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At multiple points in the play, characters accuse Yelena for infecting others with her idleness and boredom. In these instances, Chekhov uses a metaphor to liken boredom to a disease. Even Yelena herself suggests that her boredom has a fatal effect when she says in the start of the third act that she is "dying of boredom" and doesn't "know what to do." In response to Yelena, Sonya sustains the metaphor comparing boredom to a disease:
You’re bored, you can’t find a role for yourself, and boredom and inactivity are infectious.
To substantiate her claim that Yelena's boredom is infectious, Sonya brings up three examples of the way in which her appearance at the estate has interrupted the way the people in the household operate. First, "Uncle Vanya does nothing and just follows you round like a shadow." Combining the overarching disease metaphor with a simile, Sonya suggests that Yelena's idle presence empties Voynitsky of his vitality. Second, she says that she herself has been infected by Yelena: "I’ve left my work and come running to you to talk. I’ve got lazy, I can’t do it!" Usually busy and hardworking, Sonya finds she has changed since Yelena showed up at the estate. Like a disease would, Yelena has interrupted the work flow and energy that Sonya used to inform her sense of self. Finally, the disease has even spread to Astrov, the doctor, who used to pay infrequent visits but now "drives over here every day," leaving "his woods and his practice."
The metaphor of boredom as a disease is reinforced as a motif towards the end of the final act, when Astrov tells Yelena the same thing that Sonya told her in the previous act. He explains that as soon as she and Serebryakov appeared at the estate, everyone "who was busily working here and creating something had to drop what they were doing." To sum up the effect they had on the other characters, he tells her that the two of them "infected all of us with your idleness."
The metaphor acquires particular force when it comes from a doctor whose time largely goes to attempting to cure local peasants and workers from sickness. At the very start of the play, in fact, he tells Marina a gripping story about failing to save a patient from typhus. He's well-acquainted with real, non-metaphorical diseases, and likens their destructive effect to that of the couple's affluent inaction. Like a walking epidemic, Yelena and her husband "bring destruction" wherever they "tread."

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Common Core-aligned