We open this commentary with a link to a column by Nicholas Kristof entitled, “However Much Trump Spends on Arms, We Can’t Bomb Ebola”: https://www.nytimes.com/2017/03/02/opinion/however-much-trump-spends-on-arms-we-cant-bomb-ebola.html.
We can’t bomb Zika, either.
We continue to track all types of shock risks, including Zika. Right now I am traveling to three places in South America. All meetings are private.
As budget priorities are realigned by the Trump administration, we continue to track non-military shock risks. Years ago I chaired a worldwide dialogue on food, water, and health that took two years to complete and involved five continents. The Global Interdependence Center was the convening organization, and its policy position is simply to convene a neutral forum for dialogue.
Lessons learned during that multiyear study suggest that Kristof’s warnings have validity.
Now here is an update on Zika. I’ll be back in the US on March 12. Between meetings I will try to say hello to a friendly Patagonian rainbow trout.
We last reported on the Zika situation back in early October 2016, (see www.cumber.com/zika-cuba-american-politics). In the US and its territories at that point, the number of pregnant women who had been positively diagnosed as carriers of the Zika virus was 2298. Now – in spite of the fact that we have been in the “off” season for mosquitoes that carry the virus – the number stands at 4759, a 107% increase. And the total number of US citizens infected with Zika has grown from 25,694 to 43,380, an increase of 69%. (All current figures are as of Feb. 21; data from the Centers for Disease Control [CDC].)
Most critically, the number of babies born with microcephaly and/or other birth defects in the continental US has climbed from 21 last September to 47 now (counting only live births). (Data on Zika-related birth defects in Puerto Rico was hard to come by last October and remains so. All we could turn up was an August 2016 estimate by US health experts that as many as 270 babies in Puerto Rico might be born with microcephaly. That estimate was developed at the point when the number of Zika cases in pregnant Puerto Rico women was only about 60% of what it is today.)
But along with the alarming increases in Zika statistics in the past half year, there have been important advances in our understanding of Zika.
First, researchers have learned that babies born with Zika often suffer not only microcephaly but a whole range of devastating birth defects, including decreased brain tissue; damage to the back of the eye; joints with limited range of motion, such as clubfoot, and excessive muscle tone, restricting movement soon after birth. This pattern is now referred to as congenital Zika syndrome, (see www.washingtonpost.com/news/to-your-health/wp/2016/11/03/congenital-zika-syndrome).
More is now known about pregnancy outcomes, too. It had previously been estimated that between 1% and 13% of pregnant women infected with Zika in the first trimester would have babies with birth defects. In January, a report published in the Journal of the American Medical Association (JAMA) brought that number into better focus, (see www.jamanetwork.com/journals/jama/fullarticle/2593702). Of 442 Zika-infected women who completed their pregnancies between January and September, 2016, 6% delivered babies with one or more Zika-related birth defects. But among women infected during the first trimester, 11% had fetuses or infants with birth defects. CDC officials said the findings show that the rate of fetal abnormalities related to Zika among these babies born in the United States is similar to the rate in Brazil, the epicenter of the Zika outbreak.
“This basically puts to rest speculation that Brazil was different in some way,” CDC Director Tom Frieden said in a January interview.
There is also new evidence that Zika can be transmitted not just by two species of mosquitoes, as had been thought, but rather by as many as 35 species, including 7 found in the continental US (www.miamiherald.com/news/health-care/article135414359.html).
We are approaching mosquito season again. How prepared are we? If the Trump administration shifts its budgetary focus from babies to bombs, how many more families will suffer the unnecessary trauma and expense of bearing, raising, and supporting Zika-damaged children for their entire lives?
In a January 18, 2017 report in Scientific American (“Trump’s CDC May Face Serious Hurdles”: www.scientificamerican.com/article/trump-rsquo-s-cdc-may-face-serious-hurdles/), outgoing CDC director Tom Frieden stated, “There’s a need to establish a rapid-response fund for emergencies that has both dollars and emergency authority. It’s a big problem that when there is an emerging threat, we are not able to surge as rapidly or work as rapidly as we should, because of lack of money and legislative authority.”
Specifically, a repeal of the Affordable Care Act appears likely to eliminate the CDC’s Prevention and Public Health Fund and cost the agency nearly $1 billion a year, or about 12 percent of its annual budget. “Zika is the first predictable problem,” Frieden explained. “Zika is not over. It is likely to spread in Latin America and the Caribbean for months and years to come, and we still don’t fully understand the range of birth defects it causes.”
Our military, however armed to the teeth, can’t bomb Ebola. Homeland Security can’t deport it. Effective disease control requires funding, extensive data gathering by a well-equipped and staffed CDC, and a timely, nimble, far-reaching response. These hard facts have held predictably true for Zika and remain unforgivingly true whenever and wherever a health threat jeopardizes the wellbeing of American families and ultimately the economic health of the nation.