Medical Examiner

Olympians Should Still Go to Rio

The risk of Zika is not big enough to warrant skipping the games.

Gymnast Gabby Douglas competes on Saturday in Hartford, Connecticut.
Gymnast Gabby Douglas competes on Saturday in Hartford, Connecticut. Douglas is setting a brave example by vowing to attend the Rio Olympics despite the threat of Zika.

Maddie Meyer/Getty Images

When Muhammad Ali, Olympic and World Champion and the greatest boxer in the history of the sport, overcame the profound tremors of Parkinsonism to light the Olympic flame 20 years ago in Atlanta, he went beyond the brave spirit that has come to symbolize the Olympics. Muhammad Ali died this past weekend, and we owe it to his memory to recall this message of courage both inside and outside the boxing ring. “He who is not courageous enough to take risks will accomplish nothing in life,” he once wisely said.

This is why it so disturbing to hear that NBA basketball star Pau Gasol and other athletes are considering not coming to Rio for this summer’s Olympic games because of the risk of Zika. Our athletes are role models, and Gasol and others are spreading outsized fear over the mosquito-harbored virus. While Zika is a serious disease that we should closely track, it is also one that has received outsized attention, given the relatively low risk it poses. And it is almost certainly not a reason to reschedule or move the Olympics away from Rio. Top health officials—including public health experts Dr. Anthony Fauci of the National Institutes of Health and Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, along with officials at the World Health Organization—tell us that Zika spread around the globe is not expected to be altered by the Olympics. The games should continue as planned.

Don’t get me wrong, I can understand why American cyclist Tejay van Garderen is withdrawing because his wife is currently pregnant. There is a theoretical if remote risk that he could become infected via a Brazilian mosquito and transmit it to her. He should also know that the risk of Zika causing birth defects appears to be far greater early in pregnancy and the risk of spreading Zika sexually appears to be quite rare. In fact, the regular and proper use of a condom should completely prevent it. But given everything we’ve seen so far about how people react to Zika, I am concerned that van Garderen’s decision will spread more hysteria than responsible concern. Overcoming viral fears means focusing on what the real risks of an emerging disease are. In the case of Zika, everything we currently know suggests they are relatively small.

Zika poses the highest risk for people who are either pregnant or actively attempting to get pregnant. Anyone else should take the advice of Olympic gymnast Gabby Douglas, who told the Associated Press on Friday, “It’s the Olympics. Mosquitoes? Like, whatever. I’m going. This is my shot. I don’t care about no stupid bugs.” For healthy, nonreproducing people, Zika poses little threat—most people won’t even experience symptoms, and risk of death is very low.

Even better than following Douglas’ lead would be to take inspiration from the 10 athletes from around the world who will make up the first ever refugee team at the Olympics. The worldwide refugee problem has spurred a public health crisis involving global killers such as tuberculosis. A deadly disease that can be spread simply by coughing, tuberculosis causes 1.5 million deaths worldwide per year, according to the CDC. As far as total impact, it is far more damaging than Zika, and yet it is the latter that is currently receiving the most attention. Perhaps we would be wise to use the refugee team to spur our interest in the growing TB problem among refugees instead of continuing to obsess about Zika.

Remember, mosquitoes are a rate-limiting barrier to the spread of Zika. Eradicate the Aedes aegypti mosquito in a region, and you stop the virus in its tracks. The South and Southwestern U.S. don’t have near the mosquito control problem that Brazil and the Caribbean have. It is true that the Aedes aegypti mosquito is found here, and breeds on very small amounts of water and bites aggressively during the daytime. But the risk of a sustained outbreak is remote. In Houston, attempts are being made to collect abandoned tires and drain standing water. In Florida, Rui-De Xue, director of the Anastasia Mosquito Control District, said that he thinks the risk of sustained spread of Zika is low because there are relatively few of this type of mosquito left since the 1990s and plus they “have launched an eradication program for several months by street-by-street and door-by-door inspection.” Since Zika has already been found in Asia and originated in Africa (and there have been previous outbreaks in both places), travel to and from Brazil is not going to change that equation appreciably for people coming from these areas.   

Still, prevalent or not, mosquitoes scare us as vectors of disease, and they should. But we should be more wary of the other diseases they carry. Dengue fever infects close to 400 million people yearly via the same mosquito, and malaria, 214 million via the Anopheles mosquito. Both diseases make people far sicker, and malaria kills half a million yearly. Yet it is Zika that scares us the most because it is new, much as West Nile virus scared us more than a decade ago when it first began to appear.

We are scared mostly because of the annoying buzzing sound, because mosquitoes are so tiny we can’t get them before they get us, and because they may carry an invisible virus that can impact our lives. We are right to be concerned about any disease that can infect and damage the brains of our unborn babies, our most vulnerable, our precious future. But our fears dilate whenever we don’t know the exact risk. How many pregnant women are infected by a virus that only causes symptoms 20 percent of the time, and how many of these fetuses will become afflicted by exposure to Zika? We don’t know. Instead, we talk about every young woman as though she has a pregnancy about to happen (even though most women can control the if and when of becoming pregnant), and we wrongly imagine that any pregnancy in a Zika-affected area will almost certainly end in birth defects.

We should channel our fears into worldwide mosquito control and disease prevention, and we should lobby Congress to approve at least $1 billion to that end and also to accelerate NIH vaccine development, which is at least a year away at this point. A vaccine is a great public health tool in the fight not only against a virus but also the spreading fear of that virus. Of course the primary tool against irrational fear is not information but courage—which is what we can find in Olympians like Douglas, and is certainly what we find so enduring about Ali’s commitment to light the torch for all to see.

Read more Slate coverage of the Zika virus.