WHO declares monkeypox a public health emergency
statnews.com
statnews.com
Now we have tens of thousands of cases outside of Africa and it doesn’t appear to be lethal at all and goes away on its own. Depending on the severity it seems like the biggest issue is pain/itchiness for a week or so.
So what’s the “emergency” in that context?
You've named it: "tens of thousands of cases outside of Africa". It entered the white world (disclaimer: I'm white myself).
On top of that we've just lived through (hopefully) the worst if the COVID pandemic, so WHO is additionally spooked.
And apparently this decision was actually an overrule by the director - a panel actually voted against it.
But that's not news. That's well known. Also, generalising 'news' makes no sense. Of course news sources from certain countries will focus on news that effects their readers. Deaths from diarrhea are of little relevance to the readers of any 'western' news source.
You’re probably being downvoted for this though it’s completely true.
> Monkeypox is a disease of global public health importance as it not only affects countries in west and central Africa, but the rest of the world. In 2003, the first monkeypox outbreak outside of Africa was in the United States of America and was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. This outbreak led to over 70 cases of monkeypox in the U.S. Monkeypox has also been reported in travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021 and May 2022, to Singapore in May 2019, and to the United States of America in July and November 2021. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries.
[0] https://www.who.int/news-room/fact-sheets/detail/monkeypox
This is as good a reason as any.
Even if monkeypox is only an annoyance (which I doubt), if 7 billion people all have to get sick for a week, that deprives humanity of ~134 million people-years of life that they'd rather spend doing something else -- even if there are no longer-lasting impacts.
How do you figure? I got chickenpox in the 90s.
I think chickenpox spread before smallpox in any case?
https://en.m.wikipedia.org/wiki/Varicella_zoster_virus
https://en.m.wikipedia.org/wiki/Smallpox#Cause
Similar symptoms, substantially different family trees.
So are monkeypox and smallpox, right? Related, but different diseases.
So are this year's strain of influenza, and the Spanish Flu. Related, but different diseases. Should extant monkeypox cause more alarm than extant influenza?
Nothing is a priori worthy of more or less alarm. Public health officials raise a degree of alarm based on the best epidemiological, medical, and demographic information available to them.
Smallpox is concerning, monkeypox as it is today isn't very concerning. If I understand the comments in this thread, the great concern is that monkeypox could become something quite deadly like smallpox was.
Is that risk substantially greater than the risk of a new influenza that rips through the population like the Spanish Flu once did?
If a deadly influenza strain is in our future, we're decently prepared.
On the other hand, we haven't manufactured or administered human pox vaccinations at scale in... 50 years?
The only experience we have with poxes in humans is smallpox and monkeypox. Smallpox was not a good time. Past monkeypox outbreaks have killed 5%. This one is behaving very differently, but we don't know if it's going to revert to killing people! It has in the past, like every outbreak, so it's a rational worry.
These diseases are caused by single celled organisms which keep spawning clones rather than having sex among a population. So the point you call a different COVID or influenza strain a different disease is effectively arbitrary unlike with sexual species where you can draw the line when they can’t breed with each other.
How many people are dropping dead from it? It doesn't seem like an arbitrary distinction to me.
Variola minor is a strain of smallpox with fatality rates under 1%, while some strains of monkey pox are believed to kill 10% of the infected.
In the end where exactly we draw the line within https://en.wikipedia.org/wiki/Orthopoxvirus is arbitrary, but not without justification.
All differences between two things is always arbitrary. This is something I wish more people understood. Two different things are never the same thing. You can come up with similarities based on arbitrary criteria, and that's all.
For example, what we consider make two different person a woman is arbitrary criteria that we just all agree on, or debate forever.
> How many people are dropping dead from it? It doesn't seem like an arbitrary distinction to me
You want to engage in that "forever debate of semantics", but I don't think that's your point.
Currently, it's agreed on taxonomy that chickenpox is not on the same family as monkeypox and smallpox. That's just agreed upon arbitrary categories.
Now the arbitrary doesn't mean useless. Often categories are chosen based on some practical aspect. For example it helps to group them if they have a similar behavior in some way that is often helpful to group in the default case.
