus so we’re actually going to eradicate cervical cancer.
We’ve eradicated peptic ulcer disease, which was due to bacterial infection.
Hepatitis B is the major cause worldwide of liver cancer.
So, these sorts of things that came out of genetic methods, I think are going to have a huge impact on the quality of life and the amount of disease that we see – chronic disease as well as acute.
We also have to change our mindset about protecting other human beings. As I say, when you go to Japan, people are very conscious of the fact that they are potentially causing harm to other people, so they try to stay home. That’s the other point: if you’re sick, you shouldn’t go to work; you shouldn’t risk making other people sick. You can’t afford to; it’s too dangerous.
Now that we can get on board with. Sorry boss, looks like it'll be another day of Jezza Kyle and Coach Trip for us tomorrow.
||Contagion is out on DVD and Blu-ray now.