
As Zika virus spreads, El Salvador asks women not to get pregnant until 2018 - muriithi
https://www.washingtonpost.com/world/the_americas/as-zika-virus-spreads-el-salvador-asks-women-not-to-get-pregnant-until-2018/2016/01/22/1dc2dadc-c11f-11e5-98c8-7fab78677d51_story.html?tid=pm_world_pop_b
======
geertj
Terrifying. Doing some quick back of the envelope calculations: 1,000,000
people in Brazil got the virus, and there are 4,000 cases of microcephaly.
Let's assume that most of these are caused by the virus (pre-virus level of
microcephaly were very low) and assume half of the people are women. Also
assume roughly two pregnancies over a women's life, and an average life
expectancy of 73 years.

This would mean that of the 500,000 women that got the virus, roughly 2% of
these women were pregnant while getting the virus, which equates to 10,000
women, resulting in 4,000 cases of microcephaly. This would be a 40% chance of
microcephaly when a woman catches the virus during pregnancy. That is absurdly
high for a virus that is starting to become (or already is) an epidemic.

There's many assumptions in the calculation and I'm sure the medical
profession has much better numbers. As I said it's a back of the envelope. But
even if the chances are 20% or 10%, that is still extremely high and worrying.
The recommendation not to get pregnant in countries where the virus is active
suddenly makes sense.

~~~
aikah
> The recommendation not to get pregnant in countries where the virus is
> active suddenly makes sense

How is one going to implement such a policy ? one can't make people stop
having sex and AFAIK El Salvador is very religious (no abortions...) and poor
(no contraceptives ...). This epidemic concerns the whole world IMHO and we
should put a maximum of resources into finding a cure or a vaccine (if none
exist yet) ASAP. Now i'm even hearing that this virus might be a STD ...
scary.

~~~
snegu
It's not a policy, it's a recommendation. Women can do with it what they will.

~~~
meagain20000
Indeed. Hope the government educates them at least on how to prevent pregnancy
and also provides the resources.

In reality man should also be educated and provided with lots of condoms.

~~~
gpvos
It's going to be really interesting to see the response of the RC church to
this.

~~~
Karunamon
Well, they don't have any problem with correcting hereditary problems in the
womb[1], and it appears okay to straight up not have kids if you know you have
a problem that's going to affect the fetus as well[2].

What they absolutely aren't okay with is finding out the child has
microcephaly, and aborting as a result.

It's my own personal read on canon law that giving birth in such an
environment, to the point where the civil authorities are saying "please
don't", would present an unacceptable risk to the child, and thus be immoral,
and thus be a sin.

[1]: [http://catholicstraightanswers.com/what-is-the-churchs-
posit...](http://catholicstraightanswers.com/what-is-the-churchs-position-on-
prenatal-diagnosis-and-fetal-research/)

[2]:
[http://www2.loras.edu/~CatholicHE/Arch/Sexuality/Genetic_dis...](http://www2.loras.edu/~CatholicHE/Arch/Sexuality/Genetic_dis_comment.html)

Don't expect a sudden 180 on birth control. The advice for people will be to
abstain.

~~~
knughit
>The advice for people will be to abstain.

Which is a well-proven failed strategy.

~~~
Karunamon
Tangent, and not a particularly religious one:

Why does sex seem to get a pass for "you can't control your biological
impulses" when other drives don't?

\- We're driven to eat as well, and have a growing problem with obesity. At
least, when you eat too much, you're only harming yourself. Yet, we (the
society "we") tut at the obese, in some cases make fun of them. "Why can't you
control yourself?" we say. "Put down the fork!" says another.

\- We have a drive to be social, yet humans are pretty well controlled when it
comes to expressing that drive at the wrong times in the wrong places.

\- It's expected to be protective of your family, but in another time, that
would have meant meting out lethal punishment to an interloper. Now, doing
that lands you a prison sentence.

Without moralizing on any of this:

The drive to reproduce, we somehow don't expect people to stop screwing when
it's likely that doing so will have _really awful_ consequences for a
perfectly innocent life. Either now, in the case of a virus causing congenital
defects, or in other cases, such as not being able to support a child. We
throw our hands up, say "welp, abstience doesn't work, knock yourselves out",
and try to work around the problem with birth control (something which still
has a <100% chance of stopping unwanted births)

Why is this? Surrender to the implacable force of human nature doesn't seem to
be the answer, seeing as how we've at least partially tamed most other
impulses, or at least refused to give up.

