The spread of the Zika virus, a growing medical threat through much of the Americas, demands “urgent action” from regional governments to help control the potential economic damage an epidemic could cause, according to the World Bank and other institutions.
The international financial group aimed at decreasing poverty and urging economic growth among poorer populations has predicted that even with an immediate coordinated effort, costs likely will hit US$3.5 billion in the Caribbean and Latin America this year in prevention and medical-care expenses.
Beyond that, visitor-dependent economies could lose billions more in tourist revenue as North Americans and Europeans shy away from what they may perceive as a danger zone.
Without a well coordinated response to nip any epidemic in the bud, World Bank President Jim Yong Kim said, the economic damage could smack the region with far greater costs.
In fact, the World Bank computed that countries where the cases of the virus have been confirmed or where it is expected to spread could suffer a $63.9 billion drop in international tourism as travelers reconsider visiting places with high Zika risk.
The $3.5 billion figure represents less than 0.1 percent of the region’s Gross Domestic Product. But the higher figure totals almost a full 1 percent of GDP, if the World Bank figures are accurate. A tourism shortfall of $11 billion is estimated as the share of lost visitor revenue the Caribbean region alone might suffer.
World Bank commitment
Whatever the extent of any future health crisis, Kim said in February, “The World Bank stands ready to support the countries affected.”
The institution has committed US$150 million to help countries combat the burgeoning mosquito-borne virus that has been linked to skin rashes and influenza-like symptoms including fever and joint pain, perhaps weeks of illness for those infected, and, most dreadful, possibly grave birth defects among children of women who become infected during early pregnancy.
Chief among the defects thought to be a consequence to the newborns of infected mothers is microcephaly (a fatal or severely crippling malformation of the baby’s head) as well as other neurological disorders, including Guillain-Barre syndrome.
The U.S. Centers for Disease Control and Prevention currently has medical teams in Brazil, where the possible link between birth defects and Zika surfaced, examining the evidence. For now there is no vaccine against Zika, nor any treatment. Plus, infections frequently go undetected since the antibody test is far from perfect.
The World Health Organization, which has been researching the consequences of Zika and the implications of a pandemic, said the region’s vulnerability meets the conditions for a “Public Health Emergency of International Concern.”
That’s because transmission of the virus from one host to another comes courtesy of an ancient human enemy, one that also transmits other pathogens, including malaria and dengue fever – the mosquito. The moist climate that prevails from the Southeast United States, across parts of Mexico and the Caribbean and through much of Central and South America is just right for these buzzing, biting insects. Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito, the same mosquitoes that spread dengue and chikungunya viruses.
No travel restrictions – yet
An emergency committee convened by the WHO saw no reason at this time to restrict travel or trade to prevent the spread of Zika virus, but restrictions could emerge if infections in Caribbean and Latin American destinations get out of hand, according to the international organization.
“If an epidemic got to the point where groups were issuing warnings or restrictions to travel, you could consider that the economic cost of any virus outbreak might skyrocket,” a spokeswoman for the CDC said. “Caribbean nations, especially, are highly dependent economically on tourism.”
News of the disease’s spread has tourism departments concerned. Siegfried Victorina, Curacao’s minister of public health, reported that over three weeks in February, the island’s incidence of Zika infection rose from four cases to 35. None of the ill were pregnant women, Victorina noted. But the rapid proportional increase suggests there could be many more cases in short order.
“Consider that there is a growing pool of people in a tight geographic region, an island, who are infected,” explained Mexican epidemiologist Dr. Carlos Ruiz. “They bear the virus in their bloodstream. Mosquitos bite them and then move on to other, not-yet-infected people. And so it spreads.
“That’s how an epidemic gets rolling,” Ruiz said in an email exchange. “So if it gets a foothold in the islands, soon many people may have this infection. That’s the arc of an epidemic. As the word gets out, people in Canada or the U.K. or the U.S. question whether to go to that island for a vacation.”
The WHO in recent weeks has issued travel warnings for 25 countries, including Brazil, site of the 2016 Summer Olympics. With all of this in play, it is no surprise that Dr. Margaret Chan, director-general of WHO, said Zika had progressed from “a mild threat to one of alarming proportions.”
Week by week, more and more potential travelers in the Western Hemisphere have become aware of possible dangers of infection. Some athletes and sports fans worldwide have gone on record saying they might forgo the 2016 Olympic Summer Games in Brazil, which has recorded the greatest numbers of infections.
The WHO warns that every nation in the hemisphere will confront Zika victims over time. Mosquitos are not solely creatures of the rain forest. A Chicago resident can get a mosquito bite in Costa Rica and then carry the infection home.
