WHO declines to label monkeypox a global emergency
science.org
science.org
"The Committee was concerned about the potential for exacerbation of the stigmatization and infringement of human rights, including the rights to privacy, non-discrimination, physical and mental health, of affected population groups, which would further impede response efforts."
This is giving me strong early 2020 vibes . . . basically, "let's not declare an emergency to avoid stigmatization".
>The Committee discussed key issues related to the outbreak, including: current observations of plateauing or potential downward trends in case numbers in some of the countries experiencing outbreak early on...
>...The Committee recognized that monkeypox is endemic in parts of Africa, where it has been noted to cause disease, including fatalities, for decades...
>...However, the Committee unanimously acknowledged the emergency nature of the event and that controlling the further spread of outbreak requires intense response efforts...
>...The Committee considered that the occurrence of one or more of the following should prompt a re-assessment of the event: evidence of an increase in the rate of growth of cases reported in the next 21 days, both among and beyond the population groups currently affected; occurrence of cases among sex workers; evidence of significant spread to and within additional countries, or significant increases in number of cases and spread in endemic countries...
My reading is that the primary reason why a "Public Health Emergency of International Concern (PHEIC)" wasn't declared is because there's not enough evidence of growth and in fact evidence of a plateau in case numbers. Obviously I don't have access to any special information either way about whether this is a fair assessment.
Worries about "stigmatization" of gay men also seems to be a factor, and I agree that it would be really weird if offending the sensibilities of gay people in Western countries was a main concern (or something like that), but reading between the lines a bit I think it's probably more about the countries in Western Africa where monkeypox has already been endemic for decades and homosexuality is punishable by law.
https://en.wikipedia.org/wiki/Criminalization_of_homosexuali...
Won't have high case counts if you don't have testing! Yeah we really are acting like we haven't been watching this exact same movie for the last 2 years. Incredible.
This is just not an airborne disease, so forcing a new national test tracking program is not warranted.
COVID is infectious for several days before any symptoms. This makes classical spread control mechanisms highly inefficient. You can reduce the human-to-human interaction through lockdowns and restrictions, but cannot stop it completely. So a small percentage of pilots, police officers, nurses and other essential jobs will always carry and spread COVID, just because that's how probabilities work. The only thing you can do with restrictions is reduce this number to hopefully lower R0 below 1, but that's not viable.
Monkeypox spreads through visible and identifiable scabs. You can easily tell whether someone is infections from a simple visual inspection, so if we ever start running low on hospital beds due to it, the spread-reducing measures will be much more effective.
Also, from the original article:
>vast majority of cases is observed among [...] not previously immunized against smallpox (knowing that vaccination against smallpox is effective in protecting against monkeypox as well).
So:
1. We already have a working vaccine
2. The potential R0 will be much lower due to lack of asymptomatic spreaders
The media will do its best to paint it as the next apocalypse and divide people further based on their perception of the risk, but I do not think it would be wise to follow that lead.
In my experience medicine has a lot of blind spots where they won’t test for things that are considered rare, but it’s possible that it is only considered rare because they’re not testing. I hope monkeypox isn’t one of them.
EDIT: The tweet I saw; https://twitter.com/ahandvanish/status/1541214341558636547
HIV/AIDS research had a hard time during the 80's since it was considered EXTREMELY homophobic to ask if a person had a homosexual experience when diagnosed with HIV/AIDS/Kaposi's Sarcoma, which was an issue when tests were extremely limited/unsure of efficacy and the CDC was trying to figure out infection vectors.
This was an issue since, while not unique to the gay community, it massively increased the likelyhood of transmission, but it was politically untenable to claim that AIDS could be spread sexually and that anal sex massively increased the changes of transmitting it since it was considered homophobic.
Reagan didn't mention AIDS publicly until 1987, and the reason for that was definitely not that he wanted to avoid being seen as homophobic.
The saunas and baths where gay people convened were mostly in the big cities, the places where the AIDS epidemic were most concentrated due to basic population density.
The very places where the message that "you should probably use condoms and have fewer partners due to this new disease that we don't understand yet but are pretty sure is sexually transmitted" was a political death sentence in the cities where the message actually mattered.
This doesn't excuse Reagans response or the general homophobic attitude, but lets try to be more historically accurate.
There are reasons why Fauci, who used to be hated by the gay community for above reasons, is now considered one of the good guys fighting for the gay community.
You're confusing the cart and the horse. Homophobia was mainstream, to the point where it was extremely dangerous to honestly answer that you had a homosexual experience.
This is bad, of course. But I feel like you buried the lede. Did she have monkeypox?
>it’s possible that it is only considered rare because they’re not testing.
Unlike COVID-19, monkeypox has frank symptoms (welts) that clearly distinguish it from other diseases. It cannot be mistaken for much else. Therefore, only a certain fraction of cases (the least severe) are even candidates to be missed, since I find it hard to believe that even the "medically reluctant" would not visit a doctor when they find themselves developing a monkeypox rash.
EDIT: to another poster's comparison with AIDS, it's my understanding that the incubation period for monkeypox is not months long as happens with HIV, either.
It's stated that their whole family has symptoms. I agree, anyone who has symptoms should be able to get a test if available. In the case where not enough tests are available I would prefer a probabilistic approach (e.g. multi-armed bandit).
They then went on to discuss it with (someone related to the medical / testing field in some way) who explained that it's very hard to order a test for; something about there being a limited number of labs that can test for it or some such. And doctors needed to justify the test and would likely be on the phone for an hour just to get it ordered. As such, a lot of doctors just... won't, because it's such a commitment of time/effort to do so.
