Olympics should move or be postponed because of Zika, doctors say

More than 100 prominent physicians, bioethicists and scientists from around the world posted a letter Friday urging WHO Director-General Margaret Chan to exert pressure on Olympic authorities to move the Olympics from Rio de Janeiro or delay the games because of public health concerns over the Zika virus.

Brazil, which is hosting the Olympics and the Paralympics, is at the epicenter of the rapidly evolving mosquito-borne epidemic.

The letter is signed by 150 individuals from more than a dozen countries, including Brazil, Japan, Israel, Russia, Sweden, South Africa and the United States. It calls on WHO to convene an independent group to advise it and the International Olympic Committee, and for authorities to reconsider the decision to hold the Games in Rio.

“We are doing it to ask for an open, transparent discussion of the risks of holding the Olympics as planned in Brazil,” said Arthur Caplan, a bioethicist at New York University and one of the letter’s four authors, in an email explaining the reasoning behind the letter.

The group of scientists is not seeking “general assurance” from WHO, Caplan said. Instead, they want “a frank discussion among independent experts,” he said.

“If Rio is going to happen, the world deserves a full discussion of why and at what potential risks and liabilities,” Caplan said.

The other authors are Lee Igel, an associate professor at New York University; Amir Attaran, a biologist and law professor at the University of Ottawa; and Christopher Gaffney, a senior research fellow at the University of Zurich who studies the impact of major sporting events on urban populations.

Each author has published articles in recent weeks and months calling for the Games to be postponed because of Zika.

In the open letter posted Friday on Twitter and Facebook, the authors said evidence shows that Brazil’s Zika strain has more serious medical consequences than researchers previously knew, that Rio de Janeiro is one of the hardest hit areas of the epidemic, and that Rio’s mosquito-killing efforts are not meeting expectations.

Zika infections during pregnancy can cause serious fetal brain abnormalities, including microcephaly, which is characterized by abnormally small heads and severe developmental problems. The virus has also been linked to neurological disorders in adults. Zika is primarily transmitted through mosquitoes but can also spread through sexual contact.

In the most recent letter, the authors say that Rio’s public health system is so “severely weakened” as to make a last-minute push against the mosquito that transmits Zika impossible. Citing government data, the letter notes the increasing number of cases of dengue, a related virus spread by the same mosquitoes, that is considered a proxy for Zika.

In the specific neighborhood of the Olympic Park, Barra da Tijuca, there have been more dengue cases in the first quarter of 2016 than in all of 2015, the letter said.

“It is therefore imperative that WHO conducts a fresh, evidence-based assessment of Zika and the Games, and its recommendations for travelers,” the letter said. “Given the public health and ethical consequences, not doing so is irresponsible.”

The IOC insists the Games will go forward as planned. Earlier this month, WHO urged athletes and travelers planning to attend the competitions to take measures to protect against infection, but it did not call for the Olympics, which start Aug. 5, or the Paralympics, which begin Sept. 7, to be canceled or postponed.

U.S. Olympic Committee officials have said the decision to attend the Games is up to individual athletes.

The authors say the estimated 500,000 foreign tourists from all over the world who are expected to attend the Games represent an unnecessary risk because they could potentially get infected and return home to places where the virus can become endemic.

“Should that happen to poor, as-yet unaffected places (e.g., most of South Asia and Africa) the suffering can be great,” the authors wrote. “It is unethical to run the risk, just for Games that could proceed anyway, if postponed and/or moved.”

U.S. health officials disagree with that assessment.

In an interview this week, Tom Frieden, the director of the Centers for Disease Control and Prevention, said: “We don’t see from a public health standpoint any reason to cancel the Olympics.”

“There’s been some claims that if the Olympics happen, it’s going to disseminate the virus everywhere, it’s going to amplify it,” Frieden said. “Well, we looked at the numbers. The Olympics account for less than one quarter of 1 percent of all travel to Zika-affected areas.”

Frieden has said the risk to Olympians is “very, very low.” About 100 athletes, coaches and staff of the U.S. Olympic delegation are already being monitored for the virus as they begin to go to Brazil; up to 1,000 are expected to be monitored as the Olympics and Paralympics begin.

He said it was unfortunate that Major League Baseball recently decided to scrap a two-game series in Puerto Rico and move it to Miami amid concerns over the Zika virus.

CDC and health officials across the globe have advised women who are pregnant to avoid traveling to regions where Zika is prevalent, and they have advised women who are trying to become pregnant, and their male partners, to use condoms or abstain from sex during their stay for months after and after returning home.

The CDC is also conducting a risk assessment for each of the approximately 180 countries with athlete delegations. More than 10,500 athletes are expected at the Olympics and about 4,350 are likely to be at the Paralympics. Analysts are looking at the expected number of athletes and travelers likely to go to Brazil, the susceptibility of those countries to epidemic diseases, and the potential for how added travel might accelerate the spread of Zika.

But in Friday’s letter, the authors say the many uncertainties about Zika “currently make it impossible for mathematical models to predict the epidemic’s course accurately.”

This story was originally published May 27, 2016 at 7:22 PM with the headline "Olympics should move or be postponed because of Zika, doctors say."