Contagion

The movie Contagion is about an outbreak of a terribly, deadly, unidentified disease. It is originally thought that this outbreak was a bioweapon meant to kill thousands, but the CDC in Atlanta ultimately finds that the disease is genetically similar to a virus found in pigs and bats, and is caused by the MEV-1 virus. With knowledge of the MEV-1 virus, doctors at the CDC were able to make a vaccine against the virus. At the very end of the movie, we find out how the outbreak of the virus started: it was traced back to a bat in China, and ultimately ended up in Beth's body. Overall, I thought this movie was very good- and it was definitely worth seeing twice. 

Outbreak can be defined as the sudden or violent start of something unwelcome, such as war or disease. The movie's premise is that of a giant outbreak of an unidentified disease (later found to be a virus). The outbreak results in an extreme and sudden outbreak investigation, which was focused at the CDC in Atlanta. Doctors hurriedly worked to find the source of the outbreak as well as to prevent the spread of additional cases. Medically, one of the correct responses to an outbreak is an outbreak investigation. Socially, one of the correct responses to an unknown outbreak is isolation of those who are infected, and quarantine of those who are not (and technically those who are). This separation of the infected and the non infected can help to prevent further spread of the disease. 

Throughout the movie, there are definitely places where public health agencies ideally should have been better prepared for the outbreak and its effects. Although public health agencies did take control of putting the infected in isolation and everyone else in quarantine, I think they could have been more prepared by making sure there was no spread of disease through things such as food and water. As the cause of the virus was at first unknown, I think better precautions regarding the spread of disease through food and water is plausible. For example, what if a non infected person in quarantine ate pork, which came from a pig who was infected with the virus? Another way that public health agencies could have been better prepared is to increase the staff and services at hospital facilities for the time being. It is obvious that the more staff available, the more people will come to the hospital and the better chance they have at regaining health. This is the same as saying the more hospital beds, the more patients will stay overnight at the hospital. By increasing the availability of doctors who can attend to infected patients, the better chance they have of becoming healthier. Despite these two criticisms, I think the public health agencies and doctors handled the outbreak of the MEV-1 vaccine well. 

Health Care

The Dartmouth Atlas Project aims to improve health and health systems across the country. They track the differences in treatments and costs in regions around the country in order to improve ongoing healthcare efforts. They found surprising differences in health and treatment in various locations across America. There are huge variations in treatment and spending across the country. As supply drives demand in the world of medicine (more doctors allow for more doctor visits), the number of doctors in a region greatly effect how the healthcare system of that area is run. 

I think that access to health care is a right. Even looking as far back as the constitution, it is said that all men are entitled to life, liberty, and the pursuit of happiness. How can man be entitled to life without proper health care? This would not be possible. Why should one man's life be more important than another's? I do not think that putting one man's life over another based on how much money the two men have is fair. Healthcare is a right, not a privilege. 

In Grand Junction, Colorado, it is stated that the requirement of being a physician is that you agree to see all members of the system, even if that physician works in an independent medical practice. Doctors care both about the physical and mental aspects of their patients. Grand Junction is a place where all patients pay the same amount of money for the same procedures. As the general population in this area is very healthy, this system of health care is clearly efficient. This system was able to work because of charities and the money doctors set aside to cover the uninsured. In Grand Junction, everybody is covered, costs are controlled, and people are healthier. 

In Seattle, Washington, medical systems have embraced the idea of Co-Ops, where customers own businesses. One example is the Group Health Cooperative, where doctors organize their schedules around their patients. They are paid a salary, rather than being paid for the number of patients they see. 

In Everett, Washington, doctors take a less expensive approach. First, they treat diseases from the outset with generic drugs. Additionally, doctors don't perform as many expensive (sometimes unnecessary) procedures. For example, doctors will perform less MRIs. 

In Lebanon, New Hampshire, health care is up to the patient. The patients' insurance pays all of their bills, but the doctors leave most decisions up to the patients (shared decision making). This saves money as doctors cannot force patients to pay more money than they can for unnecessary procedures. I think this approach can be very effective if spread to other areas of the country. 

I think the most effective approach is the one in place in Lebanon, NH. Where I live, I find that most doctors want to make the most money they can. Living in NYC, professionals like doctors are very money-driven. Thus, sometimes it can be found that some doctors will perform unnecessary procedures that cost money the patient cannot spend. Therefore, I find that the shared decision making approach can be very effective. If doctors put aside their personal desires and become less motivated by money and (more motivated by personal reasons), the healthcare problem in NYC can greatly improve. 

Vaccine Wars

As stated in its title, "The Vaccine Wars" focuses on the debate of immunization: should newborns be vaccinated or not? Prior to watching the video, I thought that vaccination is something that every newborn should have. I was myopic in the sense that I saw no reason not to be vaccinated. Why should one decline vaccination for their child when this action would simply put their child in danger of being infected by a horrible disease? However, after watching the video, I recognized some of the cons of immunization- both from the parents' and doctors' points of views. This was very interesting to me, as I have never thought about the negative effects of a vaccine, something that prevents terrible diseases from resurfacing the population. 

