Via The Atlantic: Can Congress Stop the Puerto Rican Zika Outbreak? Excerpt:
As Congress dithers over funding for Zika prevention on the mainland, the island commonwealth of Puerto Rico is at a stage well beyond the reach of a preemptive strike. As the virus still struggles to establish a beachhead among Aedes aegypti mosquitoes in southern Florida, it has found a home in the Caribbean heat and moisture of Puerto Rico. And that’s awful for an island still deep in the throes of an economic and humanitarian disaster, and for one that’s always struggled with an underfunded and undermanned health infrastructure.
Though Puerto Rico’s unique tropical climate is an outlier compared with that of much of the continental United States, the underlying issues with its infrastructure provide examples of just how Zika could spread elsewhere in the country, too.
It’s been less than a year since the first reported case of Zika in Puerto Rico, but doctors in the territory are already at their breaking points. Zika infections themselves are not terribly taxing to health-care systems—symptoms usually resemble those of a cold or flu, if patients exhibit them at all—but the potential complications can stagger even well-funded health systems. Treatment for microcephalic infants and adults that develop neurological complications can cost millions per patient.
Evidence from Brazil presented in an upcoming Centers for Disease Control and Prevention study indicates that the true burden of neurological disorders from Zika is underreported, and that in addition to a well-reported link to Guillain-Barré, the disease is associated with a rise in expensive hospitalizations from other neurological conditions, including encephalitis, myelitis, and encephalomyelitis.
Additional services for child and maternal health—including screening and access to abortions—and contraceptive services simply add to the price tag. And with so little information available about Zika’s long-term effects, it’s impossible to know if hidden symptoms and costs don’t lurk down the road.
That’s all bad news, and especially bad news for Puerto Rico, which simply doesn’t have the resources to fight even the immediate effects of Zika. Since the decade-long economic crisis began, the commonwealth has hemorrhaged hundreds of thousands of people—usually healthy, younger people seeking work—in a steady mass migration to the mainland.
In that flood of people were hundreds of Puerto Rico’s doctors, and perhaps over a thousand physicians have moved away since 2014. The result back on the island is devastating. Not only are the remaining people more likely to be those most vulnerable to Zika—children, elderly people, and poorer families and women—many would-be primary-care providers are gone.