New global health emergency declared

s'nic said:
Sadly after the pandemic we all know how fast this has the potential to spread
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Well, it varies by disease of course. I think this one spreads more by touch than by aerosol, doesn't it? This clade is said to have ~10% fatality, so if I'm offered a vaccine I'm taking it.
 
Just checked as that was my thought - how does it spread?
The touching something an infected person has touched is a bit concerning, but tho it seems you can catch it via respiration that seems less likely to happen.

World ecomonic forum - "Human-to-human transmission is limited and the virus is transmitted through direct contact with bodily fluids or skin lesions as well as indirect contact with lesion materials through items such as contaminated bedding or clothing. It can also spread through respiratory droplets, but does not travel easily by air and requires direct, prolonged contact with someone who has an active rash."

BBC - "Unlike the virus that causes Covid-19, which primarily spreads through tiny droplets expelled as we breathe and is highly infectious, mpox is not as readily transmissible. It instead relies on close physical contact – usually prolonged – to pass from person to person, or animal to person.
"It could be contact with someone who has an infectious rash, such as lesions, scabs and bodily fluids," says Madeline Barron, from the American Society for Microbiology (ASM). "You can also get it by touching items that someone who's infected may have touched." "

WHO - "It can be transmitted through physical contact with an infected person, animal or contaminated materials."
 
s'nic said:
"It can be transmitted through physical contact with an infected person, animal or contaminated materials."
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So there's every chance it can be contained successfully, presuming we have reasonable luck and the virus continues to behave as expected.
 
I'm interested to see how this plays out this time. A potentially new pandemic around the corner just as the last one drops from the news. I've no idea anything will come of this but I have lots of questions based on my experience of the last pandemic.

Will countries be doing their own isolations of the mpox (money pox) clade 1b virus or will the world be solely reliant upon one labs results? Will they be developing traditional (whole virus protection) one dose vaccines known for giving immunity from illness and transmission or a novel 2,3,4,5,6,7 etc dose /booster mRNA platform (protection to only part of the virus) which allowed multiple infections, illness and the continuous spread of the virus? Will they be giving us both the relative risk (e.g 95% effectiveness) reduction AND the actual (e.g 1%) risk reduction.

Will they contain the virus early in symptomatic individuals as a h.c.i.d high consequence disease or change status and go for lockdowns?

Will naturally acquired immunity be completely ignored? Will they still test those already recovered from it? Will they be recommending vaccinating those already recovered from the virus?

Will they release all the test data, including the number of tests, not just giving the so called positive results, so we can gauge as a percentage how many people are "positive" as a ratio of the total number of tests. E.g are only 1 in every 1000 tests testing positive?

How will they be determining what a "case" is? Will one have to be actually sick or well to be locked in their homes? Will everyone be told to stay home (lockdowns) to flatten the curve? Will a "case" be anyone who tests "positive"? Will they be using a PCR repetition cycle of a billion repeats, which can find traces of almost any virus in anybody to get a positive result? Will a m-pox death be anyone who tests positive, regardless of whether they even have any symptoms of the disease? Will they be asking people to leave their homes (at the risk of spreading it to others) to get tested (even though there was no treatment available)? Will the tests show if one is actually infectious or will it just be a "positive" for non infectious inactive virus traces? Will they be locking people in their homes just from being at the same restaurant as someone else (contact tracing) who tests "positive"?

Will the people leading the response be following their own advice?

Will we be seeing the ludicrous strategies, scotch eggs, changing seats on your train journey as we pass from England to Scotland?

Will they be telling people they're sick even when they are not and have no such symptoms?

Will they be claiming mpox cause of death even if person never had any symptoms of such?

Will they be making the most of our isolated island and prevent targeted overseas travel immediately to prevent a pandemic in our country or will they keep flights etc open throughout?

Are they going to shutdown, ostricise, block and prevent any scientific opinion that doesn't align with their agenda and fact check everyone but themselves?

Are we going to get accurate, factual and honest advice? Or lots of "we don't know" or "we have no evidence" when they know fine well that the likelihood that some things will in all likelihood be useful, e.g taking vitamin D3 and improving gut biome. Will they be condemning potential cheap, safe and widely used (non patentable) drugs that could help?

Will any potential treatments and preventatives be ignored or mocked in the media to ensure an emergency authorisation of a novel vaccine be given.

Will we hear any actual public health advice to help protect and reduce the effects of the virus? Things like encouraging good gut biome, vitamin d3, healthy diet etc or will we be officially (from parliament) advised that there is no benefit in increasing our vitamin d levels.

Will we be told there is "no evidence" anything works except a novel vaccine. Note "Absence of Evidence is not Evidence of Absence". https://www.bmj.com/content/311/7003/485

Will we be hearing the dodgy model data suggesting a far worse scenario than imaginable? Showing data for an outcome if we do nothing. Where in reality we were always going to be doing something.

Will they aggressively push the excess deaths rates only to revise them later by O.N.S to show no excess deaths occured?
 
