________________ CM . . . . Volume XVIII Number 22 . . . . February 10, 2012


Outbreak: Anatomy of a Plague = La variole: Anatomie d'un fléau.

Jefferson Lewis (Director & Writer). Kenneth Hirsch, Adam Symansky, Christian Medawar & Line Richard (Producers). Kenneth Hirsch, Ravida Din & Yves Bisaillon (Executive Producers).
Montreal, PQ: National Film Board of Canada, 2010.
85 min., DVD, $99.95.
Order Number: 153C 9910 146.

Grades 10 and up / Ages 15 and up.

Review by Frank Loreto.

**** /4


When talking about the possibility of a pandemic, those in the know claim it is not a matter of if, but when, something will hit us. Ebola, SARS, Swine Flu, Avian Flu have each proven not to be the one, but what if the next attack is something we thought eradicated? In Outbreak, writer and director Jefferson Lewis imagines that smallpox makes a comeback.

      Outbreak is actually two films in one. The backdrop story is a retelling of the great smallpox outbreak of 1885 in Montreal. Juxtaposed with this, Lewis sets a similar smallpox scenario in present day Montreal to show how it could unfold-based on what happened in the past.

      In 1885, a train conductor from Chicago arrived in Montreal exhibiting some flu-like symptoms. Early stage smallpox symptoms are similar. He was suspected of having smallpox, but since the actual smallpox hospital had been closed, he was sent to Hotel Dieu. The English hospital did not want to take him in.

      The present day scenario has a flight attendant arriving in Montreal from England. Her early symptoms were missed since smallpox is not on any present-day doctor's radar. As she sits in a crowded clinic, she is unknowingly contaminating those around her. She feels better after a few days, but she infects the chambermaid at her hotel.

      No one wanted to admit that smallpox was back in 1885, so by the time a newspaperman uncovered the story, many had been affected. Once the word was out, the medical community advocated vaccination. Two doctors were available to treat the 200,000 people living in Montreal. More immediate service was available for those who could afford the $1 price (a day's wage). An anti-vaccination movement grew among the poorer French Canadians. A rift grew between the English and the French as the poorer French had more people affected. When the vaccine used proved to cause more harm than good, there was celebration in the anti-vaccine camp. Meanwhile the smallpox claimed more lives.

      In present day Montreal, the spread of smallpox is shown over time. Smallpox is not officially known until Day 28 of the outbreak. Initially, as the chambermaid is of Caribbean extraction, there is a reaction to all Caribbean citizens. In most outbreaks, a scapegoat is found. Those suspected of being carriers are shunned by the general public. Reason is abandoned as a sense of panic starts to creep in. Emergency plans which look fine on paper do not work. Who gets vaccinated first? The vaccine is over 30 years old. Will it still work? What services are essential? Who will look after the power supply if those workers stay home due either to illness or to avoid public contact?

      In the 1885 epidemic, those in the hospital were sent home so the hospital could be cleaned. This response simply spread the contact.

      In both situations, the spread initially seems to be contained; the number of infected people levels out and the belief is that the worst is over. Life goes back to normal, and the isolation of the suspected groups ends. People mix with each other again. However, doing this just makes everything worse.

      In 1885, people gathered to celebrate the return of soldiers who went west to put down the Riel Rebellion. Summer was the time for religious festivals, and that year Buffalo Bill arrived with his Wild West Show. The smallpox came back, and by mid July, 200 were dead with 400 more infected. Houses were quarantined; many people left the city, and by August the dead numbered 500 and the city, itself, became quarantined. People were advised not to travel to or deal with Montreal. The city was a centre for the manufacturing of shoes and cigars. No one wanted these products anymore. As a result, many people were unemployed. Families were torn apart by unemployment, poverty and illness. The veneer of civilization disappeared as the spread of smallpox increased. Mandatory vaccination in 1885 resulted in a riot. Club-wielding police were called in to disperse the crowd. Children were forcibly taken from their families and placed in hospitals. Understandably, this action caused violent reprisals by the parents.

      In present day Montreal, by Day 204, the number of dead is growing. Funeral directors interviewed admit that they cannot handle such a surge of bodies. Even the crematoriums would be unable to deal with these numbers. They have a contingency plan, but the question is asked: what happens when the funeral workers get sick? With reference to the SARS outbreak, viewers are reminded that some front-line health care workers were infected and many others were unwilling to treat those who were sick. In a smallpox epidemic, the reaction would be similar.

      Only a robust health care system would be able to handle such a situation. The film makes the accusation that ours is not ready. Beds would be in short supply. Staff would be overworked. Health care workers would be frightened and exhausted. In other segments of society, workers would not report for work due to illness or fear. Curfews are in place by Day 218. Public gatherings are forbidden. Riots erupt as people search for a scapegoat. The government calls in the army. Cemetery workers complain that there is no place to put the bodies by Day 268, but then a new normal starts to slip in. The vaccines start to work, and those susceptible to smallpox have been taken. The outbreak is over.

      By November 1885, 20,000 people had been stricken by smallpox. Of the 5,000 dead, most were French Canadians, and, of those, most were children under the age of 10. The outbreak ends by the new year.

      Outbreak can be seen as two excellent films. For the treatment of the 1885 Smallpox Epidemic, the film enlists the expertise of historian Michael Bliss. The treatment is thorough and, at times, graphic as it quotes from first-hand witnesses. The current day smallpox outbreak is fast-paced and not histrionic. The suppositions are based on existing systems and the reactions to recent outbreaks. Blending the history and the prediction is done smoothly, and the film moves at a fast pace.

      If 1885 Montreal is not on the high school curriculum, Outbreak may not have much applicability in a History class, but it would be excellent in a Science or Biology class studying the spread of disease. Also the people's reaction to panic would work in a Sociology or Psychology class.

Highly Recommended.

Frank Loreto is a teacher-librarian at St. Thomas Aquinas Secondary School in Brampton, ON.

To comment on this title or this review, send mail to cm@umanitoba.ca.

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