The Movie: Contagion

Contagion the movie is based on the spread of this new infection that was first believed that it was the flu. The Centers for Disease Control and World Health Organization had to identify the type of virus and find the means to combat it that took several months. It takes several months, but it still spreads around. However there some people that are immune to this virus, as leading actor in this movie Matt Damon. The outbreak is threatening that they research on a new vaccine that is well succeeded.

During my past weeks taking Introduction to Public Health, we’ve learned about vaccination, Centers of Control Disease and more about health issues that affect the world. In this particular movie that I’ve seen before, it is definitely shown the importance of vaccines. How this vaccine helped to stop the spread and also avoided to those that weren’t immune, to be immune to this virus. It also helped me understand the GREAT importance of the role of the Centers for Disease Control (CDC) here in the states. CDC investigates, does research and fully goes into detail to those new outbreaks and prevents them from happening.

Several terms were indirectly or directly shown during the movie. 

Outbreak. Outbreak is sudden or violent starts of something unwelcome, in this case a virus. An outbreak investigation which is help by he Outbreak Management System assisting public health worker in the managements of outbreak by enabling the integration of data on demographics, case investigation, laboratory results, exposures and other relevant factors. The National Notifiable Diseases Surveillance Program is a state based system that facilitates the exchange of data between public health and other laboratory and clinical providers. The outbreak is DEFINITELY relevant to the movie. Why? Because that the whole plot of the story, how an outbreak became a threat, a danger worldwide. It was a sudden virus that was spread around due to a mix of pig and bat hybrid virus at Beth’s Company at Macao that those pigs were then transferred to the casino where they were being roasted by the chef. When Beth came and the chef casually wiped his hands off and shook hands with Beth. That’s when it all started.

Isolation. Another term that was used during the movie both in the medical field isolating the virus to find the vaccine and the process of isolating from an environment that is contaminated. Dr. Hextall finds that the virus is a mix of genetic material form pig and bat virus. They start to find the cell culture to grow the new virus on called MEV-1 while on the other hand Professor Ian violates order from the CDC and destroys his samples seeing that theirs a line of bat cells that could help search for a new vaccine. As Dr. Hextall develops this new vaccine she vaccinates herself and exposes herself to the world. This vaccine was developed because using a “live” virus of it. Also Alan, he isolated himself on getting sick and how he claims that he derived from forsythia a homeopathic cure. Also Matt Damon is put in isolation but it turns out that he immune to the unknown virus.

Quarantine. A state, period or places of isolation in which people (in this case) that have been exposed to infectious or contagious disease are placed. At the beginning of the movie we see how actor Matt Damon and his daughter have been in quarantine since they have been exposed to the virus, that later we found out that is immune to it.  A military quarantine was imposed and were forced to go home. Also another scene that quarantine was shown was when Dr. Leonora, a World Health Organization epidemiologist travels to Hong Kong and collaborates with other locals epidemiologists to talk about Beth, who she was the primary patient that the virus was first identified on. One of the epidemiologists, Feng, isolates Dr. Leonora for the vaccines that turned out to be placebos, and she rushes to tell the villagers to run away before getting quarantined.

Contagion definitely highlighted the importance of Public Health Preparedness. Through the plot of this movie one major EXAMPLE that I saw that it could’ve have been better prepared was the communication. Communication worldwide was weak, and there was no sense of honesty or trust in the issue with the MEV-1 virus. A common frequency should’ve been used. They should’ve contacted Macao, were Beth was to do quarantine. Contact every city that surrounded it just in case. A lot of miscommunication was shown between doctors, between hospital facilities, epidemiologist, and even public health affairs itself. Also Centers for Disease Control was also an issue here during the movie because no communication was given and also there was limitations, that even though they were broken, it gave out a good cause for the outcome of the vaccine. Also due to the placebo incident, it really could’ve created chaos since they had no vaccines for the small little village there in Hong Kong. I think communication could have changed everything in this movie from doctors to public health affairs, to hospital facilities, to federal government, etc.

Health Care for ALL or NOT for ALL

The Dartmouth Atlas of Health Care provides the understanding of the efficiency and effectiveness of Health Care System. This project has documented some variations in how medical resources are distributed in the United States such as Grand Junction and Seattle, Washington and more. Medicare has provided them data and analysis from the hospital and there affiliated physicians. These data are held and analyzed for them to improve health and the health systems across the country. They study medical billing record, study’s results, and the variations of American’s medicine, the different treatments and its costs around the country. They also study the issue of how the supplies that they need drive demands. Through their deep detailed research they found perfect models that define a true health care system such as Mason County in Colorado. It is a great model health care delivery. At the Grad Junction in Mason Country they have a digital record keeping making the information pure gold. They ensure protection and medical care for prenatal situations, meaning that they provide medical care no matter if they have insurance or not before the baby is born. They have medical coverage to everyone, cutting the cost of health care. They also help non-profit clinic that provided health care, dental and mental health care.  At Seattle, Washington, Factoria which is a Global Health patient center medical home, a group of doctors, or so called medical team, organize patients’ schedule and they are responsible for every patient. They see cases every day, and increase virtual medicine, the use of Internet and telephone to communicate with patients. They say that every dollar they spent to create the medical home they save a dollar and fifty cent. To save money they use the appropriate utilization that patients will use. At the Evereff Clinic, they treat 250,000 patients. At this clinic they lowers the cost of care by cutting the cost of unneeded test. They also cut the use of prescription drug and local insurance provides them with data on generic data patterns. They say that the issue of pharmaceuticals is that there’s a 60% error related to the physician’s penmanship of physician and pharmacist retail. Another cut cost are the blood transfusions during procedures. It is also a patient’s decisions, which could lower cost for them.

