Is Monkeypox the World’s New COVID-19? Scientists make a judgment call

As if one pandemic wasn’t enough, a dangerous new virus is spreading around the world. About two weeks ago, monkeypox — a pathogen that originates in West and Central Africa and causes flu-like symptoms and a rash — started in places where it isn’t usually found.

Portugal, Spain and the United Kingdom have jointly reported several dozen cases. And now the United States. Authorities in Massachusetts discovered the infection Tuesday night, and the U.S. Centers for Disease Control and Prevention quickly confirmed it.

But don’t panic. The world has had monkey pox outbreaks before. And we are even better prepared for the virus now that we have been practicing with the new coronavirus for three years.

“I’m not worried about anything that looks like an outbreak,” Irwin Redlener, the founder of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast. He used the epidemiological definition of outbreak, a sudden spread of an unusual disease, but in a small geographical area rather than worldwide.

The handful of cases of monkeypox in a handful of countries do not yet qualify as an outbreak, by the standards of many scientists. Can the virus spread to more people in more countries? Yes. But don’t expect it to be anything like the spread of COVID. “SARS-CoV is much more contagious than other infections,” Stephanie James, the head of a viral testing lab at Regis University in Colorado, told The Daily Beast.

A slower spread means authorities have more time to confirm cases, isolate the infected and trace their recent contact with others. There is no specific vaccine for monkeypox, but the virus is similar to smallpox, so smallpox vaccines should be fairly effective — and a useful tool for blocking the transmission of the smallpox once contact tracers have identified the people at risk.

That’s what happened in 2003, the last time monkeypox got a big foothold in the United States—then via rodents shipped to Texas from Ghana in West Africa. Forty-seven people got sick, but a quick response from state and federal health officials — and a few doses of smallpox vaccine — prevented anyone from dying and quickly eliminated, albeit temporarily, the virus in the U.S.

Monkeypox, which first made the leap from monkeys or rodents to humans in 1970 in the Democratic Republic of the Congo in central Africa, flares up every now and then — mostly in Africa. But it rarely infects more than a few thousand people a year and killed just 33 people in the most prolonged outbreak in the DRC between 1981 and 1986.

A scar from a smallpox vaccination is visible on an upper arm. There is no approved vaccination specifically against monkey pox. However, according to historical records, a smallpox vaccination offers good protection against monkeypox – and probably for life.

Photo by Bernd Weissbrod/Photo Alliance via Getty Images

There are good reasons why monkeypox is not nearly as contagious as COVID. Where COVID spreads through very fine saliva droplets — the kind we all spew yards in all directions every time we breathe, talk, laugh or cough — monkey pox prefers larger droplets that don’t travel very far. It can also spread through direct contact between the pathogen and an open wound, but that transmission route is even less likely than those large, rapidly falling droplets.

The key to controlling monkeypox is identifying it quickly so that isolation, contact tracing and treatment can begin before the virus spreads too far. We were pretty good at that a generation ago. We’re even better at it now, thanks in no small part to COVID. “Most of the world is much better prepared for monkey pox than it was two and a half years ago,” Paul Anantharajah Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection in Singapore, told The Daily Beast.

We need to quickly find out what’s going on.

Testing is more advanced — not just for SARS-CoV-2 infections, but for a whole host of viral diseases. “I’d like to think we’ve learned how to do mass testing more efficiently,” James said. “PCR testing is actually simple, as long as we have the right reagents. We can also test for several viruses at the same time.”

We’re also better at tracing contacts. Investigating people’s movements and relationships to map out who and when they came into close contact was a niche practice three years ago. Meanwhile, tens of thousands of health professionals around the world have experience with contact tracing.

The general public is also more alert. Certainly, COVID-related restrictions on schools, business and travel annoy many people. Nobody likes to wear a mask. Small but stubborn minorities in some countries even refuse to take the free, safe and effective vaccines that offer strong protection against the worst effects of COVID infection.

Head of the Institute of Microbiology of the German Armed Forces Roman Woelfel works in his laboratory in Munich, May 20, 2022, after Germany discovers its first case of monkey pox.

Photo by Christine Uyanik/Reuters

But that recalcitrance belies the deep awareness most people now have when it comes to viral illnesses. People are likely to notice if a friend, neighbor, or relative gets the smallpox — and they’re likely to take it seriously. “The COVID-19 pandemic has shed light on the critical importance of staying ahead of the threats of infectious diseases rather than chasing them around continuously,” Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health, said. to The Daily Beast. “The world is now familiar with the terms ‘case research’, ‘contact tracing’ and ‘genomic sequencing’.”

Perhaps most reassuringly, we already have a vaccine. With COVID, we had to lock up and wait a year before the first shots were ready. But since the smallpox vaccine works on monkeypox, there is no waiting period.

If there’s cause for concern in the recent spate of monkey pox cases, it’s that we don’t yet know exactly where and how it started. Locating the origin of a viral spread naturally helps contain it. “We need to quickly figure out what’s going on,” James Lawler, an infectious disease expert at the University of Nebraska Medical Center, told The Daily Beast.

“That said, we generally consider monkeypox to be much less deadly than smallpox, easier to control in terms of transmission, and amenable to vaccines and antivirals,” Lawler added.

All this is to say, don’t worry. Unless a contact seeker knocks on your door (an unlikely proposition) or you notice weird blisters on your neighbor or yourself (even more unlikely), you don’t need to do anything else. “The risk to the general public is very low,” Rimoin said.

Monkeypox is making one of its periodic comebacks. But this is a virus that we’re really good at.

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