Posting has been a bit sparse today, in part because I've been ransacking the Brazilian and other media for some mention of the Mattos Report that I discussed here yesterday. Not a sausage, as the British would say. In Brazil as elsewhere, Zika stories today are all about the virus's presence in saliva and urine, further entrenching Zika as a titillatingly sexual threat. Meanwhile, still more (suspected) microcephalic babies keep being identified.
A narrative has locked in, with Zika as the sole cause of microcephaly with no other interpretations or evidence worth considering. It's reminiscent of Egypt early in the H1N1 "swine flu" pandemic. The over-literal authorities slaughtered all the pigs in the country—who of course had nothing to do with H1N1—and thereby triggered a major public nuisance. The pigs had thrived on garbage that people threw into the streets; without the porcine cleanup crews, garbage piled up and stank.
The new Lancet report, posted earlier this afternoon, doesn't refer to Mattos but backs up her concerns about conflicting standards of measuring newborns' heads and thereby identifying microcephaly...while also aggravating maternal anxiety and likely wasting the time and efforts of understaffed and underfunded health ministries all over Latin America.
I can see why the Brazilian government might be slow to respond to the Mattos Report. While Mattos seems to exonerate Zika as the cause of microcephaly, she implicitly criticizes governmental failures to reduce the true causes—especially the poverty and malnutrition of millions of Brazilian mothers. And she implicitly criticizes the government's long failure to maintain adequate surveillance over the threats to the public health of Brazil's 200 million people.
Politically it's far easier for the government to blame an alien Polynesian invader for microcephaly, and to throw the Brazilian army into a blitzkrieg against Aedes breeding sites in old tires and water storage tanks. It would be embarrassing to admit that Zika and microcephaly might be two coincidental but unrelated problems, with microcephaly far more serious.
But if the Dilma Rousseff government had the sense and guts to change direction and change the narrative, it could use the Mattos Report to make real progress in public health.
Through her Health Minister Marcelo Castro, Rousseff could say:
"Dr. Sandra da Silva Mattos has found serious evidence that we may have had an unrecognized microcephaly problem for many years. I am ordering a nationwide retrospective survey of microcephaly since 2000, using the methodology of her survey of newborns in Paraíba state since 2012, and a single, internationally accepted criterion for defining the condition. This will give us a baseline for determining if we have really seen an increase in microcephaly since the arrival of Zika. If we have, we will pursue further research to identify the mechanism involved, and to stop it.
"If we have not, then the true causes of microcephaly will demand our attention: other infections, and especially the poverty and malnutrition of the mothers of Brazil. We will address these issues in any case, as threats not only to Brazil's public health, but to our future as a great nation.
"Meanwhile, we recognize that Zika in itself can be a painful disease that may also trigger Guillain-Barré syndrome. It is carried by the same mosquito, Aedes aegypti, that has already caused millions of us to suffer from dengue and chikungunya.
"Whether or not Zika causes microcephaly, mosquito-borne diseases will no longer be tolerated in Brazil. We once exterminated Aedes aegypti, and then allowed it to return. It will now be the policy of this government to exterminate Aedes aegypti again, for good, and to encourage its extermination throughout its range in the Americas and overseas."
Brazil's next problem would be dealing with the demands for education and jobs from a large cohort of healthy young Brazilians eager to start their own healthy families. And that would be a lot tougher than fighting a goddam mosquito.