The access for health care should be a privilege however they should have the right to access/ visit to a primary care physician. If those people put the health first over luxury or any other thing, they do deserve health care. Health care is a delicate topic to discuss. To those people that follow rules, follow what the doctor tell them to, take their medicine, go to their appointments, have their routinely treatment, etc. they have the right and the privilege to have health care. However, there’s patients that do have health care that is provided by the government for free called “La Reforma” that is formally used in Puerto Rico, most of those individuals take advantage of it. “La Reforma” is a form of medicare that is provided for the poor or low income families that have no private health insurance. They have the right to access private physicians as well as primary care. Most of them don’t follow rules, they can’t manage the wait, or they don’t take advantage to those needs and attention that they are given every single day knowing that they are getting it for free. They are getting the same treatment, the same medications and the same attention as to those that have private health insurance. However, all human being should have access to primary care visits. It is the individual who shows interest to their health and shows respect to those that help them.

What I found really interesting from each of the medical systems that were discuss in the PBS program is how patients have the right to choose their treatment, lowering cost. It is strongly believed that physicians still want the best for their patients and have the best outcomes out of those treatments. It was interesting how giving a voice to the patient made the cost be cut and lower the cost of care. Also what I found interesting is how at Seattle, Washington they eliminated the pharmaceutical representatives, which caused a lot of controversy due to the high cost since the United States spends a quarter of a trillion on prescription drugs. I was shocked on how much cost and money was put into prescription drugs/medications. Also the percentage of error that is caused at the pharmaceuticals, which is sixty percent due to penmanship of physician or pharmacist retail. Also blood transfusion! They control the use of blood transfusion during procedures and they found out that lowering blood transfusions places the patient in a non-risk environment.

I think this could be duplicated, especially how the Grand Junction is done with its highly organized new technology and other health benefits. However, it hasn’t been implemented where I’m from, Puerto Rico, because the government plays a big role in the health care issue and there’s a lot of corruption. Also we get a lot of federal funds, however organization should be the primary aspect here and the restructure the health care system. Also there’s a huge population in a small little island, and more than fifty percent of the people are maintained by the government which could be an issue here if you have given them for so many years free access to every health care and given them every free health benefit that they could ever ask for and not take advantage of it. The people and the government should be educated and then the health care system could be reconstructed to a better one.

Blog 3: VACCINE WARS

The video represented two main different points of views of vaccines: parent’s choice vs. community needs. During the fifty-five minute video, it has shown why vaccines were achieved and the importance that the Central Disease of Control has for the communities around the world and how Public Health is involved. However, some parents hesitate on putting vaccines to their children and how they prefer their children to have measles than have autism. It has brought so much tensions between the government, state laws, and the issue of making decisions that it has become a political involvement as well as scientific. It was clearly shown that there has been no scientific proof based on the twenty two-epidemiologist tests that MMR and thimerosal are the NOT the causes for autism. However, those parents truly believe that they have evidence because they are children were at risk. Another point view that was touched during the video was how social media such as the internet, YouTube, the news, etc. has affected those people’s decisions on taking the vaccine or not or putting vaccines to their newborn. The main message and detail that this video is giving the audience is that THIS IS A PUBLIC RESPONSIBILITY and IT IS A PUBLIC HEALTH ISSUE and A GOVERNMENTAL ISSUE because of the issue of quarantine and the protection of the community. Vaccines have proven to increase the life spam of a human being for thirty years and prevent sixteen diseases for children.

I am a firm believer that vaccination should be done! It has proven my belief even more. While I was getting my vaccines at the lab, I saw this news that this young kid had gone to do a community service down at the Dominican Republic and Haiti. He didn’t have the meningitis vaccine. Once he got back home, he had to be transferred to the States and get his legs and arms amputated because he had meningitis. This is clearly evidence and proof that if he had his vaccines on time, this could all be avoided.

During the video, they explained what her immunity how the critical numbers that are not vaccinated put at risk to those that are and can’t afford it. Dr. James says that it is the responsibility to Public Health because there job is to look for the good of the world. They don’t believe that putting at risk to those are wanted to be protected and those who can’t afford vaccines. They also firmly believe that these is a matter of those parents that don’t believe in vaccines as a private affair for their own beliefs that a public responsibility for them. However Public Health thinks differently. Also Public Health has the right to make epidemiologist test, and they conducted twenty-two test to prove that both hypotheses that those parents believe that vaccines cause autism or the content of it were wrong.

