What it’s like reporting on Zika for The New York Times
Global health reporter Donald G. McNeil Jr. tracks the Zika epidemic in a new book on the disease, the outbreak and the (occasionally baffling) response
Donald G. McNeil Jr. (@donaldgmcneiljr) is a global health reporter for The New York Times who has covered plagues and pestilences from bird flu to Zika. His new book, Zika: The Emerging Epidemic, is the first definitive account of the virus’ origins.
On Sept. 8, McNeil answered questions during an exclusive Q&A with our community of over a million healthcare professionals. You can read the full discussion on Figure 1.
“Protecting babies is everyone’s responsibility.”
When one nursing student asked McNeil what everyone should know about the virus, he pointed to one of the most vulnerable populations of all:
“[Zika] is mild for almost everyone but utterly devastating for babies, and protecting babies — including other people’s babies — is everyone’s responsibility.”
While many patients with Zika have experienced little to no symptoms, the CDC officially announced that infection from the virus during pregnancy can cause microcephaly (an abnormal smallness of the head) in babies.
During McNeil’s Q&A session, one family medicine physician wanted to know why the incidence of microcephaly seems higher in Brazil compared to other countries in Africa and Asia with a longer history of Zika.
McNeil ventured that, because the virus has circulated for a longer time in those countries, women were more likely to be infected by the virus at a young age. This means that they would be immune to Zika during their child-bearing years.
But McNeil said that this could also be an issue of visibility: “[I think microcephaly] was noticed in Brazil because even the poorest Brazilian women tend to give birth in hospitals. When women give birth at home [in lower income countries], severely deformed babies may die — or may be hidden from the world. But this is a guess.”
Related article: “Can you tell Zika from dengue fever?”»
“Now, what I find completely baffling …”
Some of McNeil’s most pointed comments were aimed at public health authorities — and specifically their reluctance to clearly advise women in affected regions to delay pregnancy.
Now, what I find completely baffling is that neither the C.D.C. or the W.H.O. will loudly and clearly — but gently — suggest to women that they avoid pregnancy — if they can — during the high-transmission season. It seems so obvious. No nation — including ours, has stopped mosquito transmission. No person, no matter how highly motivated, can avoid mosquito bites for nine months. There is no vaccine and won’t be for quite a while, probably years. It’s the only sure-fire way to avoid damage or death to a child, and possibly a lifetime of caring for that child. We’re not talking about the government ordering women to do anything. And I’ve heard all the arguments about 50 percent of all pregnancies being unplanned (I’m suspicious of that one) and some being the result of rape and incest (I realize that). And I know some older women have only one last chance, perhaps. But for women who have a choice, why are public health authorities not suggesting it? They are very much moving to make it possible. The CDC is moving hundreds of thousands of doses of birth control pills, IUDs, nuva rings, etc. to Puerto Rico. But they won’t speak up and say “Here’s why we’re helping you avoid pregnancy at this time.”
Are northern U.S. states prepared for a possible outbreak?
According to the CDC, Florida is the only U.S. state reporting locally acquired cases of Zika. But several travel-acquired cases have been reported as north as New York. One registered nurse asked whether northern populations were adequately prepared for a possible outbreak.
In response, McNeil said that he doesn’t think the preparedness is adequate anywhere and that,
“I’m still shocked by how often I meet or hear of pregnant women who seem unconcerned. But in cold climates, you can’t do much but tell people to be careful whom they sleep with. And that’s good advice at all times.”
