Should The Rio Olympics Be Can­celed Or Post­poned?

ForbesWeekly - - FRONT PAGE - BY JUDY STONE, CON­TRIB­U­TOR

Whether to can­cel the Rio Olympics is more com­pli­cated than the pres­ence of Zika alone and is be­ing in­creas­ingly de­bated.

Al­most a year and a half ago, oth­ers and I raised con­cerns about “Rio Sew­er­cide,” as the heav­ily-pol­luted wa­ters of Gua­n­abara Bay are teem­ing with hu­man and an­i­mal waste. As I noted then, “Shock­ingly, 70% of Rio’s sewage goes un­treated into the bay—an enor­mous vol­ume, given Rio’s pop­u­la­tion of 12 mil­lion.”

Olympic sailors will be com­pet­ing here. Dur­ing prac­tice, just with be­ing splashed, or “in­ci­den­tal con­tact,” a num­ber of th­ese ath­letes be­came ill. As longdis­tance swim­mer Lynne Cox said, “Olympians shouldn’t swim through sewage.”

The swim­ming com­pe­ti­tions are now sched­uled to be held at Copaca­bana Beach, at the mouth of the bay. The As­so­ci­ated Press com­mis­sioned wa­ter qual­ity tests in the re­gion. Virol­o­gist Fer­nando Rosado Spilki found virus lev­els 1.7 mil­lion times higher than would be ac­cept­able in Cal­i­for­nia. Kristina Mena, an­other ex­pert in wa­ter­borne viruses, “pre­dicted that ath­letes who in­gest just three tea­spoons of wa­ter from the bay have a 99% chance of in­fec­tion.”

The In­sti­tuto Oswaldo Cruz (of the Brazil Health min­istry) found the lo­cal wa­ters to be con­tam­i­nated with multi-drug re­sis­tant or­gan­isms car­ry­ing the car­bapenem-re­sis­tant Kleb­siella

pneu­mo­niae enzyme, a.k.a. KPC. Th­ese are one type of car­bapenem-re­sis­tant en­ter­obac­te­ri­aceae (CRE) su­per­bugs and are re­sis­tant to al­most all an­tibi­otics. While the Olympic or­ga­niz­ers prom­ise the wa­ter will “meet stan­dards,” that ap­pears to be a pipe dream.

The wa­ter where ath­letes will be com­pet­ing re­mains heav­ily pol­luted, putting the com­peti­tors at risk of se­ri­ous ill­ness and al­most as­sur­ing that the highly an­tibi­otic-re­sis­tant bac­te­ria will be more quickly trans­mit­ted through­out the world.

View­point: Games should be can­celled

This week, Amir At­taran, a pub­lic health pro­fes­sor at the Univer­sity of Ot­tawa, cre­ated quite a stir, strongly rec­om­mend­ing that the games be post-

poned or moved. I found his ar­gu­ments com­pelling.

First, At­taran notes that Rio de Janeiro has the high­est rate of sus­pected Zika in­fec­tions any­where in Brazil. Although the mil­i­tary has been tapped to do widespread fu­mi­ga­tion, the in­ci­dence of dengue cases, which are also trans­mit­ted by the same Aedes ae­gypti mos­quito that trans­mits Zika, are six­fold higher than last year. This is not re­as­sur­ing as to the ef­fi­cacy of Brazil’s en­hanced mos­quito con­trol pro­gram.

About 80% of Zika in­fec­tions are asymp­to­matic—peo­ple will not know that they’ve ac­quired the virus. Di­ag­nos­tic tests have only re­cently been de­vel­oped (a re­mark­able feat!) and are not read­ily avail­able.

As we learn more about Zika, we see more and more com­pli­ca­tions be­com­ing ev­i­dent-not just birth de­fects with ab­nor­mally small heads, but se­vere re­tar­da­tion, blind­ness, deaf­ness and other neu­ro­logic de­fects. In adults, Guil­lain Barré, an au­toim­mune paral­y­sis that can be deadly, is in­creas­ing as a re­sult of Zika. Even with ex­cel­lent med­i­cal care, 3 to 5% of GBS pa­tients die of com­pli­ca­tions.

We re­cently learned that Zika can be trans­mit­ted sex­u­ally and can still be found in se­men for months af­ter in­fec­tion. While Zika has been known to cause mild in­fec­tions for decades, the link with mi­cro­cephaly is rel­a­tively new. Sci­en­tists now be­lieve that the virus has mu­tated, mak­ing it more vir­u­lent with pan­demic po­ten­tial. Dr. Peter Hotez, dean of the Na­tional School of Trop­i­cal Medicine at Bay­lor Col­lege, told the At­lantic that when com­par­ing dif­fer­ent strains from Africa, Poly­ne­sia and Brazil, “It also al­lowed us to go back to do stud­ies show­ing that mi­cro­cephaly and Guil­lain-Barré Syn­drome prob­a­bly first be­gan with the Asian strain.”

Who knows what new wrin­kle will be­come ap­par­ent in the com­ing months?

More than 1.3 mil­lion peo­ple were in­fected with Zika in Brazil just last year. More than 2.2 bil­lion peo­ple, liv­ing in trop­i­cal and sub­trop­i­cal coun­tries con­ducive to the Aedes mos­qui­toes, are now at risk of in­fec­tion.