Vaccination is different from other personal health decisions. Vaccination is the immunization of the community that we are surrounded and the law comes into play as well as physicians for the children’s own protection. It also prevents for polio, measles, meningitis and other rare or sexual transmitted diseases to be avoided.  Vaccines have been also been to play in social media such as youtube, fox news and the Internet. Also those close-minded individuals that believe in not vaccinating their children are putting at risk to those that surround them. A clear example was shown at the end of the video. This clearly affirms that the state and local governments should put into play because others get affected directly or indirectly. The Public Health officials, physicians and the state should decide the required vaccines.

Several reasons that parents won’t let their children get immunized is because first:

1)  Autism

2)    Mercury, thimerosal, and other ingredients

3)    They feel forced by their pediatricians and have no say in it.

4)    YouTube videos, media (fox news), internet and other social medias

5)    They don’t believe that they are not putting anyone at risk because those diseases don’t exist anymore

6)    It is a private affair not a public responsibility for them

7)    They don’t relay on doctors at all. They follow the media.

8)    They prefer a natural disease than autism

9)    There’s no reason for vaccines and they believe that natural diseases exist for a reason

While I was reading and searching information in our required book I read that the health of schoolchildren has been a public health concern since the late nineteenth century. Cities began to employ medical inspectors to check on those that were ill. I firmly believe that reinforcing this method for protecting those children that are vaccinated should make an attempt. Also the issue of health insurance is also big since it is expensive. In a perfect system, this could work by giving National Health Insurance to those in need. On the other hand for those that have health insurance and don’t want their kids to get vaccinated this should be required as a Public Health Law and State Law. It should be implemented and practiced. The world is at stake for these serious diseases and it is equally compelling to do the best for those children that are protected and for those that need protection. 

Blog 2: Non-Smoking wives of heavy smokers have a higher risk of lung cancer

Non-Smoking wives of heavy smokers have a higher risk of lung cancer

A study that was performed in Japan concluded that wives of heavy smokers are exposed to a higher risk of developing lung cancer. Also they had other health issues such as asthma and emphysema but it wasn’t statistically high compared to lung cancer. At the same time, they weren’t dramatically exposed to the risk of cervical cancer, stomach cancer and Ischaemic heart disease as it was shown in table III. In this study, 29 health center districts in Japan took into account 91,540 non-smoking wives aged 40 and above followed up for 14 years since 1966 to 1979. Also, standardized mortality rates for lung cancer were measured to their husband’s smoking habits.

Based on these results, they divided the study based on husband’s smoking’s habits: if he was a non-smoker, ex smoker (1 to 19 days) or a heavy smoker. They also considered husband’s occupation and age as two different factors for the risk of lung cancer. These relations were analyzed. It was pointed out that between the husband’s smoking habit and the wife’s risk of developing lung cancer was particularly significant in agricultural families when the husband aged between 40 to 59 years. The constant variable from all these results is that the patient (the wife) had to be a non-smoker. Another factor that they considered was husband’s alcohol drinking habits if it was a strong factor for their wives’ to get lung cancer. It clearly showed that it had no affect on wives’ mortality from lung cancer. Once the analyses were done, they studied the effects of passive smoking and direct smoking. Passive smoking (or second hand smokers) was shown a one half to one third of direct smoking. Based on this relative risk ratio, ratio of incidence rate for persons exposed to the factor to the incidence rate for persons I the unexposed group, excess deaths from lung cancer due to passive smoking is smaller than direct smoking due to the large amount that is exposed.

The cohort study that was performed in Japan it is probably the most accurate. It calculated the relative risk of the passive and direct smoking effects. The cohort study was based on a large number of people questioned about there exposures. This study was up to date and consistent during those fourteen years. It was an important study because it showed the public that they were all at a health risk to get diagnosed with lung cancer. It could have helped if there was an epidemic during that time and to see what could have been the cause of these nonsmokers to get diagnosed with lung cancer especially in Japan.

There’s an advantage to use the cohort study because a large number of people are being studied for a long period of time to see whether those who are exposed are more likely to develop lung cancer that those who were not.

The Cause and Effect in this cohort study defined and discussed the study of a large number of people that is more likely to yield valid results than a small study, had a stronger measure between exposure and disease, the exposure was a cause of disease and epidemiologic evidence is more convincing than biological explanation. I personally believe that this study did support that second hand smokers do get affected and have a higher risk from lung cancer as a risk factor, not a cause and effect situation. However, even though the relative risk of passive smoking is smaller than direct smoking due to the fact that 73% men smoked and 15% of women as well, there was still a larger group exposed than unexposed to passive smoking since the there was a larger group of women that don’t smoke. However this doesn’t not support that passive smoking IS a CAUSE for the EFFECT: Lung Cancer, it is a variable or risk factor. As well as direct smoking causes lung cancer. This article is more explaining the risk factor or a precaution giving us tables and graphs that should be considered for those nonsmokers or victims of passive or direct smoking.