Any public health initiative seeking to reduce the mosquito population is a welcome one -- and there's one taking place in New York City right now. It's called "Fight Back NYC," a three-year, $21 million citywide Zika virus awareness campaign.
No one likes mosquitoes, or the viruses they carry, but I think that Mayor Bill de Blasio, together with Health Commissioner Dr. Mary Bassett, really missed the mark with this plan. That's because their singular focus on mosquitoes has ignored an issue of even greater importance to reduce transmission: condom use.
In my view, our Zika public awareness campaigns should look more like they did for HIV/AIDS in the 1990s.
Since the CDC's report came out Feb. 5 we've known that Zika virus is sexually transmitted, and there are new reports of sexual transmission every week. But, instead of educating the public about this route of transmission, the city is plastering subway cars and garbage trucks with this 3-point plan as how to prevent Zika infection:
- Remove standing water so mosquitoes cannot breed
- Apply insect repellent and cover exposed skin to avoid bites
- Use window screens to keep mosquitoes out
Well, thank you Mr. Mayor. Perhaps the next $21 million should be earmarked for a campaign to tell New Yorkers that umbrellas are useful for staying dry on a rainy day.
With more and more sexually-transmitted cases, why are our city officials only talking about mosquitoes? How much of a real concern is it that Zika will be delivered here by these warm-weather pests? First of all, the Aedes aegypti mosquito, the main carrier of Zika, does not exist this far north (although a computer model showed that it may be able to be here this year). And, the Aedes albopictus, which can be found in New York, may be a vector for Zika, but that has not yet been confirmed.
Even if we do end up with one of the Zika carrying mosquitoes here, telling people to remove standing water is futile as the mosquitoes only need a teaspoon of water to breed and their eggs are frequently found in places such as inside the tires of a car.
The 1,132 cases of Zika infection in the continental U.S. have been classified by the CDC as "travel associated," meaning that the Zika was obtained elsewhere. So, until we have a single case of a person in this country infected by a mosquito, which would most likely happen first in warmer, southern regions, it's safe to say that we should not panic over a puddle on the corner of 42nd and Lex.
At April's rollout of "Fight Back NYC" Mayor de Blasio said, "We are doing all we can to target the mosquito that could transmit Zika here in the city, and building the capacity to respond to every possible scenario, no matter how unlikely."
However, a very different scenario may be looming. We are aware of it, and we know how to combat it. However, the risk of sexual transmission is not only being underestimated, it is frequently being completely dismissed. All we need is to get the message out.
At the same rollout news conference, Dr. Bassett said, "it’s very important that people understand that this isn’t a person-to-person spread.” which is completely wrong. With the city's top public health official giving such grossly incorrect information, how can we expect our public health campaigns to be effective, or even accurate?
It's also worth noting that in a separate initiative that began in May, NYC is sending one million condoms to Puerto Rico for Zika prevention measures. So if our government recognizes that combating sexual transmission is important there, why not incorporate that message into the "Fight Back" initiative here?
So, thank you, Mr. Mayor for holding up different brands of insect repellent while repeating three mosquito-reducing tips we already knew about. And it's now been three months since the "Fight Back" rollout in New York, and there's been no mention that safe sex can lessen Zika's threat.
Hopefully, the next time you address Zika and public health, you'll instead be holding up the most potent weapon of all -- a condom.