WHO Declares Mpox Global Health Emergency | Hacker News Reader

WHO Declares Mpox Global Health Emergency

bbc.com

53 pointschoult16 comments

Keep in mind that this is spreading in countries with extremely poor health care systems, and a high baseline level of disease. Any estimate of mortality, based on current examples, is not reflective of what would take place in a first-world country.

For small numbers. If the healthcare capacity gets saturated so-called first-world countries might not do so much better. Massive HIV prevalence is going to distort the case fatality ratios for sure, but on the other hand I'd say high baseline exposure to serious infectious diseases could well be an argument for resilience rather than vulnerability.

Healthcare capacity is not going to get saturated from a virus that spreads by close contact. This is not a respiratory virus.

Even in its limited state in the areas of Africa we're talking about, I doubt that health care was "saturated". The more fundamental problem is that you have a lot of people who are ill or malnourished to begin with.

That turned out to be the case with the 2022 epidemic. This is a novel virus variant which is spreading with enhanced efficacy and to several areas where the disease has hitherto not been reported, by means which have not yet been adequately characterized.

And I'd say healthcare capacity in the afflicted areas is already saturated by default, in the senses I meant, which is that they have no remaining means to improve the outcomes for new disease cases. Severe deficit of vaccine and relevant immunoglobulins, no meaningful access to antivirals (admittedly I'm guessing about this one) and little to nothing to offer in symptomatic treatment over self care. My question to you then (and given your PhD background I guess you may actually have seen some data on it) is how many cases does it take before most "first-world" countries are in that situation as well? The USA may be better off than most due to strategic stockpiles of anti-smallpox measures, but let's say for the typical rest of them.

> That turned out to be the case with the 2022 epidemic.

No, it didn't. There were less than 100,000 cases globally in the 2022 outbreak. At the peak of the outbreak, in the US, there were about 500 cases a day, nationwide.

https://www.cdc.gov/poxvirus/mpox/response/2022/mpx-trends.h...

> This is a novel virus variant which is spreading with enhanced efficacy

Aside from some scary quotes in a BBC article, there's no evidence of what you're claiming. There have been less than 14,000 cases since the beginning of the year. That sounds like a lot, but we're talking about multiple countries in Africa. It's not a huge number.

> My question to you then...is how many cases does it take before most "first-world" countries are in that situation as well? The USA may be better off than most due to strategic stockpiles of anti-smallpox measures, but let's say for the typical rest of them.

It has nothing to do with anti-smallpox measures. Once someone has the virus, treatment is symptomatic:

https://www.cdc.gov/poxvirus/mpox/clinicians/treatment.html

Those things matter to completely contain the spread of the virus, but once someone is infected it comes down to people being healthy enough to survive any infection. Remember: uncontrolled HIV is rampant in these parts of the world. That alone probably explains a lot of the elevated mortality in this outbreak.

The first world is fundamentally a different place when it comes to viruses like this. It's not something you need to worry about.

The good news is that mpox is related to smallpox, so a vaccine was made available relatively quickly in 2022 during that outbreak and had high efficacy.

I'm not sure I'd call that unequivocally good news. But certainly it's fantastic that a high efficacy vaccine already exists. At that time it was available in very restricted quantities, used in countries which had access to it for highly targeted vaccination of individuals at very high risk for the sexual transmission (which seems to be just about the only really effective mode for that lineage). I wonder just how much better off we are for doses and production capacity today. A press release a couple of days ago mentioned about 200k doses from the EU donated to African countries at risk. I'm not going to say that isn't generous, but it's not huge numbers compared to the populations involved.

At the very least we don’t have to spend the months or years in clinical trial holding our breaths for something that works while people die.

Massive plus for sure. Even better than cutting a decade of research to less than a year for SARS-CoV-2 because most of the lessons learned from SARS-CoV turned out to apply, because in this case the existing vaccines are already tried and effective (and presumably the new clade is not different enough to change that in any significant way).

well since we're being pedantic.... you're saying you still have doubts of whether or not the existence of a working vaccine for a deadly disease qualifies as good news, because the availability of the vaccine may not be universal

Certainly not. Whatever gave you such a bizarre impression?

I'm strongly implying that I'm not particularly happy about this being an orthopox virus of significant lethality, despite that circumstance meaning it's reasonably well-researched.

> A previous [WHO] mpox public health emergency, declared in 2022, was caused by the relatively mild Clade 2.

July 2022, https://www.science.org/content/article/declaring-monkeypox-...

  The World Health Organization (WHO) today declared the global spread of monkeypox a Public Health Emergency of International Concern (PHEIC), even though a special advisory committee again declined to recommend the action. This is the first time since the PHEIC system was created in 2005 that the agency has made such a declaration without the panel’s endorsement.  “This is big, unprecedented decision-making by the director general,” says Clare Wenham, a global health expert at the London School of Economics who has studied the history of PHEICs.

This time around, a WHO PHEIC declaration can test-drive the June 2024 amendments to the 2005 IHR (International Health Regulations) treaty, which were a fallback after failing to gain consensus on a global pandemic treaty, https://www.who.int/news/item/01-06-2024-world-health-assemb...

  World Health Assembly, the annual meeting of its 194 member countries, today agreed a package of critical amendments to the International Health Regulations (2005) (IHR), and made concrete commitments to completing negotiations on a global pandemic agreement within a year, at the latest, and possibly in 2024. These critical actions have been taken in order to ensure comprehensive, robust systems are in place in all countries to protect the health and safety of all people everywhere from the risk of future outbreaks and pandemics.

Anyone know the logic for why it was renamed from Monkeypox to Mpox?

The WHO explains their rationale here: https://www.who.int/news/item/28-11-2022-who-recommends-new-...

I'm not saying this is something that should be ignored, but it feels out of place for HN.

From the guidelines:

> If they'd cover it on TV news, it's probably off-topic.

We talk about health topics all the time on HN. That particular thing is mostly for obvious flamewar bait.

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