~~~
rsanders
Sex isn't just a biological impulse. Many couples feel that it's important to
their bond. One might respond more reductively with "why does the biological
need for oxytocin to maintain intimacy get a pass" or somesuch, but the fact
is that sex is never something that our evolution needed to control or limit.
Having _some_ sex is absolutely necessary for the species to survive. You're
comparing that with maladaptive behaviors, whereas it's the exact opposite.
You might as well expect people not to eat at all.

~~~
Karunamon
Reproducing when the result will end up in a damaged child, or one you can't
support, isn't maladaptive?

This is what I mean - we can obviously prioritize our needs and put a lid on
biological drives when social needs demand for, pretty much everything else.
Why is it so strange to expect that same restraint when it comes to sex?

------
navaati
This, on top of all the other mosquito-born diseases, may finally convince the
authorities/ethical commitees/whoever has the decision power to use this
CRISPR specie-killing scheme talked about some time ago. It's scary, but it's
badly needed. Because as sibling comment said, asking people not to get
pregnant will never work, anytime anywhere in the world.

~~~
bayesianhorse
Asking people to delay pregnancies will reduce some of the burden.

I don't think the mosquito-killing gene editing technology is ready for
deployment yet...

~~~
sandworm101
>> mosquito-killing gene editing technology.

That cannot be allowed to be a thing. Mosquitoes fill an important niche in a
great many ecologies. Any society capable of creating such a thing will surely
be able to create a vaccine or treatment. That is where energies should be
focused.

~~~
ak217
> Mosquitoes fill an important niche in a great many ecologies.

Source please. I am not aware of any study that confirms this statement. See
also
[http://www.nature.com/news/2010/100721/full/466432a.html](http://www.nature.com/news/2010/100721/full/466432a.html).

~~~
sandworm101
Go to the north. Wait. Wait until the sky darkens and you are afraid to
venture outside. Then say that mosquitoes don't matter. There is some evidence
that they consume more caribou, by weight, than the wolves.

~~~
ak217
So you don't have a source?

I went to grad school with a lot of ecologists (not an ecologist myself). I've
seen countless presentations about anthropogenic threats to all kinds of
ecosystems. I've never seen anything that included mosquitoes as anything but
a disease vector, and I've heard numerous opinions saying that mosquitoes are
the one class of animal whose absence would not be noticed by the ecosystem.
To back that claim up, I have the micro-review in Nature that I linked above.
You can find more sources by following the citation web from it.

Gene drives are certainly a powerful and dangerous technology. But if you want
to argue against using a gene drive on mosquitoes from a scientific
standpoint, you need to present scientific evidence.

~~~
meagain20000
I wonder if we could employ similar technology for lice, bed bugs and roaches.
Would be awesome not to have to deal with those pests.

------
lkrubner
Let's all remember that abortion is illegal in El Salvador, even in cases of
rape. A woman who is raped and who also gets the Zika virus has no recourse.
This is a very Catholic country. Access to birth control is extremely
difficult. This new government recommendation is in conflict with dozens of
other laws that the El Salvador government has passed, all of which are
designed to maximize pregnancy.

~~~
sago
Indeed, let's not forget that their anti-abortion laws are so strict that
women have been imprisoned for more than a decade for having miscarriages, and
_premature (healthy) births_.[0]

Seems a high risk if you get pregnant in El Salvador at any time.

[0]: [http://www.theguardian.com/global-
development/2015/dec/17/el...](http://www.theguardian.com/global-
development/2015/dec/17/el-salvador-anti-abortion-law-premature-birth-
miscarriage-attempted-murder)

~~~
wlievens
That's abhorrent. As a father of three-months early twins, this hits home.

It's pretty much Saudi-Arabia levels of cultural villainy.

------
openforce
Diseases transmitted by mosquitos have increased tremendously in the last
decade, Especially in developing nations. I am from India and we never used to
hear about cases of Dengue or Chikungunya 10-15 years ago. Now its all too
common. Looks like this is a similar disease, now with links to microcephaly.
Dramatic increase in city populations, poor infrastructure result in increased
mosquito breeding grounds These nations need to heavily invest in taking out
disease carrying mosquitoes or situations like these are only going to
increase.

~~~
bayesianhorse
I sometimes wonder how much of "we never heard of x/y/z disease 10-15 years
ago" is due to less frequent testing.

~~~
openforce
Significant number, maybe. Penetration of medical services in these countries
has increased quite a lot in the same time span. But, impact of this depends
on the type of disease.

Significant increase in breast cancer cases for example is I believe a direct
result of increased diagnosis. But, for the increase in cases of viral
diseases, I believe the majority cause is due to things like more dense
population, unsanitary conditions and poor infrastructure.

~~~
bayesianhorse
I'd exclude breast cancer because it's detectable with non-medical means
before it becomes fatal. I also wasn't speaking so much about medical
incidence statistics, but more about perceptions.

------
dexwiz
Truly a terrible disease. The fear associated with it must be horrible for
pregnant women. I wonder if the warning would be the same if the virus had
killed or disfigured 4000 newborns instead of affecting fetuses. We seem to
put more emphasis on the health of a fetus than anything (prenatal
supplements, mother's habits, etc).

~~~
sandworm101
It isn't so much that it is killing many. It isn't. The problem is that these
babies are being born relatively healthy, but with debilitating mental/brain
deficiencies that will follow them and their families for decades.