An example of this is how in culinary science, a Tomato is made a Vegetable, because it's more useful to club vegetables around their flavor profile. You most of the time don't want to use a Tomato for a recipe that calls for fruits. But in botanical science, flavor isn't useful, it's more useful to think in terms of what contain seeds, thus a Tomato is made a fruit.
Each science uses their own arbitrary classification based on what is more practically useful for their line of research.
Ok, so I think your point isn't to try and tell virologists that their chosen taxonomy isn't as optimal for their line of research. But that in the case of public policy and messaging, virulence might be more important.
Even though both virus are of the same family, there is still a major difference in their virulence. And maybe that property holds more weight in this case.
I think that's a great point, but that you were arguing wrong by attacking the definition instead of bringing up the characteristic of importance and explaining why.
Now this is as much as I know of virology, so I can't say if there are good reasons to be worried about the chances of virulence changing because they are in the same family or not. But I'd say you're right, virulence is what the public cares about, and it be nicer for virologist to explain the chances of the virulence getting worse through some mutations and if they think it's high, why, or if they think it's low, why.
The herpes lineage is no joke, especially given recent evidence for long-term effects, but Orthopoxviruses has some nasty members (for humans and other economically-important species).
And when I say "nasty Orthopoxviruses," I mean ~25% case fatality rate in the affected species, with an increased fatality rate in infants. So... pretty horrible stuff. :(
These numbers seem squishy (keep an eye on the situational caveats they note for a specific row), but lists relative CFRs for different diseases. Chickenpox probably isn't going to kill you, unless you're a pregnant mother who acquires it in a specific window: https://en.wikipedia.org/wiki/List_of_human_disease_case_fat...
Honestly, IMHO, this is what the WHO should be doing: looking at the potential for pandemics and making moves ahead of time. (2) & (4) should be enough to scare the crap out of anyone who accepts the possibility of mutations once it's more widely circulating.
Smallpox is objectively horrific, and its eradication was one of public health's greatest modern triumphs. So anything close should be taken seriously.
Not panic. But pragmatic seriousness.
(WARNING: Not for the faint of heart) https://en.m.wikipedia.org/wiki/Smallpox
the very nature of an "emergency" does cause panic, though. from what you are describing I don't see how that word can be justified. sounds more like "public health threat" or sth like that.
We have lots of language to say this sort of thing, but the more words you add the easier it is to be misunderstood. On a sociolinguistic level we do sort of overuse the word “emergency” but it’s primarily because we tend to do most of our “highest priority” communication with chunks of words that fit in a sound byte, or newspaper headline, or bullet point that fits on a PowerPoint slide ,or tv news lower third.
Money pox can be transmitted via infected bodily fluids, via via contact with the blisters/lesions/“rash” that forms, via inhaling droplets of infected fluids (simplest example, heavy breathing + sweaty bodies very close together), and potentially any method where infected fluids from one body come into contact with the mucous membranes of another person, so that’s the eyes, nose, mouth, etc. Also it can contaminate surfaces so there’s a risk of infection via contaminated bedding. Only one of these is mitigated by a condom.
Effectively the only preventative options are vaccinations and avoiding exposure via the normal ways, trying to not come into contact with anyone infected (the “avoiding high risk behaviour” option) and by wearing personal protective equipment such as disposable gowns, gloves, masks... which is basically all the sort of things medical staff do to prevent the spread of all sorts of diseases around hospitals, but its a whole list of stuff you need to do and remember to do right, to the point where medical staff need training and spot checking to ensure they do it right all the time... understandably its not something the public is very well equiped to do.
Oh and it’s infectious before it’s “obvious that you have monkeypox” since the first early few days the various skin symptoms could be mistaken for a zit or pimple or other skin reaction and don’t necessarily start somewhere you regularly look at, such as behind the ear.
The wikipedia article is actually pretty informative https://en.wikipedia.org/wiki/Monkeypox other than not having a clear idea yet what's different about the new strain spreading around, we actually know quite a bit about monkeypox since its endemic to certain African animals there has been cases to study for decades, and the fact its related to the much more deadly Smallpox virus (the Smallpox vaccine is apparently 85% effective against Monkeypox) means its been an interesting virus for researchers to study, basically since we started trying to wipe out smallpox decades ago.
