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Countries disagree over severity of Monkeypox

Since the Monkeypox outbreak was declared a Public Health Emergency of International Concern — the World Health Organization’s highest level of alert — on July 23rd, reactions across the world have varied in urgency.

In the wake of WHO’s announcement Australia declared Monkeypox a “disease of national significance” on Thursday. This prompted a series of inter-regional coordination measures to manage the outbreak. As of 28th July, only 45 cases had been detected in Australia.

Europe’s first Monkey-pox related death was reported in Spain on Friday, and the second on Saturday.

There are thought to be only three deaths so far outside Africa in the current outbreak.

  • It may mark a turning point in the trajectory of the disease containment, but so far the government has stuck with its strategy of public information campaigns, and vaccinating healthcare workers and suspected close contacts.

As of 1st August there have been a suspected 2,759 cases in the United Kingdom.

  • But the government has to declassify Monkeypox as a so-called “High Consequence Infectious Disease.” A joint statement from several UK health bodies suggests the strain of Monkeypox associated with the current outbreak can be relegated to a less concerning status. It is a known quantity, there is a vaccine, and several functional treatments.

Furthermore, the statement stressed that an “overly precautionary response” might create a public health risk in itself.

  • To bolster the UK’s attitude of cautious optimism, just days after WHO declared a public health emergency, transmission in the UK has showed signs of plateauing.

By contrast, on Saturday New York City — the current epicentre of the US outbreak — became the second American city to declare a public health emergency over the virus, just two days after San Francisco did the same.

In a joint statement from New York City Mayor Eric Adams and the Department of Health and Mental Hygiene, Commissioner Dr. Ashwin Vasan said: “This outbreak must be met with urgency, action, and resources, both nationally and globally, and this declaration of a public health emergency reflects the seriousness of the moment.”

  • Since then, California has declared a statewide public health emergency, but the federal government of the United States is yet to make such a move.

Disagreement about the level of the Monkeypox threat appears to go all the way up to the committees of the WHO itself.

When the body declared a public health emergency, its director general Tedros Adhanom Ghebreyesus did so without the consensus of his advisors, The International Health Regulations Emergency Committee.

  • The committee twice recommended against declaring a public health emergency.
  • Most recently, after a seven hour meeting, nine of its members were against the proposition while only six were in favour. This is the first time since the establishment of the PHEIC system that the WHO has gone against the recommendation of its advisors.

Meanwhile, certain health commentators that rose to prominence calling for heavy suppression of the COVID-19 epidemic are now calling for containment measures against Monkeypox.

Dr. Deepti Gurdasani, a clinical epidemiologist, has said it is “vital to act early – the cost of acting late will always be higher. And we can’t dismiss the risk to children, given what we know.”

Meanwhile, Eric Feigl-Ding, an epidemiologist who regularly called for more stringent lockdown measures during the pandemic, warned: “The US #monkeypox situation is spiraling out of control. The Biden WH needs to hurry up its public health emergency declaration”.

A former advisor to Joe Biden, Andy Slavitt, said in a now-deleted tweet: “It is long past time for better action on Monkeypox. What it will take is people caring more about the damage it causes & understanding the impact of continuing not to address it.”

An editorial in Science magazine argued: “Unless the world develops and executes an international plan to contain the current Monkeypox outbreak, it will be yet another emerging infectious disease that we will regret not containing.”

By late July over 22,000 cases have been reported worldwide.

Source: Finn McRedmond – UNHERD