Covid-19 Chronicles: Living in ‘Contagion’

WHEN the movie "Contagion" came out 10 years ago, I had just completed my Master of Science in Public Health and an internship with the World Health Organisation’s Immunisation, Vaccine and Biologicals Department at their headquarters in Geneva.

I was due to begin a PhD to study whether it was possible to develop a rapid test to diagnose infectious tuberculosis (TB) using a drop of blood. (Spoiler alert: it was not).

I was just becoming an "infectious disease" person.

As such, when I watch movies depicting deadly outbreaks, even the really entertaining ones, I get irritated with how simplified, inaccurately, or over-dramatised the science is portrayed.

But I was impressed with details in "Contagion" that closely resembled the world of infectious diseases, and how it featured the public health leadership and diplomacy that is rarely portrayed (albeit still dramatised).

I recall thinking uneasily about Jude Law’s character, a blogger out to manipulate the masses for money. Watching the scene where he records (fake) symptoms of being infected with the virus and then supposedly cures himself with a herbal remedy called "forsythia", I wondered, surely people in the real world would not so easily believe a mere video?

I vividly recall laughing heartily at the idea of a vaccine being made within the span of a few months.

In hindsight, these scenes now seem eerily prescient.

It has now been nearly two years since Covid-19 emerged. Deceptive videos from various sources continue to circulate and spread in a way unimagined before the advent of social media. Before the end of the first year, we did not have one vaccine approved for emergency use, but three promising vaccines, two of which were the first of its kind.

The fact that "Contagion" predicted Covid-19 so eerily with its fictitious MEV-1 pandemic does not serve as credit to conspiracy theorists.

Instead, it was a credit to the infectious disease people who were consulted. The pandemic today has had a shocking impact, but the explanation of the events that unfold can be found across centuries of amassed scientific literature.

But the movie ends with the distribution of an effective vaccine after a death toll of 26 million people, which quickly sees life returning to normal — suggesting the elimination of the virus.

It also ends with Jude Law’s character being arrested for conspiracy and securities fraud.

With this, "Contagion" and the reality of Covid-19 part ways. The happy ending in the movie was one the scientists desired. Reality is never so neatly concluded.

Misinformation and protests against lockdowns persist. Students learn from a distance and in isolation. Travel remains nostalgic memories for most people, and those that have been able to, travel with anxiety and significant hurdles. Businesses continue to hurt.

By early 2021, it seemed that reprieve from Covid-19 was just around the corner — all each country had to do was pull off an historic adult mass vaccination campaign.

In the backdrop of new safety concerns and old suspicions about vaccine safety, some pulled off this feat better than others — with countries like UAE and Portugal exceeding 75% of the eligible population with completed vaccinations. Malaysia too has now exceeded the world average in proportion of vaccinated adult population.

Yet, as arms continue to receive a shot of a Covid-19 vaccine, over 4.6 million people have lost their lives, and millions more have had to endure burying beloved friends and family from a painful distance.

Malaysia has not been spared, and the statistics are difficult to digest. Some daily struggles become more difficult to bear. With new more contagious variants mushrooming from different parts of the world, it is time to forget a time when Covid-19 did not exist.

Although this seems like a depressing thought, especially with many of us living with Covid-19 under various forms of lockdown and life suppression, I am hopeful.

As an infectious disease person, now more than ever, I trust public health tools to get us over the line to a place where our healthcare system may find reprieve — as they have been doing for many historically devastating infectious diseases.

We may never have gotten rid of TB entirely, and may never will, but children today who are vaccinated against TB no longer die before the age of five, and adults infected with TB who are diagnosed early can hope to be cured with antibiotics.

I am convinced that with continuous support for and distribution of vaccines, we can begin to make peace with case numbers, and instead manage the toll of disease.

Recent data from 1.44 million blood donors in the United States shows that immunity to Covid-19 reduces risk of (re)infection; and a majority developed immunity via vaccination.

Conversely, in US states where a high proportion of people do not have immunity, deaths and hospitalisations from Covid-19 remain higher than in the first wave.

I am convinced that diagnostics, particularly simple and affordable self-administered rapid tests, will not only more quickly identify and isolate new cases but provide the empowerment for individuals to manage their health and stay confident while continuing to navigate a world with Covid-19.

The UK has blazed this trail and the data on mass repeated rapid testing to reduce community spread shows that integrating rapid testing with other public health strategies is possible and promising.

As human history continues to march into a post-lockdown Covid-19 prevalent setting, we must continue to invest and build capacity in science and public health, and to do so with equity.

Already we see the trend of disparity in access to Covid-19 vaccines. While 40.6% of the world population has been vaccinated, this proportion drops to 1.9% among people living in low-income countries.

Children have been left painfully vulnerable without any vaccines approved for under 12 year olds.

The ceiling price of RM16 per test for the rapid antigen test is still unaffordable for most people. If there was a time to subsidise the cost of diagnostics, it is now.

We may not get the neat happy ending that the infectious disease people dreamed of for "Contagion".

But if we work together, leaving no one behind, and trust in the science and our people working in the science and leadership of infectious disease, we may hope for a promising beginning to the next chapter of living with Covid-19.