The haunting picture of the mother holding her infant who mostly cries in pain led to a new interpretation of Gaetano Donizetti’s phrase describing love. Below is the English translation.
One tear that falls so furtively
from her sweet eyes has just sprung,
as if she envied all the youths
who laughingly passes her right by.
Our congressional representatives enjoy their summer recess. Both political parties have conventioned, nominated, and vilified each other’s choices. Neither mentioned the political dysfunction they own with their respective behavior.
Meanwhile, a dangerous virus expands its reach as mosquito season advances. Zika has gained a foothold in the continental US. Health officials have concluded that local Miami mosquitoes are the likely carriers that infected four recent non-travel-related cases of Zika in Florida. Because the Senate has not passed a bill funding Zika prevention measures despite many months of partisan wrangling, the CDC is now “scrambling to come up with money” to combat Zika’s spread. (For details see http://www.bloomberg.com/news/articles/2016-07-29/florida-says-zika-cases-likely-transmitted-locally-in-u-s-first.)
Zika spreads, largely unchecked by the kind of federal preventative initiatives that would effectively limit its impact. Meanwhile the CDC estimates the cost of care for each child born with Zika-caused microcephaly to be as high as $10 million over a lifetime. (See http://www.cbsnews.com/news/the-true-cost-of-zika-in-the-u-s-could-be-staggering/.)
Let that sink in. The $1.1 billion Zika prevention bill voted down in the Senate earlier this month may represent the lifetime costs incurred for as few as 110 individuals born with microcephaly. Thirteen of these children are already with us (http://www.cdc.gov/zika/geo/pregnancy-outcomes.html). The ultimate economic cost of a rampant Zika epidemic makes the cost of doing something now look like pocket change.
The children themselves and their families matter more than dollars do. We do not know all the ways those children will be impacted – only time will tell. But the observation offered by ophthalmologist Camila Ventura, working in hard-hit Brazil, hints at what lies ahead: “The babies cannot stop crying” (https://www.washingtonpost.com/national/health-science/lifelong-care-heartaches-ahead-for-babies-born-with-zika-in-the-us/2016/07/24/2cc5e360-42d6-11e6-bc99-7d269f8719b1_story.html).
Neurological damage caused by Zika is not limited to microcephaly, as journalist Lena Sun explains, reporting from a special meeting in Atlanta convened by CDC and the American Academy of Pediatrics to develop guidelines for the care of children affected by Zika:
“In addition to microcephaly, a rare condition usually characterized by an abnormally small head and underdeveloped brain, Zika can cause neurological harm affecting vision, hearing, and muscle and bone development, research shows. The range of impairment can be vast. Some babies lack the most basic sucking reflex, which means they might never develop the ability to swallow.
“Even in babies who look ‘absolutely fine’ at birth, ongoing screening may be necessary to detect subtle changes that could signal serious problems. Abnormal movement and prolonged staring, for example, could indicate an emerging seizure disorder.” (https://www.washingtonpost.com/national/health-science/lifelong-care-heartaches-ahead-for-babies-born-with-zika-in-the-us/2016/07/24/2cc5e360-42d6-11e6-bc99-7d269f8719b1_story.html)
Even now, there are 433 pregnant women known to be infected with Zika in the 50 states, and 422 more in US territories. The numbers continue to grow (by 77 women this past week alone). What will the totals be by the time Congress reconvenes after Labor Day? What will they be when our elected representatives finally come to terms on Zika funding?
This week in the Wall Street Journal, Ron Klain, former White House Ebola response coordinator and now an external adviser to the Skoll Global Threats Fund, theorizes that Senators failed to pass legislation because they failed to grasp the magnitude of the threat posed by Zika (http://blogs.wsj.com/washwire/2016/07/25/zika-funding-what-if-political-gridlock-isnt-why-congress-hasnt-acted/ ).
But their job is to grasp it and to address a public health emergency in the making. If a two-legged enemy had set about brain-damaging our population, with a hit list in the thousands or tens of thousands and the long-term cost of that damage mounting to many billions, Congress would have thrown some funding at defense. Where is the resolve to defend our country when the tank that carries the enemy is an insect, and the enemy itself is microscopic?
Zika is a threat that dwarfs the agendas of partisan politics and politicians’ machinations, bickering, filibustering, and addiction to obstruction. The arrival of Zika in the US is not an occasion to wage a legislative skirmish over Planned Parenthood, or to hold up critical Zika prevention funding because of one. We Americans elect our representatives not to joust endlessly but to work together to govern and to protect. Partisan shenanigans have no place when the enemy is at the gate, time is of the essence, and American lives stand to be saved or squandered.
Zika is spreading not only via mosquitoes but also by sexual contact; it is carried primarily by one type of mosquito, Aedes aegypti, but also by another, Aedes albopictus, and the two together range over half the nation. Zika is already circulating locally among Florida’s mosquitoes, and a person-to-person transmission of the virus from a father to a son in Utah remains unexplained. (See http://www.forbes.com/sites/judystone/2016/07/25/while-zika-spreads-in-u-s-congress-goes-on-vacation/ and http://www.theatlantic.com/news/archive/2016/07/zika-florida/493409/.)
Fully half of the two million American women who will become pregnant in the next year live in parts of the US where Zika could become endemic if we cannot control its spread. Of those infected, up to 13% may give birth to infants devastated by microcephaly (http://www.cbsnews.com/news/the-true-cost-of-zika-in-the-u-s-could-be-staggering/).
Zika is not a bullet we can dodge entirely – that bullet is already lodged in hundreds of US babies’ developing brains – but every day that passes without concerted preventative action ensures that human tragedies multiply, along with long-term societal costs.