~~~
ars
It might be killing fetuses. That would show up in elevated levels of
miscarriages - do they track that though?

------
sandworm101
What is the rate of ultrasounds in these countries? This deformity is very
detectable. I know that the only treatment, if one can call it that, is
termination, but this may be important in coming years.

In many communities mothers would commonly opt to terminate these pregnancies.
It's harsh and vicious, but it does happen. We need to think about such
sociological differences when predicting this disease. The wave of birth
defects hitting Brazil may not be replicated in countries where ultrasounds
are standard and attitudes to termination differ.

~~~
dexwiz
Latin America in general is very Catholic and very Pro Life. Abortions are
often illegal or only legal in select cases. Even if the disease was
detectable, they mothers may not terminate.

~~~
sandworm101
That's precisely my point. The rate of birth defects is dependant on more than
the spread of the disease. The epidemiologists predicting the long term
situation will have to account for this.

------
Justsignedup
The real question is:

Is the virus just like the flu where we kill it and life goes on? Or is the
virus like herpes where it gets repressed but permanently there?

------
JangoSteve
It's mind-boggling to think of the societal effects this will have at the
nationwide level for the countries where this is so prevalent. Entire programs
that will need to be increased or completely created anew to handle the amount
of people affected with microcephaly.

Likewise, depending on how effective the government's urging will be, imagine
being one of the few children born during those two years, having only 3 other
children in your class through your entire primary and secondary education
(I'm not sure what the El Salvador schooling program actually is, so these are
large assumptions; but I imagine at this point, not entirely outside the realm
of possibility).

------
beambot
Just wait for the Olympics to make this a worldwide epidemic...

~~~
Gustomaximus
Really? In what way would this happen?

~~~
beambot
I thought it was obvious... 2016 Summer Olympic games are being held in
Brazil, the epicenter of the Zika virus pandemic. Aedes aegypti (a mosquito)
is the disease vector. Tourists traveling to Brazil for the olympics will be
at risk on contracting the disease and returning home. There are no known
treatments or vaccines. The CDC has already issued warnings against traveling
to these locations.

Aedes aegypti seems to be spreading in the US, with recent sightings in
Sounthern and Central California -- not to mention natural populations in the
South. So yeah, it could be really bad.

~~~
Gustomaximus
Yes but catching this in Brazil and pandemic are not necessarily linked. In
this article I didn't see any reference that being infected in brazil will
mean is a mosquito or other transmission in your home country is likely. I
know in my country of Australia only one species of mosquito can potentially
carry this virus, and they exist is in a remote region itself even if they can
get this virus from the human that caught it and returned to a non-infected
country.

Do you see where I'm coming from? I'm not saying this couldn't be a point to
spread this virus around the world. However I'm not seeing any information
that confirms this is a real risk other than people from around the world will
be going into a live infection region. It takes much more that people simply
visiting this area to make this into a Zika virus pandemic.

~~~
beambot
Fair enough.

------
ars
Does anyone know if getting sick with Zika produces lifetime immunity?

Because if so then women should get sick on purpose, wait to get better. Then
not have to worry anymore.

------
macintux
If this pope, and this crisis in his own back yard, aren't sufficient to
compel a change in Catholic teachings on birth control, I think it's safe to
assume it'll not happen for generations.

~~~
paulddraper
I don't think that's how it works.

It's God's mind you have to "change", not the Pope's.

At least, if I understand Catholicism correctly.

~~~
archimedespi
95% of Catholicism is re-interpretation by the Church of their holy documents.
Changing the mind of the church is definitely a thing - see heliocentrism.

~~~
knughit
Heliocentricism is not a religious belief.

~~~
archimedespi
Heliocentrism _was_ a religiously- _derived_ belief. There are certainly other
examples - for some verses in the bible, there are _hundreds_ of
interpretations.

------
truebosko
We just cancelled our trip to Guatemala and Belize (planned leaving date was
Feb 2nd.)

Just not worth the risk to go down there (Yes, my wife is pregnant)

Horrifying and I hope the impact can be reduced for the people living in the
affected countries.

------
anonbanker
Could you imagine if China had the threat of a virus to ensure people stopped
breeding for two years? Imagine the help that would've done to their
depopulation campaign!

------
bobthechef
From what I hear, the link between microcephaly and the disease is still a
matter of debate.

------
rogeryu
If they want this, they should give them the means to do that: birth control!
For free!

~~~
GFK_of_xmaspast
El Salvador can't even manage to legalize miscarriages.

------
protomyth
So, what's the current best bet to kill that type of mosquito?

~~~
ams6110
DDT. We were in sight of eliminating malaria when it was banned.

~~~
ceejayoz
In certain areas, but resistance to the chemical was observed even in early
usage. It's highly unlikely malaria would've been eliminated by DDT use in the
long run.

------
blowski
I wonder what the political fallout will be from this. It's easy to imagine
Chavista and Peronist style politicians using this to their advantage.