Edit: Missed a key point. The extra trouble is they need to "thread the needle" with their messaging to ensure what they are saying isn't misinterpreted as pointing the finger at the MSM (men who have sex with men) since they have mountains of evidence on how badly handled everything was with HIV/AIDS. They don't want the regular public assuming this is a disease only gay people can get, because its not, but the kinds of activities that are most likely to cause you to catch it are most commonly associated with gay men, which is sort of at odds with their first goal.
At some (I feel like close) future point, people will see “emergency” and equate it to “someone’s being cautious. This is possibly not a problem at all and therefore can be ignored.”
What’s that old saying along the lines of “intentionally use more subtle language in your writing because it gives you room to be intense later.”?
I feel safer that the WHO has declared an emergency, and so does the rest of the world.
-98% gay/bisexual
-41% have concurrent HIV
-95% transmission by sexual activity
-13% hospitalized for derm/anogenital lesions
-No deaths
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478203/
It has lost lethality in our population, thanks to a high vaccination rate, and a better understanding of how to care for people with it.
And, of course, nobody knows how lethal the dominant strain of COVID that will be circulating in 2023 is going to be.
What's the W.H.O. process which allows the director-general to bypass the W.H.O. process for scientific debate by experts?
The W.H.O. has (so far) failed to achieve international consensus on an international treaty that would give the W.H.O. the legal authority to override local health authorities (national, state, city) in the declaration of public health emergencies. If such a treaty were in effect, today's declaration by one human would have immediately affected the daily lives of 8 billion humans.
> As of yet, there has been almost no public awareness or debate of the substantial amendments to the IHR although the WHO Secretariat circulated the US initiative first in January 2022 to state parties ... Attention to the US amendments was further drowned by the stir made around the launch of the negotiations to draft a new treaty on pandemic preparedness and response by 2024 with a hitherto uncertain scope, content and outcome, as well as an uncertain relationship to the existing legal framework of the IHR.
Without objective reporting and analysis on the nuts and bolts of these ongoing treaty negotiations, which affect every person and country on Earth, we're left with coverage by polarized blogs, https://jamesroguski.substack.com/p/stop-the-who
41% of those infected with monkeypox were coinfected with HIV.
https://www.nbcnews.com/nbc-out/out-health-and-wellness/monk...
For anyone worried that monkeypox will be equivalent to Covid, the evidence does not support that.
And, either way, the statistics would have looked exactly like that in the early years of the HIV epidemic, which obviously became a huge burden on society as a whole, both in terms of infections and death as well as curtailing sexual freedom.
Hopefully this is a reason to reallocate money to a critical part of public health.
If anyone is curious, there's a 2019 survey of "the challenges experienced by state and local public health entities at the frontline of STD prevention and control" (NCSD Phase II report): https://www.ncsddc.org/wp-content/uploads/2019/11/NCSD-Phase...
But it's spread so extensively in the gay community, that it's also going to infect people outside that community now. And it's likely going to stay with the gay community as yet another STD for many years going forward.
There is also a high risk that now, when it's solidly established itself in humans, it may mutate to become much more human-to-human transmissible. (like Covid did)
This has already been the case for a long time, maybe forever? It's endemic in parts of Africa, just never managed to gain much of a foothold outside that area. But even without that movement, the petri dish for such mutations has been open for business for quite a while.
But in this case, we already have a vaccine for it. In the US at least, once we start opening up smallpox vaccine reserves, if you're in the gay community and you have a lot of partners, seems like a no-brainer to get the vaccine and be done with the risk of tissue-scarring pox.
There’s also the question of availability and it currently isn’t clear how available the monkeypox vaccinations are.
The fact that it's mainly in populations of gay men in San Francisco and New York also help - I would wager that cross section of the population is heavily left leaning, and heavily vaccine supportive.
The monkeypox vaccine is just the smallpox vaccine. The US has a stockpile of it and it is still given to military members.
I've heard from various outlets that people who are not MSM were, as of a couple weeks ago, in some places being denied tests even with distinct symptoms because they didn't meet the criteria for test allocation.