As expected, doctors and other professionals in the field generally argued for immunization of all children, as they stated that vaccines are a public health miracle. They supported their standpoint by arguing that any unimmunized children can be infected by a virus, and can in turn harm immunized children. This is not fair. In addition, they argued that the risks of immunization outweigh the risks of unimmunization. Specifically, one doctor argued that the only risk of getting a vaccine is getting a harmful reaction or small amounts of pain, while the risk of not getting a vaccine is getting a serious disease. Ultimately, the risks of unimmunzation are greater than those of immunization. 

On the other hand, many parents argued against vaccination. Some main arguments for this point of view are that children should contract natural illness the same way people have in the past: without vaccination. Illness is not bad, and people must deal with it. They also argued that vaccines can cause brain injury in a small segment of the population. For example, many parents truly believe that the MMR vaccine can cause autism. In addition, some parents don't see the need for a vaccine against diseases that they haven't seen in generations. For example, some parents argue that there is no need for the polio vaccine, as polio has not surfaced the population in many decades. Lastly, many parents think that the doctors just want money;  doctors don't care about protecting the patients against disease, as long as they are making money from their vaccines. 

The vaccine war is especially prevalent in the public health world. This may be the case because of the few serious reactions to the vaccines. When someone reacts badly to a vaccine, the word quickly spreads. This creates a serious debate between those parents against immunization and health professionals who are for vaccination. In addition, the video made it clear that there are many people who see health professionals as money-seeking and uncaring for their patients. While I don't believe this to be true, it could cause a serious debate on the topic of vaccination. Regarding the debate, I think the parents should be the ones who ultimately decide whether children should receive a specific vaccine. However, I think it is the doctor's job to convince the parents that vaccination is the right thing to do. 

In order to attempt to increase vaccination rates, health policy makers could use the mass media to promote the goodness of vaccines to the public. Just as the community uses the mass media to show a bad reaction to a vaccine (for example, the Redskins cheerleader), health policymakers could show people who have been protected against the disease. One example that was especially persuasive to me was the idea of herd immunity. Herd immunity is immunity of a community, or population. In the view of the health professionals, the more immunity of a community, the better. Herd immunity can be compared to a brick wall protecting a community against an enemy. If more people in the community are protected, the less likely anyone in it is to be harmed. The idea of herd immunity is compelling, and is one that i think policymakers should use. 

Second-Hand Smoke and Lung Cancer

The article titled "Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan" focuses on exactly what the title states: the effects on non-smoking wives of their smoking husbands. Importantly, the study indicates a relationship between second-hand smoke and lung cancer. 

The study was designed as a 14-year analysis of the mortality rates for lung cancer in non-smoking wives with husbands who smoked various amounts per day. The aim of the study was to look at the relationship between passive smoking of the women and lung cancer. Not surprisingly, the results showed a clear relationship between the two. More specifically, the data shows that the effects of passive smoking is between one-half to one-third that of direct smoking in terms of mortality due to lung cancer. This is a relatively large number given that non-smokers exposed to smoking can be at a serious risk of the same disease as smokers. 

More specifically, the study analyzed the age and occupation of the smoking husbands as well as how much he smoked. They found that women with husbands  aged 40-59 at enrollment who worked in agriculture had the greatest risk of mortality due to lung cancer. Additionally, it is important to note that the study found no relationship between the husband's smoking habits and any other type of cancer in the non-smoking wive. There is a small relationship between the husband's smoking habits and the wife's risk of developing diseases such as emphysema and asthma, but this relationship was significantly small and therefore not focused on. 

As detailed questions about lifestyle were asked of husbands and wives independently at the start of this study, this study design is particularly advantageous; the design allows for no subjective bias on either subject of the study. Therefore, all [or most] results are credible and conceivable. 

Although I was not unaware that second-hand smoke is dangerous prior to reading this article, I was surprised by the immensity of the relationship between non-smokers exposed to second-hand smoke to lung cancer. This great relationship forces us to question whether or not it is useful to compare "smokers" to "non-smokers" when studying the risk of developing lung cancer from smoking, because the "non-smokers" could be exposed to large amounts of smoke. For example, a non-smoking wive who has a husband that smokes three packs of cigarettes a day could be exposed to even more smoke than a smoker who only smokes one or two cigarettes a day. To fix the problem, researchers should categorize the non-smokers based on how much second-hand smoke they are exposed to. This would allow for the results to be more accurate. 

It is also important to note that these findings were not a result of chance. In other words, it is not an instance of chance that non-smoking wives with smoking husbands had a higher mortality rate due to lung cancer than non-smoking wives with non-smoking husbands. This is the case because as the results of the study show, there was a statistically significant relationship between the amount of cigarettes the husband smoked and the morality rates due to lung cancer of their non-smoking wives. This fact shows that there is a fine relationship between second-hand smoke and lung cancer in non-smokers.