In the U.S., states along the southern border have been the most hard-hit in North America. At the end of February, Florida’s total was approaching 30, all among people who had traveled abroad within the hemisphere.
In late January, U.S. health officials brought President Barack Obama up to date on the virus and its potency. A White House statement said, “The President was briefed on the potential economic and developmental impacts of the Zika virus spreading in the Western Hemisphere.” Clearly, world leaders are taking the illness seriously.
In February, Obama requested more than $1.8 billion in emergency funding from Congress to fight an outbreak of the virus.
Nonprofit aid organizations, including the Red Cross, have committed millions to research, efforts to eradicate mosquitos, treatment and community education to help spread information about protection from the virus.
The message at large: travelers beware
Virtually everywhere Zika has surfaced, government sources and health activists have been distributing information on how to avoid becoming a victim. Mostly, it includes this advice:
- Cover exposed skin by wearing long-sleeve shirts, long pants and hats.
- Use an appropriate insect repellent, including DEET, Picaridin, Bayrepel and icaridin, oil of lemon eucalyptus or IR3535.
- Use permethrin-treated clothing and gear, including boots, pants, socks, and tents (do not use permethrin directly on skin).
- Stay and sleep in air-conditioned or screened rooms.
- Sleep under a net if you are exposed to the outdoors.
- Use insect repellent that contains 20 percent or more DEET for protection that lasts up to several hours.
- Empty, clean or cover containers that can hold water, such as buckets, flower pots or tires, places mosquitoes can breed.
- Also, since researchers have new evidence that Zika can spread via sexual contact, travelers should use precautions in that regard too.
None of those are terribly expensive protections, but they are reminders of a considerable risk and could influence eager holiday seekers to make different plans.
Airlines on board
Airlines are also responding to the anxiety some flyers feel about travel. United Airlines said it would refund or waive the extra fees customers pay to change their flights to Zika-affected areas. American Airlines offered a more limited response.
NBC News reported that an American Airlines spokesperson said, “We will allow a customer to receive a refund if they provide a doctor’s note stating that they are unable to travel to one of the following cities due to their pregnancy; San Salvador, San Pedro Sula, Tegucigalpa, Panama City, Guatemala City.”
In addition, Grupo LATAM, Latin America’s largest airline, said it would not charge pregnant travelers for cancellation or flight-change fees for travel to affected countries.
None of the airlines agreed to share estimates of how much these new policies would cost them, but they are by no means free to the carriers and are considered a new cost of doing business.
Meanwhile, the CDC issued and has continued to update a list of nations pregnant women should avoid visiting because of Zika outbreaks. Here’s the list:
In the Caribbean: Aruba, Barbados, Bonaire, Curaçao, Dominican Republic, Guadeloupe, Haiti, Jamaica, Martinique, Puerto Rico, St. Martin, U.S. Virgin Islands
In Central America: Mexico, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
In South America: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Paraguay, Suriname, Venezuela.
Paying the local freight
Caribbean and Latin American governments are now struggling to put measures in place to eradicate mosquitos and prepare their medical facilities for treatment – and possible quarantine – of increasing numbers of infected residents and visitors. The one thing they agree on is that it is too early to set aside sufficient financing for such an effort.
A policy statement from the Ministry of Health in Barbados said government workers were fumigating mosquito breeding grounds and cleaning up pockets of stagnant water as well as offering medical support to anyone who fears infection.
In Kingston, the Jamaican minister of health, Horace Dalley, made public a long list of responses the government has instituted to protect citizens and visitors from Zika.
“We have heightened our fever and rash surveillance in the area and the entire country,” Dalley said.
On a recent Saturday, workers visited 1,894 households near an infection site for “fever surveillance and interviews” and to enhance public awareness.
Beyond that, “A fogging blitz began in the community on the same night that the results were received. This means fogging for three consecutive nights and repeating this weekly for the next three weeks.”
Moreover, Jamaica has set up an island-wide surveillance system to monitor all fever and rash cases, neurological syndromes and congenital malformations that could suggest infection by the Zika virus. Such widespread vigilance – along with support the nation has sought from the Caribbean Public Health Agency, the CDC and WHO and its Pan-American counterpart, PAHO – is a vital national service, the health ministry said.
The U.S. Virgin Islands Department of Health, too, notes it is working with world-class health consultants on ways to minimize mosquito habitat and identify and isolate any Zika outbreaks as quickly as possible. “The stakes are high,” a communiqué from the health department said.
Since the first news broke of the Zika virus’s dangers, Dr. Samuel Williams-Rodriguez, the Cayman Islands acting medical officer of health, has made information available on the government website.
By late February, there still had been no reported Zika infection in the Cayman Islands, perhaps a credit to its long-standing mosquito-eradication program.