Monday, May 30, 2016

Brazil, Zika, Olympics

"If Brazil is unable to get this thing under control, how are you going to do it in Congo? How are you going to do it in Nigeria?"
"The most prudent public health advice is, when you've got a fire burning, don't pour gasoline on it. That's what I worry is happening."
"We just have to be willing to accept that the Olympics are not too big to fail, that they are subject to the laws of gravity and public health."
Amir Attaran, professor of public health and law, University of Ottawa

"I'm less concerned about this biological entity, this Zika virus and the mosquitoes that carry it, than I am about the ability of this chaotic, disastrous mess that is called the government of Brazil to ... muddle through."
"I'm worried about the entire picture. There are just so many tiers to this that seem utterly chaotic and crazy. It's many factors beyond what we've seen in past Olympics. It makes the challenges South Africa faced look trivial."
"Brazil is facing a far larger dengue fever epidemic, a massive chikungunya epidemic. It has been struggling with all kinds of vector-borne diseases."
"So from the point of view of say, a team physician, I'm worried about the amalgam, the totality of this enormous burden of vector-borne diseases and whether I can provide to my athletes, particularly those who will be in outdoor venues, sufficient protection to ensure that they're not going to get bit by a mosquito that may give them dengue, may give them chikungunya, may give them Zika."
"If I were deciding based on what I know right now, as opposed to two months from now, I would say we'd better have a Plan B for the Olympics -- somewhere else."
Laurie Garrett, senior fellow for global health, Council on Foreign Relations, New York

"Those [H1N1 flu, SARS] would have been serious challenges to us, but I don't think either of those would have resulted in the games being cancelled, because you can put in place mitigation effects to try to manage the consequences."
"It seems to me that the residual risk of accelerating Zika is not that substantial, and history suggests that it doesn't really happen."
Brian McCloskey, adviser to medical director, International Olympic Committee

"If  you've got very poor areas that have no sanitation, no running water, and people have to travel a distance to lug water to their homes, then of course you're going to get a lot of standing water around the home, because they keep it there. And that is a perfect breeding ground for Zika, dengue fever and all those other things."
Joe Foweraker, emeritus fellow, St. Antony College, University of Oxford
An aerial view of the 2016 Rio Olympics Park in Rio de Janeiro, Brazil.  The World Health Organization says it is not necessary to move or postpone the Games this summer due to the Zika virus, despite concerns raised in a letter signed by about 150 health experts.
An aerial view of the 2016 Rio Olympics Park in Rio de Janeiro, Brazil. The World Health Organization says it is not necessary to move or postpone the Games this summer due to the Zika virus, despite concerns raised in a letter signed by about 150 health experts. (Ricardo Moraes/Reuters)

Brazil's idea was that it was their turn to showcase their country, to proudly show off to the world how competent authorities there are, how advanced their society is, how capable they are of expending vast sums of money ($11-billion at last count, but then Russia spent five times that on the Sochi Olympics) in building superior facilities for the games. Of course endemic corruption would take its course, as it always did, and most certainly did at Sochi, but Brazil was certain its success would burnish its reputation as a world-class destination.

When it submitted its bid and it won, Brazilian authorities in government could hardly have envisioned the world's attention would be fixed on the country not necessarily for the upcoming Games venue, but for the alarming surfacing of a new medical threat in the form of mosquito-borne Zika virus which has already resulted in the birth of thousands of children born with microcephaly in which a shrunken skull and brain anomalies speak to the future of a generation.
Brazil Zika Birth Defects
Brazilian health authorities are convinced that this baby's head condition, known as microcephaly, is related to the Zika virus that infected her mother during pregnancy. (Felipe Dana/Associated Press)

As a staging ground for the Olympics, the city may not represent the most healthy of environments to begin with. Its waterways teem with raw sewage and this is what rowers will be faced with, and no one will expect the winners to leap into the water in celebration as is done traditionally. But for swimmers there will be no way to avoid the contaminated water, since that will be the venue they will compete in, hoping that pathogens will courteously pass them by.

The president of Brazil has been suspended, a most unusual and inauspicious situation since she would be the very person to welcome other world heads to the games, proudly showing off her country's values and valuable assets. Senior Brazilian former and current politicians and business elites have been implicated in a widespread corruption scandal. None of which bespeak a formula of pride and engagement with the world at large at a world-class arena of classical sports performance.

But all of which have spurred no fewer than 150 prominent physicians, bioethicists and scientists globally to form a committee writing to the World Health Organization asking its director-general, Margaret Chan, to use her clout to impress on the Olympic authorities the need to move the Olympics venue from Rio, or to delay the games in reflection of the dangers inherent in the Zika threat being spread by tourists coming to be a part of the festivities and leaving with more than they may have bargained for.

The games, they contend, could simply return to a previous venue where the facilities have already been established and could be re-used for this return event. It would certainly represent a financial loss, but it might be a prudent move at the same time to prevent an epidemic from spreading. The logistics facing Brazil's government with all the things occurring at this juncture, leaves many in doubt that it can also handle the transportation challenges in welcoming an estimated half-million visitors and athletes.

Living conditions in Brazil for millions of slum dwellers continue to be fraught with all manner of problems for the country, so on a moral plane it is difficult to justify the massive outlay invested in building the various games venues, rather than having been committed to an municipal infrastructure that would provide for Brazil's poor access to clean running water and electricity.

"These games were supposed to be a showcase for the Brazil that basically existed eight years ago, which was very successful, growing rapidly, with an expanding middle class and reduced rates of poverty. That Brazil is not really available to showcase any more", pointed out Harold Trinkunas, director, Latin America Initiative at the Brookings Institution's Foreign Policy Program in Washington.

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