Edit: I think this is the story (it was the radio when I encountered it) https://www.npr.org/sections/health-shots/2022/06/25/1107416...
> Providers have to go out of their way to order a test. They have to receive permission and instructions from local or state labs, Nuzzo says. The process is cumbersome and often time-consuming. Sometimes a doctor has to sit on the phone for hours.
This was also a significant concern early in the COVID outbreak, and tests are ubiquitous now. (And a head-in-the-sand attitude coming from top policy-makers didn't exactly help, either.) So hopefully it can be addressed down the line, just as COVID was.
The doctors need to explain this to the patients then, but that's probably also too much effort for them.
https://www.cdc.gov/vaccines/hcp/vis/vis-statements/smallpox...
People in high risk groups should look to get vaccinated.
Lots of other tests exits that show you have it.
I’ve had a dozen doctors all declare i definitely don’t have the condition based on negative. Despite having every single symptom and some other blood tests that strongly suggested it.
I had to fight like crazy to get the other tests run. All positive. They still didn’t want to diagnose me. So then I had to push hard to start treatment. A Month later I was doing drastically better.
Some of stuff you can’t fake. Doctor finally agreed that I probably had it.
Every doctor since then loved to try prove I don’t have it by running the initial test. Because 25% chance means 0% chance.
You will also be called a hypochondriac at every single stage if you do any of that. By doctors, by family. Everyone. You will be told endlessly that it’s just anxiety.
Family that had been frankly abusive were shocked when I started getting positive results back and responding to treatment.
Some of the issues were genetic.
So several Members of the family that have been dismissing me went and got tested. They were testing positive for the same conditions and that explained a lot of the weirdness in their life.
Also sad to hear how a lot of my relatives died fairly young in horrible agony from same symptoms But everyone just dismissed it. No one thought that maybe it’s all related.
A sick visit to our pediatrician's office resulted in us seeing the other practitioner, not ours, who couldn't figure it out. Recommended antipyretics only at that point, took blood. Still in bad shape, a night or two later we went to a children's ER where all the staff spoke to us like we were overly concerned idiot parents. Finally when we returned to our pediatrician and saw our actual doctor, she near instantly recognized it as Kawasaki's and referred us over to NYU for treatment.
Once there, we were admitted to the ER, where my daughter and I stayed the entire night w/o any real help (triage). The following morning after I left and my wife took over, they came to put a line in her and start treatment (intravenous immunoglobulins [IVIg]) but "couldn't put a line in" because she had been "stuck too many times". So they recommended SEDATING HER AND PUTTING A LINE IN THROUGH HER HEART (sorry for the emphasis, I'm still mad). My wife, on little sleep called me to tell me all this and I refused the procedure. I said "no, what you're going to do is get the best phlebotomist at the hospital to put a normal line in her". They argued but eventually got someone and twenty minutes later I got a text saying they put a line in her from my wife. I mean... c'mon.
The following day when I returned there were 3 doctors who were in some way I believe following my daughter's case. One of them insisted on a secondary treatment, the other two said we could go home. I asked the one doctor a series of questions which he effectively dismissed and told me to just do what he was asking. The other two on the other hand answered my questions (e.g): * if the disease comes back, will it present with the same symptoms * if the disease comes back, when will it come back, what is the median time * are their studies on recurrence of the disease etc. etc. long list I can't remember.
I contacted UC San Diego, where they study Kawasaki's. Read papers, got papers in Japanese which I forwarded over to this pair of doctors who entertained my questions. They translated the papers, read them, told me the findings within.
I took her home that day. I don't deal with medical "professionals" who dismiss you. Glad you didn't either.
In her case, 4+ years later, she’s great. No recurrence. Heart was cleared of any abnormalities which could have been a side effect. Avoided all that by catching it early enough
Built by overworked people that stopped studding or practicing statistics decades ago.
Ultimately I was diagnosed by my mother's coworker/friend. They were parking ramp toll booth attendants at an airport at the time. She recognized the symptoms because her dog had it. My mother had to go full Karen on a doctor until they agreed to test for it.
Your average doctor is given entirely too much faith.
WHO does something? Power-hungry bureaucrats fueled by hysteria and ideology.
The only thing we know for sure is that they're definitely not well-informed yet still fallible professionals just trying to do their job.
Also, Tedros needs to go.
[1] https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-m...
It probably represents the limits of diagnostic capability rather than increased effectiveness of test-and-trace efforts.
"Human-to-human transmission occurs through close proximity or direct physical contact (e.g., face-to-face, skin-to-skin, mouth-to-mouth, mouth-to-skin contact including during sex) with skin or mucous membranes that may have recognized or unrecognized infectious lesions such as mucocutaneous ulcers, respiratory droplets (and possibly short-range aerosols), or contact with contaminated materials (e.g., linens, bedding, electronics, clothing)."[1]
"Intubation and extubation, and any procedures likely to spread oral secretions should be performed in an airborne infection isolation room."[2]
[1]: https://www.who.int/emergencies/disease-outbreak-news/item/2...
[2]: https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-...
Nowhere does it says that it is airborne.
a technique known as 'shadowbanning'
Maybe I'm missing something here, but is the above not the definition of airborne?
Aerosols are heavier than air, and therefore have a very limited range and duration in which the virus can remain "airborne" in common parlance.
(edit: expanded the definition to include more than just viruses as I couldn't find an example of a virus that can survive unencapsulated)
"Limited person-to-person spread of infection has been reported in disease-endemic areas in Africa"
one might wonder how the child got infected ....