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Is monkeypox a distraction from the ongoing pressures of COVID, or is it real? The answer is both.
Unfortunately, the media lens is very wide at the moment, meaning we hear about an emerging infectious disease and are quickly moving to the worst-case scenario. But unlike COVID-19, monkeypox is neither new nor widespread. It is also not a single-stranded RNA virus, making it less susceptible to rapid mutations such as influenza or SARS-CoV-2.
This particular strain of monkeypox, which captures the media’s negative perception, dates back to an outbreak in Nigeria in 2017-18. It is less virulent or deadly than another type of monkeypox, which itself is much less virulent or deadly than smallpox. But it’s smallpox that we think of when we talk about monkeypox, it’s smallpox for which we have hundreds of millions of doses of vaccine stored away, smallpox that killed more than 300 million people worldwide in the 20th century alone, before the powerful vaccine eradicated it in 1977. Monkeypox, by contrast, is a poor cousin, although it can still make you quite ill with fever, fatigue, body aches, and swollen lymph nodes, followed by a characteristic pustular rash.
But the traditional live smallpox vaccines are readily available — in fact, a Department of Health spokesman told me we have enough vaccine for all Americans. But actually having it would be a huge overreaction at this point, with only sporadic cases and limited outbreaks in Europe, the US and the UK, many of which are still associated with travel or the pursuit of two major raves among gay and bisexual men stand Spain and Belgium. Apparently, monkeypox can be transmitted both through sexual contact and through close contact with secretions.
It’s hardly any other COVID and shouldn’t be viewed in the same way, as COVID, by contrast, is approaching the easy airborne transmissibility of measles, with each subvariant about 30 percent more transmissible than the last.
In contrast, despite all the attention it’s getting, monkeypox still has a total of 257 cases in 23 countries worldwide and just a handful of cases here in the US
Don’t get me wrong, the actual case count is significantly higher when you factor in community spread with milder cases that can be confused with influenza or any other virus, but still, this is not another pandemic and probably never will be . Since the main source of spread is in symptomatic patients, it is much easier to follow an effective standard public health protocol than it is with COVID. Namely identification, isolation, treatment (there are effective antivirals – TPOXX and TEMBEXA and possibly cidofovir) and ring vaccination of all close contacts.
The Centers for Disease Control and Prevention are closely monitoring the situation here in the US and there is a plentiful and growing availability of PCR tests for monkeypox. This is vital because if we don’t know who has it, we won’t be able to contain and control it.
In early 2020, as I traveled to Dulles Airport and the University of Nebraska Medical Center where the first US COVID patients from the Diamond Princess cruise ship were being quarantined, I was among the first to warn that SARS-CoV-2 dangerous is virus that is already spreading widely in our communities for which we had no vaccine or treatment. What followed defied even the most draconian predictions. But there is no reason to automatically apply the model of what happened and what went wrong in trying to contain COVID to all emerging infectious diseases.
Monkeypox is a problem, but it’s not COVID, and it can be managed by applying the best science and public health we have at our disposal. Hysteria increases the problem and doesn’t help anyone.
Marc Siegel, MD, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and the author of the new book “COVID; the politics of fear and the power of science.”