Case statistics can be affected by bias in how you identify cases.
> Infections with the type of monkeypox virus identified in this outbreak—the West African type—are rarely fatal. Over 99% of people who get this form of the disease are likely to survive.
So it has an IFR two orders of magnitude higher than COVID-19 in young people.
https://www.theguardian.com/politics/2022/jul/22/peter-stale...
So, I think it's crazy that:
> In early June, top officials assured Staley that the US had in place a stockpile of 1.2m doses of the vaccine
> The problem was most of those doses weren’t ready. Just 68,000 of the doses were already located in the US; the rest were in freezers in Denmark awaiting shipment. Worse, two-thirds of the doses in Denmark had been manufactured on a new factory line that the FDA hadn’t inspected – which meant the vaccines produced on it couldn’t be used, despite approvals from the FDA’s EU counterpart, the European Medicines Agency (EMA).
So the US is buying a stockpile of vaccines that it considers unacceptable for use? Who does that help? Was this the result of lobbying from a US-based donor with heavy investments in specific EU producers? Is this emergency-preparedness theater?
The FDA reported that it _started_ inspections of that plant on July 7. To be clear, these were bought under a Trump-administration order, so they could easily have inspected that plant a long time ago. Why wait until you actually have an outbreak?
And of the vaccines that _were_ already FDA-approved, it really seems like the administration has really slow-walked moving them.
Meanwhile, in my city which has perhaps the worst outbreak in the US in per-capita terms, vaccines are scarce enough that people can wait for hours in line and then not receive it. People who are in the group who are advised to get the vaccine can call one of several phone numbers to try to get an appointment, but no one will answer.
https://www.sfgate.com/bayarea/article/san-francisco-monkeyp... https://www.theguardian.com/world/2022/jul/21/san-franciscos...
So while others in this thread are arguing that the WHO shouldn't be declaring this an emergency, I'm frustrated that the people calling it an emergency aren't empowered to do much.
The FAA gets Boeing to hire people who carry out the jobs of regulatory approval, just think about that.
But buying vaccines that are supposed to be used in an _emergency_ (i.e. against bioterror https://www.washingtonpost.com/investigations/before-pandemi...) and storing them overseas and not allowing them to be used in a crisis because you haven't inspected the facility that produced them seems like the worst of all worlds. This government spent resources on vaccines, pretended this made us safer, and refused to use them.
I have a bag of supplies for an inevitable earthquake. Using the logic of our government, instead of storing it in my home, I should keep it in a distant self-storage locker ... and I should refuse to drink my emergency water because the bottle could have BPA.
> “We were hit by a wall of FDA arrogance, which it’s famous for: ‘This is how we do things, and this is why we do things, and you all don’t know how it works.’ They told us directly that they simply think that they are the best in the world at this and that the EMA is not quite there yet. And they won’t say why.”
I think when you fail hard, you shouldn't get to be smug at the other countries that (a) produced the vaccine and (b) had their inspectors do their jobs in a timely manner.
Not the worst idea to wipe down machines before/after use as a general rule, monkeypox or not.
I _am_ annoyed that the guidance on how it spreads keeps getting broadened. Initially it was supposed to be fluids or skin-to-skin contact ("ok, easy, no cuddling with active rashes for now").
Now the guidance says it can be carried on cloth (e.g. linens). But really, the virus doesn't know that much about what surface it's on, right? And indeed the CDC public-facing guidance does say that it can spread from "shared surfaces, and objects, such as bedding, towels, and sex toys, that were used by a person with monkeypox", but only under a collapsible heading "Can I get monkeypox from having sex?" I.e. they recognize that surfaces can carry it, but perhaps there needs to be a lot of contact with the surface in question. But if, for example, I'm unaware I'm infected but I lie on a pool-side lounge chair which someone else then uses ... couldn't that be comparable shared contact as a bedsheet? Is that so far off from contact with a bench at the gym?
Slightly more concerning is:
> "It also can be spread by respiratory secretions during prolonged, face-to-face contact"
The same page includes "talking closely" as a form of "intimate contact". So it does sound like it can be spread by airborne particles but perhaps less easily than the other viruses we've all been dealing with. If there are a few treadmills in small, not especially well ventilated room, at what point do two people running there share respiratory particles which are comparable to prolonged face-to-face contact?
