Harvard Public Health Review: Brazil Olympics should be moved or canceled due to Zika

If a new virus broke out with the potential for both serious illnesses and rapid spread through parasitic and human contact, would governments and health organizations encourage people to visit the epicenter of the outbreak? If not — and one would hope that the answer would be no — then why are governments and sports commissions planning to send a half-million people to Brazil in the middle of the Zika outbreak? The Harvard Public Health Review asked that very question, posed by University of Ottawa professor of both medicine and law Amir Attaran. “But for the Games, would anyone recommend sending an extra half a million visitors into Brazil right now?”



Brazil’s Zika problem is inconveniently not ending. The outbreak that began in the country’s northeast has reached Rio de Janeiro, where it is flourishing. Clinical studies are also mounting that Zika infection is associated not just with pediatric microcephaly and brain damage, but also adult conditions such as Guillain-Barré syndrome[1] and acute disseminated encephalomyelitis, which are debilitating and sometimes fatal.[2]

Simply put, Zika infection is more dangerous, and Brazil’s outbreak more extensive, than scientists reckoned a short time ago. Which leads to a bitter truth: the 2016 Olympic and Paralympic Games must be postponed, moved, or both, as a precautionary concession.

After reviewing the growing pathological impacts of Zika on both fetal development and on adults, Attaran wonders why anyone would encourage a deluge of potential hosts of the disease that could carry it immediately to all corners of the world:

Third, while Brazil’s Zika inevitably will spread globally — given enough time, viruses always do — it helps nobody to speed that up.[14] In particular, it cannot possibly help when an estimated 500,000 foreign tourists flock into Rio for the Games, potentially becoming infected, and returning to their homes where both local Aedes mosquitoes and sexual transmission can establish new outbreaks.[15] [16]

All it takes is one infected traveler: indeed phylogenetic and molecular clock analyses establish that Brazil’s cataclysmic outbreak stems from a single viral introduction event likely between May and December 2013.9 A few viral introductions of that kind, in a few countries, or maybe continents, would make a full-blown global health disaster. Scientists can disagree on how much the mass migration of 500,000 foreigners will accelerate the virus’s global spread and make the pandemic worse—but none can possibly argue that it will slow it down or make things better.

Fourth, when (not if) the Games speed up Zika’s spread, the already-urgent job of inventing new technologies to stop it becomes harder. Basic Zika research is already on the fast track, and with time, the odds are excellent that scientists can develop, test and prove an effective Zika vaccine, antiviral drug, insecticide, or genetically-engineered mosquito. But by spreading the virus faster and farther, the Games steal away the very thing – time – that scientists and public health professionals need to build such defenses.


Attaran then answers his basic question:

Which leads to a simple question: But for the Games, would anyone recommend sending an extra half a million visitors into Brazil right now? Of course not: mass migration into the heart of an outbreak is a public health no-brainer. And given the choice between accelerating a dangerous new disease or not—for it is impossible that Games will slow Zika down—the answer should be a no-brainer for the Olympic organizers too. Putting sentimentality aside, clearly the Rio 2016 Games must not proceed.

It might be a no-brainer, but perhaps the IOC has no brain:

Calls from a Canadian public health professor to delay the Olympics because of the Zika virus were ignored Wednesday as officials insisted the games go on.

The International Olympic Committee (IOC) said there’s no need to delay the start of the global athletic competition. The opening ceremony set to kick off in Rio in three months. …

The IOC’s medical director, Richard Budgett, said that he would continue to monitor the situation closely. But he and the IOC authorities insisted the Aug. 5-21 games would go on as planned.

If that’s amazing, it shouldn’t be. Almost a year ago, the New York Times and the Associated Press warned that the venue for the swimming and boating events suffers from pollution that makes even casual contact with the water a health hazard. The IOC turned a blind eye to that, too:


The waters where Olympians will compete in swimming and boating events next summer in South America’s first Games are rife with human sewage and present a serious health risk for athletes, as well as for visitors to this city’s famous beaches.

An investigation by The Associated Press found dangerously high levels of viruses and bacteria from sewage at the sites for the 2016 Olympic and Paralympic water sports.

The A.P. conducted four rounds of tests starting in March. The results have alarmed international experts and dismayed competitors training in Rio de Janeiro, some of whom have become ill with fevers, vomiting and diarrhea.

The ailments could prevent an athlete from competing for days.

“This is by far the worst water quality we’ve ever seen in our sailing careers,” said Ivan Bulaja, a coach for the Austrian team, which has spent months training in Guanabara Bay.

Almost a year later, nothing has changed, as Brazil’s own competitors acknowledge:

Rio de Janeiro has missed a once-in-a-lifetime chance to clean polluted Guanabara Bay, the venue for Olympic sailing, Brazil Olympic sailing legend Torben Grael said in a recent interview.

“We always hoped that having a big event like the games would help,” Grael told Canada’s CBC television. “We ourselves put a lot of pressure to make it happen, but unfortunately it didn’t happen when they had money. And now they don’t have money, and so it’s even worse.”


Another warns people to stay out of Brazil for health reasons of another kind:

With the Olympics set to begin in less than three months in Rio de Janeiro, one of Brazil’s most successful soccer players has a surprisingly ominous message for international visitors: Stay away.

Brazil is getting “more ugly,” said Rivaldo, who was on the country’s 2002 World Cup-winning squad, forming part of a lethal attacking trio with Ronaldo and Ronaldinho.

Rivaldo warned people on social media about the violence plaguing the city, citing the killing of a 17-year-old girl over the weekend.

Let’s recap. The Olympics will take place in the epicenter of a growing viral epidemic. Its venues are a health hazard, and the host city is plagued by violence profound enough that its own athletes are telling people to stay away. Attaran’s question remains, but may be better put thusly: But for the cash, would anyone recommend sending an extra half a million visitors into Brazil right now?

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