With the Zika outbreak in the Americas raging and the growth of scientific support about potential birth defects from maternal infection, some in public health have called for the 2016 Summer Olympics in Rio to be postponed or moved. As a fellow public health researcher and a pregnant Olympian swimmer and silver medalist at the 2004 Olympics in Athens, I have a close-up perspective on both sides of this issue and believe this opinion does not balance the risks appropriately.
Importantly, there simply isn't enough evidence at this point to support a large-scale, intrusive public health action that will devastate so many people. While Zika can cause severe outcomes in some, the vast majority of people who are infected will not experience symptoms. Newly emerging scientific evidence has shown clear connection between Zika and birth defects, but there are simple protective actions that can be taken to reduce the risk of infection. Often, decision makers justify extreme public health interventions "out of an abundance of caution" and a desire to remove all risk from a situation. But these arguments overlook any real consideration of the costs of taking these unwarranted actions, which are often high for those people who are affected by them.
To be sure, Zika is a scary disease that can cause serious illness, birth defects or fetal death. However, there are greater health risks that people face every day, much less when they travel to the Olympics. About 40,000 people die every year on Brazil's roads. Should we ban all athletes and fans from using motorized transportation? Although theories on how people perceive risk support the idea that people are more concerned about Zika than other risks, because of its potential threat to unborn children, we've never canceled the Olympics for rubella before, which can also cause severe birth defects.
Furthermore, arguments about the potential for the Olympics to act as a catalyst for global spread of the disease fail to take into consideration that infected travelers have already and will continue to exit the continent at a rapid rate in our globally connected world — this barrier has likely already been broken thousands of times over. This disease will travel, regardless of the Olympics, which doesn't represent a significant amount of the travel to Zika affected areas. However, infected individuals can't just transmit the disease to anyone they encounter — they would need to transmit the disease through unsafe sex or be bitten by a mosquito able to transmit the disease (only a few species can, and their range is limited), which would have to then bite another person.
For those who have experienced the games, it is clear that moving them on this short notice would be impossible (planning a quality event of this magnitude takes years) and would strike an unnecessary blow to Brazil's economy. Delaying the games would mean that a whole generation of elite athletes would have their hearts broken and their Olympic dreams tossed aside. It's not just a game to them. When I was training for the Olympics as a swimmer, it was part of who I was as a person, had shaped my life choices for years and was how I made a living. Alterations to training schedules can make a huge impact on who makes the team and who stays home. Once your chance is lost, it is often lost forever. When I went to the Athens games, there were concerns about terrorism, but I felt this was a risk I could safely take, and it was. These athletes have poured their hearts and souls into their training — they can make their own choices about the risks they take.
There are reasonable precautions to take during this Zika outbreak, many of which are underway. For instance, it's a good idea for pregnant women to abide by CDC recommendations and skip the games. Very few athletes will be pregnant at the games, but if female athletes are concerned about the potential to become pregnant, the IOC should offer a range of birth control options that can be used before, during and after the games. Men should have increased access to condoms as well, to prevent sexual transmission during and after the games. Mosquito repellent and advice on use should be provided to every athlete and attendee. Mosquito control activities should continue to be implemented at the venues.
Zika has the potential to cause serious illness, but it requires nuanced public health approaches rather than blanket actions that do little to balance risks and benefits.
Tara Kirk Sell is an Olympic swimmer and associate at the UPMC Center for Health Security in Baltimore. Her email is firstname.lastname@example.org.