It feels like they don't have a for sure good idea so they are covering all their bases just to be safe.
actually, it might. Porous vs impermeable surfaces can affect how long a viral particle remains infectious.
Could also be potential electrostatic effects, copper for example.
Not that many people have stainless steel bedsheets...
It is odd they tie bedsheets to sex contact alone. Eg if you sometimes co-sleep, that itself is a vector. Though good chances are you are also having sex with your sleeping partner.
There is a time element as well. If someone with the disease laid out on your sofa yesterday and it's dried out since, you're fine. It also probably requires sustained (and probably wet - eg sweat) contact.
Source: https://www.eurosurveillance.org/content/10.2807/1560-7917.E...
Even after they recover, they are still very infectious: https://twitter.com/alexmeshkin/status/1543313032817917953
And yes, someone with Monkeypox went to a gym after feeling sick (https://twitter.com/KxngRudy/status/1545893342994644994).
Some conspiracy folks consider the WHO, just like the UN, the manifestation of the NWO global government that secretly controls everything.
Didn't help that Trump had some weird hate boner for the WHO to such a degree that the US left it, plus a lot of "WHO is in the pocket of China to suppress the truth!" hysteria around t he same time.
Then there was this whole episode of, mostly US conservative media, creating a shit-storm over this WHO tweet [0] by interpreting that tweet as "WHO said it doesn't transmit between humans, WHO has been wrong and shouldn't be trusted!"
① Finger-pointing an institution that has very limited funding, and very limited power, for corruption, is like blaming the river for sea level rise. Sure, if you dig into the numbers, it contributes to the result; but fundamentally it is not the cause of the problem, and there are much bigger fishes that deserve much more scrutiny.
② Blaming WHO for a tweet where they simply report the words of the Chinese investigation with attribution, at a time where many countries with actual power pretended there was no risk, feels disingenuous.
I don't know if it would be possible to detect the virus earlier if it happened on some place that wasn't trying to cover it up, but when we got to know about it, it was already too late to contain.
So the virus had been in Italy at least 2 days after the first hospitalization in Wuhan, and around 5 days before doctors collected the first samples which were sent off to labs which later determined it was a novel virus.
You actually can't blame China for not acting before they really had any patients or knew anything was going on.
https://www.scmp.com/news/china/society/article/3074991/coro...
There is no way you cannot talk about the Gates foundation when talking about the AZ covid vaccine[1]. It was supposed to be open access and the Gates foundation lobbied to sell it to AZ which has a horrible track record[2].
I personally think that had they not lobbied that hard to privatize the Oxford vaccine, the problems with the AZ vaccine, would probably have been fixed with further iterations by third parties and the discussion would have looked a bit differently. But we will never know. It's worth noting that the medical branch of the Gates foundation is run by ex pharma bros.
At end of the day Gates is just another greedy grifter, hiding his greed behind altruism. That puts him squarely in line with most Billionaires that have their own little foundations that help them steer and lobby shit instead of paying tax.
[1] https://khn.org/news/rather-than-give-away-its-covid-vaccine...
[2] https://www.science.org/content/blog-post/astrazeneca-looks-...
It's easier to notice when they talk about non-tech related things, because with tech you are prone to give the benefit of the doubt that they might now what they are talking about, since if it's not your field of expertise it's harder to doublecheck the claims. With news instead everything is crystal clear. Just the usual average internet user that believes he understood everything and acts as a major expert when in reality it completely misses the complexity of the issues he's talking about.
Well done! (I mean that. It probably sounds snarky but I swear I'm just impressed with how well the self-referentiality held up over most of the whole thing.)
Anyhow, I once got to talk to Alan Kay on here. There's a lot of noise, sure, but the signal here, when you get it, is outstanding.
Why don't we always just consider posts on forums to be just some opinion, from the poster's point of view, isn't that how a conversation works? Though I know expectations differ, I'm not sure why.
And now this attitude of mistrusting anything and everything coming from an "official" source has gone mainstream.