CDC Director Tom Frieden responded to the congressional impasse this way: “We will do the best we can to protect Americans.” But he added this caveat: “There are projects that will not happen because the funding isn’t available.” Listed below are just some of the crucial initiatives that stand to be delayed or scaled back because of congressional dysfunction. (See http://www.wsj.com/articles/zika-stalemate-hardens-as-senate-republicans-reject-new-democratic-proposal-1468362079 and http://www.theatlantic.com/politics/archive/2016/07/zika-congress-cdc/491591/.)
• A second phase of clinical trials for a Zika vaccine which could otherwise be ready in 2017 (delayed)
• A study following 10,000 pregnant women during their pregnancies and shortly after they give birth
• Adequate funding for the CDC’s emergency labs and teams to handle a surge in the number of possible cases
• Initiatives to improve diagnostic tests, so that the tests can distinguish between Zika and old dengue infections
• Initiatives to find new tools for improving mosquito control in affected areas
• Surveillance efforts in at-risk communities
The history of Congressional futzing around on Zika is damning…
• Feb. 22 – President Obama submits a request to Congress for $1.9 billion in emergency funds to fight the Zika virus – to develop a vaccine; to perform surveillance of at-risk areas; to provide accurate, readily available tests with speedy results; and to control the mosquito populations that spread the virus.
• May 17 – The Senate votes 68-29 in favor of a bipartisan $1.1 billion measure to combat Zika.
• May 18 – The House approves a $622 million Zika bill along partisan lines. (The text of that bill can be found here: https://www.congress.gov/bill/114th-congress/house-bill/5243/text.)
• June 8 – The Senate votes to go to conference with the House on the Zika bills. Subsequently, Democrats complain they are left out of conference negotiations.
• June 23 – The House approves a $1.1 billion package that includes only about $400 million in new spending – the remainder is siphoned from other health-related programs, such as the Affordable Care Act and the fight against Ebola. President Obama threatens to veto the measure if it is approved by the Senate, objecting to the Republican strategy of “robbing Peter to pay Paul.”
• June 28 – The Senate blocks the $1.1 billion bill (H.R. 2577) on a vote of 52–48 (falling short of the 60 votes needed to overcome a Democratic filibuster). Democrats argue that the bill would rob Obamacare of funding, impose new restrictions on Planned Parenthood, and provide some $800 million less than the Obama administration is seeking. Republicans counter that the $1.1 billion represents a spending level to which the Democrats had already agreed (on May 17) and assert that the bill represented an attempt to provide Zika funding in a fiscally responsible manner.
• July 14 – A cloture vote on H.R. 2577 (https://www.congress.gov/bill/114th-congress/house-bill/2577) fails, effectively deferring a vote on the bill and the funding it would have provided. (Cloture is the procedure by which the Senate places a time limit on consideration of a bill and thus ends a filibuster and moves to a vote. Three-fifths of the Senate must vote yea in order to successfully invoke cloture.) Having failed to fund Zika prevention, Congress adjourns for a seven-week summer recess (the longest recess in at least three decades, according to Roll Call). When lawmakers return in September, they’ll be in session for only about a month and then gone again until after the elections. Time for action will again be short.
H.R. 2577 is not a perfect bill, and it falls far short of what health officials believe is needed. Democrats see it as deeply flawed. But passing it (had President Obama also relented and signed it into law) would have kept the fight against Zika moving forward. Those Senators who voted against cloture – against ending the filibuster, taking a vote, and passing a funding bill before summer recess – have blood on their hands. Readers can see how their own Senators voted here: http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=114&session=2&vote=00134. Hillary Clinton’s VP pick, Tim Kaine, voted “nay,” which means he voted to delay Zika defensive measures. Sanders voted nay. One Republican voted nay – Lankford of Oklahoma. One Democrat, Donnelly of Indiana, voted yea. Florida Senator Nelson, who has actual Zika cases spreading in his state, voted nay. And Utah Senator Lee, who has a Zika death in his state, was one of the four who did not vote.
Responsibility for the impasse also falls on the legislators who crafted a bill too partisan and too parsimonious to win bipartisan support. Blood is on their hands, too.
Together the two parties have condemned additional unborn children to microcephaly. They have failed to prevent new cases of nervous system disease. And they have done a huge disservice to the United States and all of its citizens as seven long weeks of mosquito season roll by without timely and adequate national response. Mosquitoes take no summer vacations.
How long will Congress fiddle like Nero while Rome burned, as Zika devastates lives and drives economic costs to levels that makes the sums they have been fighting over look trivial by comparison? How high will the toll of Zika-related birth defects and serious illnesses rise by the time this do-nothing Congress finally lays aside partisan bickering to address a public health emergency that stands to impact many thousands?
The Senate will convene for regular session on Tuesday, September 6, when Senators will resume consideration of H.R. 2577. Over the summer recess we have the ability as citizens and voters to tell Senators on both sides of the aisle to appreciate the magnitude of the Zika threat, to consider the monumental price of doing too little too late, and to engage in soul-searching regarding their own responsibility as legislators to serve their country above all.
A final note. Not once did you hear either party convention speaker mention Zika as a national threat. Not once did either party seize a national and well-publicized opportunity to mention preventive measures or to sponsor initiatives to advance them.
The behavior of Democrats and Republicans has become shameful and disgusting. They have abandoned national interests in favor of platitudes and intense, personalized vilification of their opponents.
Meanwhile, Zika numbers and Zika personal tragedies and Zika costs are destined to rise.
Our Previous Commentaries on Zika:
“Zika Update” (July 19, 2016): http://www.cumber.com/zika-update/
“The Zika Virus and the US Congress” (May 23, 2016): http://www.cumber.com/the-zika-virus-and-the-us-congress/