{"id":8076,"date":"2016-05-08T14:28:37","date_gmt":"2016-05-08T18:28:37","guid":{"rendered":"http:\/\/blogs.nejm.org\/hiv-id-observations\/?p=8076"},"modified":"2022-01-19T12:24:43","modified_gmt":"2022-01-19T17:24:43","slug":"zika-baseball-getting-new-normal","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/zika-baseball-getting-new-normal\/2016\/05\/08\/","title":{"rendered":"Zika, Baseball, and Waiting for a &#8220;New Normal&#8221;"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/05\/Zika-Time-Cover-2016.jpg\" rel=\"attachment wp-att-8077\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-8077\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/05\/Zika-Time-Cover-2016-225x300.jpg\" alt=\"Zika Time Cover 2016\" width=\"225\" height=\"300\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/05\/Zika-Time-Cover-2016-225x300.jpg 225w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2016\/05\/Zika-Time-Cover-2016.jpg 450w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a>I received an email from someone who&#8217;s known me a <em>very<\/em> long time.<\/p>\n<p>Hint:\u00a0 She&#8217;s known me longer than anyone. Literally.<\/p>\n<p>Here&#8217;s the email:<\/p>\n<p style=\"padding-left: 30px\"><em>Baseball cancelled in Puerto Rico because of Zika. This story\u00a0has you written all over it. (To use a cliche.)<\/em><br \/>\n<em> Mom<\/em><\/p>\n<p>I<em> told<\/em> you she knew me well!<\/p>\n<p>For those not obsessed with this\u00a0silly game to the same degree as I, here&#8217;s the story: Two games between the Pittsburgh Pirates and Miami Marlins were scheduled in San Juan, Puerto Rico on May 30-31 instead of in Miami.<\/p>\n<p>This two-game series, of course, was planned\u00a0before anyone had any idea that Zika would arrive and\u00a0become\u00a0a major health threat in Brazil, then\u00a0move\u00a0rapidly through Latin America and the Caribbean &#8212; including to Puerto Rico.\u00a0Several hundred cases of Zika have been reported Puerto Rico\u00a0(including one death), and some have estimated that <a href=\"http:\/\/www.nytimes.com\/2016\/03\/20\/health\/zika-virus-puerto-rico.html\" target=\"_blank\" rel=\"noopener\">25%\u00a0of the population will eventually become infected.<\/a><\/p>\n<p>The players on the Pirates and Marlins raised significant concerns about traveling there, and two days ago it was announced that the series <a href=\"http:\/\/mlb.nbcsports.com\/2016\/05\/06\/mlb-mlbpa-announce-the-postponement-of-the-puerto-rico-series-due-to-zika-concerns\/\" target=\"_blank\" rel=\"noopener\">would be cancelled as a result.\u00a0<\/a><\/p>\n<p>Puerto Rico officials were, predictably, <a href=\"http:\/\/triblive.com\/news\/adminpage\/10430052-74\/puerto-rico-zika\" target=\"_blank\" rel=\"noopener\">highly critical of the decision.<\/a><\/p>\n<p>So what was Major League Baseball supposed to do? I can see both sides of this issue.<\/p>\n<p><strong><em>In favor of cancellation:<\/em><\/strong><\/p>\n<ul>\n<li><strong>A player could contract the virus and transmit it to his partner.<\/strong>\u00a0This is\u00a0of greatest concern, of course, if the woman is pregnant or trying to conceive.<\/li>\n<li><strong>There&#8217;s still no readily available test to see if infection has occurred.<\/strong> A\u00a0large proportion of infections\u00a0are asymptomatic. Are these players supposed to wait 6 months before trying to have children? Or have unprotected sex? Seems like a lot to ask.<\/li>\n<li><strong>There&#8217;s a small (but not zero) chance that a player will get either severe clinical Zika (fever, myalgias, and rash) or, even worse, Guillan-Barre syndrome.<\/strong> Bad enough for anyone &#8212; baseball player or not &#8212;\u00a0but imagine if this player were a star like Andrew McCutchen or Giancarlo Stanton. (Brief aside: Stanton hit a home run nearly 500 feet the other day. Wow. Watch <a href=\"http:\/\/m.mlb.com\/video\/topic\/11493214\/v665977883\/must-c-crushed-stanton-hits-a-titanic-475foot-homer\/?affiliateId=clubMEGAMENU\" target=\"_blank\" rel=\"noopener\">here.<\/a>)<\/li>\n<li><strong>What do the players get out of it?<\/strong> The whole idea of these trips\u00a0is to promote the game globally &#8212; so it&#8217;s good for &#8220;the game&#8221;.\u00a0\u00a0But how about the players? They get paid the same regardless of where the games are played &#8212; why should they take this risk?<\/li>\n<\/ul>\n<p><em><strong>In favor of playing the games in Puerto Rico as originally scheduled:<\/strong><\/em><\/p>\n<ul>\n<li><strong>The CDC travel advisory on Zika\u00a0is limited to women who are pregnant or trying to get pregnant. <\/strong>Not a single professional baseball player falls into this category. Didn&#8217;t even have to look that one up.