There has been re­mark­ably rapid progress in un­der­stand­ing Zika and de­vel­op­ing strate­gies to com­bat it, in­clud­ing Ox­itec’s GMO mos­qui­toes and mozzies in­fected with Wol­bachia, to make them re­sis­tant to the virus. Nei­ther of th­ese strate­gies is ready for widespread adop­tion, how­ever.

Given th­ese un­cer­tain­ties, I agree with At­taran that “the mass mi­gra­tion of 500,000 for­eign­ers will ac­cel­er­ate the virus’ global spread and make the pan­demic worse” and that the Olympics should be can­celled. We need to buy time to de­velop th­ese en­gi­neered mos­qui­toes fur­ther, to de­velop an­tivi­rals and bet­ter tests.

There is prece­dent for moving com­pe­ti­tions. While not com­monly done, Ma­jor League Base­ball re­cently an­nounced they were moving their se­ries from Puerto Rico to Mi­ami be­cause of Zika.

Coun­ter­point: Games should not be can­celled

Not ev­ery­one agrees with that riska­verse as­sess­ment. Ashish Jha, di­rec­tor of the Har­vard Global Health In­sti­tute, be­lieves the games should pro­ceed. “We can’t can­cel the Olympics—it’s the wrong re­sponse to what will be­come in­creas­ingly com­mon phe­nom­e­non—glob­ally spread­ing in­fec­tious out­breaks…we need to fight the virus and in­vest in health sys­tems,” he told me. In­stead, he sug­gests that ef­forts be in­ten­si­fied to min­i­mize the risks, by boost­ing mos­quito erad­i­ca­tion, dis­tribut­ing con­doms and sim­i­lar pre­ven­tive ef­forts.

Two Cana­dian physi­cians, Neil Rau and Richard Sch­abas, added, “The Zika ge­nie is al­ready out of the bot­tle. It has spread like wild­fire in the Western Hemi­sphere…and we have no ef­fec­tive means of stop­ping it…Travel ad­vi­sories will be in­ef­fec­tive and are un­rea­son­ably puni­tive to af­fected coun­tries.”

Dr. Mar­garet Chan, the di­rec­tor-gen­eral of the World Health Or­ga­ni­za­tion, stressed sim­i­lar points, stat­ing, “You don’t want to bring a stand­still to the world’s move­ment of peo­ple. This is all about risk as­sess­ment and risk man­age­ment.”

Ethics and so­cial jus­tice as­pects

While many view can­cel­la­tion of the Olympics as un­fair to Brazil, oth­ers ob­ject to the dis­par­i­ties high­lighted by the Olympics, with vast spend­ing on the event at the same time as needs of the lo­cal peo­ple are be­ing ne­glected. There is ram­pant pol­lu­tion and a health sys­tem over­whelmed with the needs of ba­bies with mi­cro­cephaly and other birth de­fects. Arthur Ca­plan and Lee Igel ques­tion the wis­dom of hold­ing the Olympics. They note the par­tic­u­larly dif­fi­cult po­si­tion fe­male ath­letes are faced with as well—risk­ing their health with their goal of com­pet­ing. They con­clude, “To host the Games at a site teem­ing with Zika, an out­break the World Health Or­ga­ni­za­tion has la­beled ‘a pub­lic health emer­gency of in­ter­na­tional con­cern,’ is quite sim­ply ir­re­spon­si­ble.”

Mark Per­ry­man, in The Daily Beast, re­ported that the eco­nomic impact of the Olympics is likely neg­a­tive, cit­ing a num­ber of ex­am­ples. “Di­vert­ing scarce cap­i­tal and other re­sources from more pro­duc­tive uses to the Olympics very likely trans­lates into slower rates of eco­nomic growth than that which could be re­al­ized in the ab­sence of host­ing the Olympic Games.”

Oth­ers crit­i­cize the bas­tardiza­tion of the Olympics from an am­a­teur, non­com­mer­cial en­deavor, to ram­pant cor­po­rate com­pet­i­tive­ness and greed and en­vi­ron­men­tal de­struc­tion.

Note again that preg­nant women are ad­vised to stay away. Men who have un­rec­og­nized Zika in­fec­tions may trans­mit the in­fec­tion to their part­ner, thus men are ad­vised not to at­tempt con­cep­tion for six months af­ter ill­ness or for two months af­ter travel to a Zikaen­demic area if they did not be­come ill.

In the U.S., as well as Latin Amer­ica, ac­cess to con­tra­cep­tives is in­creas­ingly dif­fi­cult for poor women or those in some ru­ral ar­eas, and abor­tion is rapidly be­com­ing more un­avail­able.

Con­clu­sion

Given all the risks-of birth de­fects, of Guil­lain-Barré and of rapidly dis­sem­i­nat­ing Zika and su­per­bug bac­te­ria through­out the world, it seems fool­hardy to me to pur­sue the Rio Olympics at this time. I fa­vor can­cel­ing the games, or at least post­pon­ing them un­til we can be as­sured that ef­fec­tive Zika and dengue con­trol pro­grams have been im­ple­mented, and that ath­letes com­pet­ing in aquatic sports will not be ex­posed to sewage with its re­sis­tant bac­te­ria and risk of se­ri­ous in­fec­tion.

FELIPE DANA/AP

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