Over the weekend, the WHO did not declare Monkeypox (MPX) as a Public Health Emergency of International Concern (PHEIC). This was a big surprise. Cases are increasing and MPX is quickly establishing itself across the globe. Public Health Emergency of International Concern (PHEIC)
Is there even limited data on how effective the original smallpox vaccine (received by many of us decades ago) might be? Would that be important, not only for prevention, but in determining priority for vaccination?
I don’t understand your headline, esp the all caps, when you disagree w it ~ “ Wouldn’t we want a PHEIC to prevent these terrible things from happening? We must get out of this reactive response mode. The window to stop this virus is closing. As Professor Michael Worobey said:
“This is like deciding to snooze for an hour when the smoke alarm goes off to be good and sure it's a real fire. Time to realize it's smart to get out of bed even for false alarms now & then.””
It's time to form a people's WHO equivalent. The WHO and for that matter, the CDC as well, are mired in distractions and have lost their ability to follow science. All we need are a handful of qualified people in each region of the world. I would listen to what such a group had to say. As for WHO? Who cares?
There is another scenario with testing in which the patient seeks testing, the doctor agrees, but there is gatekeeping at the state DOH level, at least from some things I’m seeing anecdotally. I saw a state webinar on Friday in which the scientist friend of an MPH/PhD (who was relating the story) saw 4 doctors over 8 days before he could be tested, both with high clinical suspicion and checking off multiple epidemiological criteria boxes. I think the MSM community is certainly showing a willingness for proactive vaccination, but I have my doubts as to whether that would hold true amongst other groups…such as parents for their kids.
Why would condom use be recommended during and after infection? That seems highly irresponsible given the current state of our knowledge. People with suspected MPX infection (current or recent) shouldn't be touching anyone, let alone having any form of sex, and should be wearing masks and generally staying away from others.
Now that the WHO has declared MPX a PHEIC would you be willing to give an update of the situation? What is the risk for us? Is this still just a concern for the MSM communities? What about the potential risk for children and families? Could this become a disease that spreads in schools and daycares? What are reasonable precautions for families to take at this time?
I mean - I’m not saying panic AT ALL - but for folks with young kids, without clear data on how many cases/how wide the spread, should we be sanitizing groceries? Skipping hotel vacations given airborne COVID/how long MPX lives on surfaces (including fabrics etc.)?
A problem we're having is the severe lack of information. How much advance time do we need to get the vaccine before we are protected? How effective is the protection? I was born a few years after routine smallpox vaccination stopped in the US (1972), so I effectively have no immunological protection against monkeypox. With a search for more information comes a plethora of US news articles from late May / early June. Four weeks is fairly long when we're experiencing a public outbreak of a communicable disease.
Thank you for distinguishing the *evaluation criteria* for PHEIC from the *consequences*, which as you point out, are quite serious. Once evidence of MPX's spread mounts, it's likely too late to coordinate a meaningful international response and stop cross-boarder transmission. "Circular reasoning is a logical fallacy in which the reasoner begins with what they are trying to end with," according to Wikipedia. Once again, thank you Dr Jetelina for your clear-headed thinking, and for your bravery. I hope the powers that be at the WHO and the CDC read your post!
Cases have doubled in the US since you wrote this last week. I would presume they will keep doubling? This is seriously concerning, especially assuming it is underreported right now. Thanks for your thoughts and insights, I hope you can give us some updates soon.
Is there even limited data on how effective the original smallpox vaccine (received by many of us decades ago) might be? Would that be important, not only for prevention, but in determining priority for vaccination?
I don’t understand your headline, esp the all caps, when you disagree w it ~ “ Wouldn’t we want a PHEIC to prevent these terrible things from happening? We must get out of this reactive response mode. The window to stop this virus is closing. As Professor Michael Worobey said:
“This is like deciding to snooze for an hour when the smoke alarm goes off to be good and sure it's a real fire. Time to realize it's smart to get out of bed even for false alarms now & then.””
It's time to form a people's WHO equivalent. The WHO and for that matter, the CDC as well, are mired in distractions and have lost their ability to follow science. All we need are a handful of qualified people in each region of the world. I would listen to what such a group had to say. As for WHO? Who cares?
RE: the lines for the vaccine in NYC — June 25/26 was Pride weekend in NYC, so word-of-mouth might have been more effective than usual.
There is another scenario with testing in which the patient seeks testing, the doctor agrees, but there is gatekeeping at the state DOH level, at least from some things I’m seeing anecdotally. I saw a state webinar on Friday in which the scientist friend of an MPH/PhD (who was relating the story) saw 4 doctors over 8 days before he could be tested, both with high clinical suspicion and checking off multiple epidemiological criteria boxes. I think the MSM community is certainly showing a willingness for proactive vaccination, but I have my doubts as to whether that would hold true amongst other groups…such as parents for their kids.
Why would condom use be recommended during and after infection? That seems highly irresponsible given the current state of our knowledge. People with suspected MPX infection (current or recent) shouldn't be touching anyone, let alone having any form of sex, and should be wearing masks and generally staying away from others.
Wonderful presentation. MPX is here in Oregon and for various reasons is still a bit underreported which is worrisome. Advise extreme caution.
Now that the WHO has declared MPX a PHEIC would you be willing to give an update of the situation? What is the risk for us? Is this still just a concern for the MSM communities? What about the potential risk for children and families? Could this become a disease that spreads in schools and daycares? What are reasonable precautions for families to take at this time?
I mean - I’m not saying panic AT ALL - but for folks with young kids, without clear data on how many cases/how wide the spread, should we be sanitizing groceries? Skipping hotel vacations given airborne COVID/how long MPX lives on surfaces (including fabrics etc.)?
A problem we're having is the severe lack of information. How much advance time do we need to get the vaccine before we are protected? How effective is the protection? I was born a few years after routine smallpox vaccination stopped in the US (1972), so I effectively have no immunological protection against monkeypox. With a search for more information comes a plethora of US news articles from late May / early June. Four weeks is fairly long when we're experiencing a public outbreak of a communicable disease.
Thank you for the comprehensive update.
Thank you for distinguishing the *evaluation criteria* for PHEIC from the *consequences*, which as you point out, are quite serious. Once evidence of MPX's spread mounts, it's likely too late to coordinate a meaningful international response and stop cross-boarder transmission. "Circular reasoning is a logical fallacy in which the reasoner begins with what they are trying to end with," according to Wikipedia. Once again, thank you Dr Jetelina for your clear-headed thinking, and for your bravery. I hope the powers that be at the WHO and the CDC read your post!
How difficult is it to get a monkey pox vaccination? Dr. Echt
ORDHS's report:
https://content.govdelivery.com/accounts/ORDHS/bulletins/31c8c61
Cases have doubled in the US since you wrote this last week. I would presume they will keep doubling? This is seriously concerning, especially assuming it is underreported right now. Thanks for your thoughts and insights, I hope you can give us some updates soon.