Should the Olympics leave Rio because of the Zika virus?

Despite ongoing worries about the Zika virus, it seems unlikely that the Olympics will be moved or cancelled given how much Brazil and the International Olympic Committee have invested in at this point, according to an expert.

“It would only be under extraordinary circumstances, I would think, if the World Health Organization or if the [Zika] scare gets much more intense than it is now,” Professor Mark Dyreson, from Penn State’s College of Health and Human Development, told me. “Right now it is certainly a fear but it would have to ratchet up considerably.” He said finding another venue for the games under such short notice–the games begin on August 5–seems unlikely, though Los Angeles is always seen as a perennial back up site. And it’s unprecedented in modern history for the Olympics to be disrupted by a health scare.

The Zika virus, spread by aedis aegypti mosquitoes and transmitted through unprotected sex, is an ongoing threat in Brazil. In the latest figures released by the government, 91,387 cases were registered between February and the beginning of April, Reuters reported. More than a third of those were reported in the region that includes Rio de Janeiro.

The IOC and the WHO have said that the risk will be less in winter time when the mosquito population drops off, and have shown no signs of canceling or changing plans for the games. But public health experts are warning that while that might be true, it’s still doesn’t make sense to plan for a large number of visitors from all over the world to spend time in Zika-affected areas.

One leader in the field, Arthur Caplan, is the founding director of NYU Langone Medical Center’s Division of Medical Ethics. He said that holding the games as planned would be irresponsible, despite the WHO’s argument that the cooler winter weather and its guidelines are enough of a safe guard to let it go ahead.

“It could be devastating to public health, to tourism, and to the image that Brazil is hoping to project to the world,” he wrote in STAT, a medicine and health publication, back in February. “Postponing the games for six months to a year would be good for athletes, spectators, and Brazil.”

Last week, another prominent public health expert called for the Rio Olympics to be delayed or moved to another country because of the threat still posed by the Zika virus. Amir Attaran, a professor at the University of Ottawa’s School of Public Health and School of Law, wrote an op-ed in the Harvard Public Health Review arguing that the responsible move would be to delay or move the games until the virus is more under control.

A day after his article was published, the World Health Organization issued their first statement about Zika and the Olympics, and did not discourage spectators from going—instead it recommended that people follow travel guidelines:

As the countdown to the games in Rio de Janeiro continues, Attaran sees that statement as a sign that the organization understands that Zika is a risk but refuses to go far enough to prevent it from spreading.

“In other words, the warning is getting broader and broader but they’re still pulling punches and mincing words on saying the Olympics should be postponed,” he told me. “Why aren’t they simply being honest and saying avoid these games, or the games have to be delayed and things have to be fixed first? They’re being disingenuous, dishonest, and dangerous to the world’s heath.”

He accused the WHO of not taking a stance to delay or move the Olympics because they have a partnership with the International Olympic Committee:

The World Health Organization referred me to their statement from last week when I contacted them, and the International Olympic Committee issued the following statement:

We welcome the action taken by the WHO to deal with this issue and take note of their latest announcement. We remain in close contact with them and are following their guidance.

We are also working with our partners in Rio on measures to deal with the pools of stagnant water around the Olympic venues, where the mosquitos breed, to minimise the risk of visitors coming into contact with them.

It is also important to note that the Rio 2016 Games will take place during the winter months of August and September, when the drier, cooler climate significantly reduces the presence of mosquitos and therefore the risk of infection.

Attaran is adamant that the IOC must have a back-up plan that would be preferable to having the games go ahead on schedule.

“You don’t plan a multi-billion dollar event without having a plan B,” he said. “I mean if you hold a garden party you have a plan B. You’re telling me somebody who throws a garden party with a few hundred dollars does better planning than the Olympic Committee?”

Bu as the Opening Ceremony approaches and teams from across the world make plans to travel to Brazil in a few months, Dyreson told me it becomes increasingly unlikely that the games can be moved.

“We’re talking about a matter of months now, it’s not two years out. So how would you actually do this given the security concerns and the media and everything. I think it’s practically impossible for Brazil or the IOC to get out of this at the moment,” he said.

He also pointed out that there are health concerns beyond Zika in Brazil. The Associated Press reported in December that water in the bay athletes would use for some sports was still full of viral and bacterial contamination.

“And they haven’t seemed to care much about other health scares in Brazil,” he said. “The quality of the water in the bay they were going to row in and all this other stuff they’ve glossed over.”

On top of these health concerns, Brazil is dealing with an impeachment and financial crisis. But Dyreson said that while there have been precedents to cancel or move the games, all of the concerns in Brazil might not be enough for the IOC to make a change.

“The most famous ones have to do with world wars. The IOC is just brilliant at picking places that are going to descend into chaos,” he told me.