The government has a bit of a conundrum. Given how Keir Starmer and his Labour colleagues damned the previous Conservative administration for failing to lock down the country early enough for Covid, what are they now going to do about the new strain of monkeypox?

www.spectator.co.uk

What should Starmer do about monkeypox?

The government has a bit of a conundrum. Given how Keir Starmer and his Labour colleagues damned the previous Conservative administration for failing to lock down the country early enough for Covid, what are they now going to do about the new strain of monkeypox (or ‘mpox’, as we are now...
www.spectator.co.uk www.spectator.co.uk
 
To be fair it's a totally different illness, so comparisons are not simple. EG, airborne transmission would appear more rare - also once the skin lesions appear you can spot an infected person relatively easily.
Infectious individuals being easily identified should mean reduced numbers of infected people mingling with uninfected. The net result is likely to be a reduced / slower spread of this (of course this is life and we should expect curve balls).
 
s'nic said:
To be fair it's a totally different illness, so comparisons are not simple. EG, airborne transmission would appear more rare - also once the skin lesions appear you can spot an infected person relatively easily.
Infectious individuals being easily identified should mean reduced numbers of infected people mingling with uninfected. The net result is likely to be a reduced / slower spread of this (of course this is life and we should expect curve balls).
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The NHS has been issued this urgent public health message. It's classed (as COVID was) as a HCID with all suspected outbreaks to be isolated in hospital, ideally through one of the HCID centres. The treatment (as COVID was) is mainly supportive. All staff to wear FFP 3 masks and PPE.

Infectiousness of mpox occurs prior to showing any symptoms. They need to be using the right tests this time, tests that actually confirm infectiousness not just traces of the virus. Last time they were isolating people regardless of knowing if they were actually infectious. They had people convinced they'd had COVID even when they never had any symptoms! People ringing in work "sick" when they were actually well (they just had a positive test).

www.gov.uk

Clade I mpox virus infection

Urgent public health message to all NHS service providers regarding Clade I mpox virus (MPXV) infection.
www.gov.uk www.gov.uk
 
Amity Island said:
Infectiousness of mpox occurs prior to showing any symptoms.
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Yes I figured that was the case as the Sweden case was caught in Africa, but only detected in Sweden.
My view was that someone with covid could pop up the shop knowing they were infected, and knowing no one would realise. But once the lesions appear that scenario is much less likely with Mpox.
 
s'nic said:
Yes I figured that was the case as the Sweden case was caught in Africa, but only detected in Sweden.
My view was that someone with covid could pop up the shop knowing they were infected, and knowing no one would realise. But once the lesions appear that scenario is much less likely with Mpox.
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I really hope we don't have to go through anything like the last one. The confected (ad hoc) response was worse than the problem, absolutely devastated our country, finances, business, health, education, wellbeing etc I don't think we are in a strong enough position to be put through it all again.

Instead of keeping a cool head (keep calm and carry on), the country was put into 24/7 panic and fear.
 
Amity Island said:
Will countries be doing their own isolations of the mpox (money pox) clade 1b virus or will the world be solely reliant upon one labs results?
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Probably they'll do their own isolations and sequencing, as they did with SARS-CoV-2. (See https://theconversation.com/i-study...ronavirus-to-fight-the-global-pandemic-133675 ). But it'll depend, as always. Maybe the virus won't become widespread enough and/or won't vary enough to matter?
Amity Island said:
Will they be developing traditional (whole virus protection) one dose vaccines known for giving immunity from illness and transmission
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Whether a vaccine is good at reducing transmission depends as much on the virus/bacterium than the vaccine, and not that many are singe dose. (And there's good reason for suspecting a few doses will always be better.) MMR is pretty good at reducing transmission (for all three viruses), but the polio vaccines suck at it, with the influenza vaccines some way between the two.

I've no idea how well the current mpox vaccine does in this respect. It's a two-dose weakened whole-virus vaccine, so a traditional one. I think I've read of an mRNA one being developed (and it would be surprising if there weren't one in development).
Amity Island said:
Will they be making the most of our isolated island and prevent targeted overseas travel immediately to prevent a pandemic in our country or will they keep flights etc open throughout?
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Doubt it. That would be horribly expensive.
Amity Island said:
Are we going to get accurate, factual and honest advice? Or lots of "we don't know" or "we have no evidence" when they know fine well that the likelihood that some things will in all likelihood be useful, e.g taking vitamin D3 and improving gut biome. Will they be condemning potential cheap, safe and widely used (non patentable) drugs that could help?
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Science is provisional. I'd like to hope communications in the future will make the uncertainties clearer but I don't know whether that will happen.

I'm unpersuaded by the evidence in favour of vitamin D3 (vitamin D3 has been promoted for dozens of things, and while having low D3 is bad, there's never been that much evidence of benefit for supplementing people with normal levels). Similarly for things like gut health: not bad things to improve, but probably won't make that much difference. (And for HCQ, Ivermectin, etc., the evidence is in: they don't work for SARS-CoV-2.) I think it's perfectly reasonable and sensible not to promote things that you don't have confidence will make a difference. Imagine if the UK authorities had promoted vitamin D3 supplements for everyone and that that turned out to be of marginal value?

