Rishi Sehgal hung up the phone Monday afternoon with two new insights. One: he did not have Zika. Two: he wasn’t crazy for thinking of fleeing Florida with his pregnant wife.
“The doctor just said it was reasonable if we leave,” he said of the physician who called with his test results, noting that this sentiment was a change from the last time they had talked, before health officials announced the virus was spreading in Miami Beach.
Sehgal and his wife, who is 26 weeks pregnant, live in Miami-Dade County, the first part of the continental United States to see transmission of the Zika virus by mosquito. As it swept through Latin America over the past year, thousands of women infected during pregnancy gave birth to infants with microcephaly, a severe neurological birth defect.
But all the advice the first-time parents have gotten sums up to one simple yet terrifying maxim: “Don’t get bit.” Sehgal and his wife, Brittany, are among a small number of expecting parents who have decided that’s not enough — and are looking to leave for safer grounds.
There has been no official recommendation that pregnant residents relocate, but the federal Centers for Disease Control and Prevention has encouraged outsiders to avoid nonessential travel to Miami-Dade if they are pregnant or trying to conceive.
This contradiction is frustrating to Sehgal.
“I don’t see how you logically say one thing and not the other,” he said. “Either it’s safe for pregnant women to be there or it’s not.”
Similar conversations are occurring in examining rooms across the county, with mixed conclusions.
“Most physicians are not necessarily recommending leaving the area because that’s a luxury that the majority of our patients don’t have,” said Dr. Elizabeth Etkin-Kramer, the American Congress of Obstetricians and Gynecologists chair for the district that includes Miami-Dade. But she says she wouldn’t discourage it for those who have the option.
“If they have the luxury of leaving — it’s a personal choice — but I don’t think it’s a bad idea,” she said.
For those who don’t, health experts recommend precautions including wearing insect repellent and long clothing, and limiting time outdoors. Etkin-Kramer believes that expecting parents can keep their risks low by following these precautions to avoid bites. However, she acknowledges that leaving is the only way to eliminate the risk entirely, along with the stress from just stepping outside.
“The anxiety of whether or not they are being exposed will probably haunt patients throughout their pregnancy,” she said.
This anxiety was more than Christina Frigo, who is 32 weeks pregnant, and her husband, Scott Cunningham, could abide. When they told their doctor they were considering moving an hour north to stay with family, they thought he would say they were overreacting. Instead, he told them it wasn’t far enough.
“He said, ‘If you have somewhere farther away to go, then yeah, I think that’s a good idea,’” she recounted. Shortly after, they left to stay with family in Chicago.
Leaving presented it’s own complications. Finding a new doctor midway through a pregnancy was a challenge. Obstetricians limit the number of their patients with similar due dates, and some doctors hesitate to take on a pregnancy they haven’t tracked — fearful that if they miss a detail they could be liable for malpractice.
After verifying that her insurance would cover her in Chicago, Frigo spent over 20 hours on the phone just to set up intake appointments to ask doctors to take her on. But now, as the number of Zika transmissions believed to be caused by mosquitoes has climbed past 30 in Miami-Dade, she feels confident she made the right move: “If you’re a pregnant women, what is too much to protect yourself and to protect your baby?”
Jessica Alliot, now 23 weeks pregnant, also left Miami last week, to stay with her brother-in-law in Connecticut. Her husband, who couldn’t get away from work, stayed behind. In the three weeks before the move, Alliot noticed her doctors had ramped up efforts to educate pregnant women about the risks of mosquito exposure in the area. Her doctors “seemed neutral” but were supportive of her decision to leave.
“The doctors all say it’s a very personal decision,” she said. “But my doctor said, ‘If you can do it, why not?’”
Leaving is starting to seem like the right decision for Sehgal and his wife too, despite the significant financial burden. His wife, a therapist, doesn’t get paid maternity leave and may not have a job to come back to if she leaves town for three months. But the couple, not keen on wagering their child’s life against their ability to dodge mosquitoes, is considering uprooting to stay with his sister in California.
He feels lucky he has family who can help, and worries for people without enough resources to have the choice.
“This is my baby’s health,” he said. “What are we going to do with people who can’t afford to go on their own — I don’t know.”
The CDC needs to get out of the business of managing our perceptions for fear of a panic or fear of a loss of tourist business or who knows what else motivates them, and instead deal exclusively in facts and appropriate public health recommendations. If the situation is potentially dire, so be it. Say so. Be honest. We need an end to the CDC’s contradictions and absurdities, as when they said mosquitoes stay within small geographical areas so no one should be reluctant to travel to Miami Beach, as long as they don’t cross the magic boundary lines. Give me a break. We need to be able to trust the CDC. That goes for newspapers too.
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