Playing Games with the Rio Olympics

Against the counsel of more than 150 doctors from around the world, the International Olympics Committee decided back in January that the show must go on. The Olympic Games would continue in Brazil, they said, despite reported threats from the Zika virus.

Unfortunately, this decision was made before the Brazilian government went public with the real numbers of infected people.

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There are more than 90,000 cases across the country. In Rio de Janeiro, the site of the games, the number of Zika cases is triple the national average: 157 people per 100,000.

Initially, the epicenter of Zika infections was the northeastern part of the country, near Pernambuco, where scores of babies were born with microcephaly or abnormally small brains. Zika isn’t a new virus — it was discovered in Uganda in 1947 — but this new manifestation was a mutation of the original. This updated virus made it 53 times more likely that pregnant women infected with Zika would give birth to children with serious defects.

And scientists are still racing to understand this new version of the disease. Only 20 percent of infected adults manifest any symptoms, and those symptoms are often mild. They include a fever, rash, and some joint and muscle pain. The perceived threat is mostly for pregnant women.

However, more recent research still to be verified has shown a possible link between Zika and the later development of Guillain-Barré syndrome. This is a disorder of the immune system, where the body attacks the peripheral nervous system and can result in paralysis. Nobody knows why or when Guillain-Barré will strike — or what sets it off. But it’s likely Zika is connected somehow.

Related: Zika Vaccine Can’t Save Our Summer

Numerous doctors and scientists have lobbied to have the games postponed, but to no avail. The investors with financial stakes in the Olympics are loath to see their investments turn to bankruptcy. Dick Pound, senior member of the IOC, said Zika is nothing but a “manufactured crisis.” Oddly, the World Health Organization has remained silent on the matter.

Olympic athletes are unlikely to be sore from their workouts, so any joint pain should set off alarm bells.

Zika could change up the podiums at the games, too. Dr. Alejandro Badia, an orthopedic surgeon in Fort Lauderdale, Florida, said infected athletes will be at a serious disadvantage. “Say you’re a triathlete and you’re running a 10K race. Even low levels of infection will affect your performance, and you don’t know if you’ve been infected unless you have everyone tested,” Dr. Badia told LifeZette.

Because Zika has been an underrated threat, it isn’t clear how much access the athletes will have to testing. At this point, only a limited number of labs can test for the virus in the U.S. — and equipment availability in Brazil is sketchy at best.

Badia said Olympic athletes are likely to recognize Zika symptoms right away. At the Olympic level, they’re unlikely to be sore from any of their workouts, so any joint pain should set off alarm bells. “They should be just doing warming up and cooling down, and if they see more than the usual amount of joint pain, they should be tested immediately,” Dr. Badia said, “especially if that joint pain is diffused throughout the joints instead of localized.”

But at some point, an athlete is either on the podium or not. And for the athletes who have worked and trained hard to win, Zika could be a deal-breaker.

What happens after the games is also of concern. About 2,000 American athletes will be traveling to Rio to compete, and a University of Utah research group will be monitoring volunteers for about two years as part of a study. One-third of the participants have said they plan to get pregnant within a year of the Olympics — so a Zika infection could effectively derail those plans. It’s still unclear whether a dormant virus can result in the same birth defects.

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Hope Solo, the star of the U.S. women’s soccer team, said in an interview with CNBC that she would “begrudgingly” participate in the games, but that she planned to remain indoors as much as possible. Other athletes from different countries have refused to participate because of the virus.

Aside from the athletes themselves, the games are likely to draw upward of 500,000 spectators — all of whom could carry the new viral strain to their home countries. Dr. Amir Attaran, a professor of medicine and law at the University of Ottawa in Canada, has been an outspoken critic of the decision to move forward with the games. He said it boils down to “a simple question: But for the games, would anyone recommend sending an extra half a million visitors into Brazil right now? Of course not: Mass migration into the heart of an outbreak is a public health no-brainer.”

Given that the outbreak in Brazil stemmed from a single infection in early 2013, the mass migration of 500,000 tourists into the heartland of the Zika outbreak could accelerate the spread of a disease for which we have no cure — and which we do not yet fully understand.