I agree the early dismissal of masks was dishonest. They must have known they'd likely be effective and wanted to discourage use to preserve them for healthcare staff (since our pandemic supplies were apparently inadequate).
Amity Island said:
Will any potential treatments and preventatives be ignored or mocked in the media to ensure an emergency authorisation of a novel vaccine be given.
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That didn't happen with SARS-CoV-2 and couldn't happen with mpox since we've had vaccines for decades. What we lack is apparently the ability or sufficient empathy to provide it in sufficient quantities to those countries that need them (DRC specifically). (I've heard an estimated cost of $15m for that which seems like a trivial amount of money.)
Amity Island said:
Will we be hearing the dodgy model data suggesting a far worse scenario than imaginable? Showing data for an outcome if we do nothing. Where in reality we were always going to be doing something.
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I'm sure there'll be modelling (and likely it's already happening). One scenario surely ought to be what would happen if we do nothing, not because we won't do anything but because that's simplest to model. As the saying goes, all models are wrong but some are useful.
 
s'nic said:
EG, airborne transmission would appear more rare - also once the skin lesions appear you can spot an infected person relatively easily.
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Yes, my impression is that they think this is largely close contact transmission. So while you might get transmission without contact, you still have to be pretty close (so maybe droplets). I think WHO and other places are saying one mechanism of transmission is airborne; I get the sense that that's mostly because they don't want to rule that out rather than they think it's significant.

What does seem different from the last mpox scare is the different clade and that this one has much worse fatality rates, including children. (So not just sexual transmission. Which was never really true but it kind of looked a bit that way, especially since people who didn't fit that pattern were mostly not being tested.)

I still think it's most likely it'll end up having such slow transmission that it'll only infect very small numbers of people. On the other hand if it does transmit through the air, while we know about masks and things now there's a decent proportion of the population who'll pretend masks don't work. And we've done nothing to improve air quality in most buildings. And a decent proportion of the population dislike vaccines generally.

But most likely it won't matter because it'll stay a small problem. I just hope the west provides vaccines to those poorer countries which could really use them.
 
Bruce Stephens said:
Maybe the virus won't become widespread enough and/or won't vary enough to matter?
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The biggest point of failure may be in not planning for the curve balls. We know the mpox virus has changed over time, and we know that with a bigger pool of infected people it is more likely to mutate.

Bruce Stephens said:
I just hope the west provides vaccines to those poorer countries which could really use them.
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This seems to me the best way forward. Tackle it in the countries where cases are higher, and reduce the likelihood of mutation by minimising the numbers of infected people. Also hopefully reduce the number of cases which leave the country.
 
s'nic said:
Yes I figured that was the case as the Sweden case was caught in Africa, but only detected in Sweden.
My view was that someone with covid could pop up the shop knowing they were infected, and knowing no one would realise. But once the lesions appear that scenario is much less likely with Mpox.
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It still doesn't seem to be clear on whether it is transmitted (infectious) before any symptoms appear (e.g a fever, headache etc), transmitted (infectious) during those first symptoms, infectious once the pox appears or much later after pox appear?

The testing for mpox seems to be from PCR swab samples taken from the pox, not before the pox appear.

What have you gleaned so far?
 
Amity Island said:
It still doesn't seem to be clear on whether it is transmitted (infectious) before any symptoms appear (e.g a fever, headache etc), transmitted (infectious) during those first symptoms, infectious once the pox appears or much later after pox appear?

The testing for mpox seems to be from PCR swab samples taken from the pox, not before the pox appear.

What have you gleaned so far?
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I've been having a bad few days so not really tried to do any concentrated searches.
Part of me says it's early days yet, and we should learn a bit more soon ...
Then I think hang on a) it's a new variant of an old disease, and b) the new version has been around for a while - so they should be able to provide us (the public) with definitive ways it is being transmitted. :confused:
 
Amity Island said:
It still doesn't seem to be clear on whether it is transmitted (infectious) before any symptoms appear (e.g a fever, headache etc), transmitted (infectious) during those first symptoms, infectious once the pox appears or much later after pox appear?
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I'm not sure it's known. While it's an old disease, mostly it affects people in poor countries and research is limited. Even in the best situations, I think determining transmission details is just tricky.
 
I was listening to an expert on it the other day on Radio 4 and they seemed to be saying that whilst it can be infectious for a couple of days before obvious symptoms, transmission is mostly through close body contact which is much more limiting of the spread than air transmission with Covid.
He also said that calling it monkey pox is not strictly accurate as it is believed to have originated in rodents.
It is hard to tell if they are playing down the risk so as not to alarm people particularly as there is already racial unrest and very easy for this to play into that I imagine or if the risk of transmission is genuinely significantly lower than with Covid.
 
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