<\/li>\n<li><strong>The players will be mostly in settings where Zika transmission is highly unlikely.<\/strong>\u00a0I don&#8217;t have their exact itinerary (they don&#8217;t typically share this with ID doctors), but it&#8217;s safe to assume they would stay at 5-star air conditioned hotels when they&#8217;re not playing.\u00a0A comfortable air conditioned bus (at worst) would take them\u00a0to and from the game.\u00a0And though the stadium is old, it&#8217;s got to have\u00a0an air conditioned locker room. Sure, the game itself is outdoors &#8212; but only for a few hours.<\/li>\n<li><strong>They will only be there for three days.<\/strong> For such a short trip, the risk of getting Zika with the above conditions is incredibly small. Maybe almost\u00a0as small as <em>my<\/em> chances of hitting a home run nearly 500 feet.<\/li>\n<li><strong>How different is San Juan from Miami anyway?<\/strong> Virtually all public health officials are predicting Zika transmission in Southern Florida any day now. It might even be happening now &#8212; who knows about late May?<\/li>\n<li><strong><a href=\"http:\/\/baseball.about.com\/od\/internationa1\/tp\/Top-10-Mlb-Players-From-Puerto-Rico.htm\" target=\"_blank\" rel=\"noopener\">Puerto Rico is the birthplace of several baseball superstars.<\/a><\/strong> Plenty of Hall of Famers and near Hall of Famers: Roberto Clemente. Roberto Alomar. (Hey &#8212; <a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/worlds-collide-roberto-alomar-and-hiv\/2010\/10\/12\/\" target=\"_blank\" rel=\"noopener\">second time<\/a> I&#8217;m writing about him!) Edgar Martinez. Ivan Rodriguez. Bernie Williams. This is an important pipeline for top baseball talent, we should support it.<\/li>\n<li><strong>Zika didn&#8217;t stop hundreds of baseball scouts and other officials from recently visiting Puerto Rico to see a top prospect.\u00a0<\/strong>The guy&#8217;s name, for the record, is Delvin Perez, a high school shortstop. I&#8217;d bet good money\u00a0he never expected to see his name on this blog.<\/li>\n<li><strong>They aren&#8217;t cancelling the Olympics in Brazil.\u00a0<\/strong>If thousands of athletes from around the world can go to Rio, why can&#8217;t a couple of baseball teams go to Puerto Rico?<\/li>\n<li><strong>Given what they&#8217;re being paid, the players should just do what they are told.<\/strong>\u00a0The current average MLB salary is over 4 million dollars per year. The aforementioned Stanton has a 13-year, $325 million dollar contract. That will buy you plenty of\u00a0DEET.<\/li>\n<\/ul>\n<p>I don&#8217;t know whether baseball\u00a0made the right decision on this one. But I do know that Zika is still so new, and so much is still unknown, that the decision is certainly understandable.\u00a0With new threats of any sort &#8212; infectious or not &#8212; our risk assessment instincts are flawed, and typically biased toward fearing the worst.<\/p>\n<p>So let&#8217;s give it a few years &#8212; Zika isn&#8217;t going anywhere, unfortunately. At that point we&#8217;ll know a lot more about how it causes disease, and in whom, and maybe even how to prevent it. We&#8217;ll certainly have better testing. There will be a &#8220;new normal&#8221; attitude about a world with Zika, just as there is now with West Nile virus, another mosquito borne virus which didn&#8217;t even exist in the Western hemisphere\u00a0before 1999.<\/p>\n<p>Once that new normal happens, I boldly predict that there will be professional baseball games played in San Juan.<\/p>\n<p>Happy Mother&#8217;s Day!<\/p>\n<p><iframe loading=\"lazy\" title=\"Dads Make Pinterest Crafts For Mother&#039;s Day\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/j5ALaLFd-g8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I received an email from someone who&#8217;s known me a very long time. Hint:\u00a0 She&#8217;s known me longer than anyone. Literally. Here&#8217;s the email: Baseball cancelled in Puerto Rico because of Zika. This story\u00a0has you written all over it. (To use a cliche.) Mom I told you she knew me well! For those not obsessed [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5],"tags":[102,1118],"class_list":["post-8076","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","tag-baseball","tag-zika"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8076","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=8076"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8076\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=8076"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=8076"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=8076"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}