Dr. Anne Rimoin is a UCLA epidemiology professor who has spent two decades researching monkeypox in the Democratic Republic of Congo. She told NPR that "this virus has been spreading in marginalized and vulnerable populations [in Africa] for decades, and we've done nothing about it. We have known that monkeypox is a potential problem for decades."
But now, confirmed cases of the virus have spread to Europe, Asia, Australia, Africa, the Middle East, and parts of South America. The Centers for Disease Control reports there are over 750 monkeypox cases across the United States. But Rimoin qualified that this was certainly an undercount as there is not enough testing available.
Monkeypox is rarely fatal and is unlikely to lead to hospitalization. It usually spreads through close physical contact.
But according to evolutionary biologist Dr. Bret Weinstein, there shouldn't even be talks of a monkeypox outbreak unless something has gone gravely wrong.
Speaking to the UnHerd podcast in early June about the monkeypox outbreak, Weinstein says, "I'm very concerned, and I'm concerned about several things."
"I'm concerned about the meaning of the monkeypox outbreak. And the reason I'm concerned is because we really shouldn't be having an outbreak, right?"
"This is a disease that's actually traditionally relatively difficult to transmit. And that doesn't mean you won't see little outbreaks happen here or there. But, in general, what happens is, there is sufficient immunity to prevent such an outbreak; there can be things that cause the level of immunity to drop below herd immunity; the accumulation of enough immunologically naive people in a population that an outbreak can get itself started."
Weinstein continues, adding that the attention brought toward monkeypox could be a result of increased "surveillance."
But then he asks, "why is it circulating now, you know, around the world? Is that a matter of greater surveillance? Possibly, but probably not. Is that a matter of something having changed in our level of immunity?"
"So, for example, a mass vaccination campaign could have altered people's immunity to that disease. In other words, the process that kept it under control might have been changed by the intervention in the immune system that we made; that's one possibility."
Weinstein continues, warning that there is an "intervening in a series of nested complex systems. That is not a winning formula, right? One should be extremely cautious in intervening in a complex system. Let alone a complex system, you know, where you have the immune system inside a population experiencing a pandemic, right? The chances that we know enough to do that well are pretty low."
Biologist Joseph Osmundson at New York University told NPR in June, "we have no concept of the scale of the monkeypox outbreak in the U.S."
The CDC said in June that it would "lean forward with an aggressive public health response to the monkeypox outbreak" as well as activate its emergency operations center.
The CDC also said on Monday that commercial laboratories have started testing for monkeypox.
Rimoin adds that "the good news is we have vaccines, we have therapeutics, we know a fair amount about this virus. The bad news is now we have to get the logistics together to be able to confront it head on."
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