opinion | Monkeypox is spreading rapidly and should be declared a pandemic

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Eric Feigl-Ding is an epidemiologist and co-founder of the World Health Network. Kavita Patel is a physician and former director of policy for the White House Office of Intergovernmental Affairs and Public Engagement. Yaneer Bar-Yam is President of NECSI and co-founder of the World Health Network.

It’s time for the global public health community to acknowledge a growing reality: monkeypox is now a pandemic. And if we don’t declare an emergency and act quickly to fight it, we risk repeating the same mistakes we made in our fight against Covid-19.

No longer confined to a single continent or found only among travelers, the monkeypox virus is being community-transmitted in dozens of countries worldwide and is spreading unchecked at an alarming rate. This is especially dangerous for immunocompromised, pregnant women and young children. They all have hospitalization and death rates from the virus much higher than healthy adults.

But despite the growing number of cases, the World Health Organization has largely downplayed the outbreak. On June 24, the agency failed to declare a public health emergency — just as it repeatedly failed to make emergency and pandemic declarations for the coronavirus, eventually declaring a pandemic in March 2020.

The monkeypox virus, historically found in west and central Africa, began spreading internationally in early May when the UK announced its first confirmed positive case. The global response has been incredibly slow ever since. Case numbers appear to be low compared to Covid-19 and the world seems lulled into complacency, like a frog gradually heating water. Today, the virus has spread to more than 70 countries on six continents with no sign of relief. According to the WHO itself, cases in Europe have tripled in the last two weeks. We must become aware of the fact that we are already in a boiling pot.

Available European data shows that most infections have occurred in men who have sex with men (MSM), who are generally young adults. However, there are reported cases among household members, heterosexual contacts and non-sexual contacts, and children. About 10 percent of patients were hospitalized for treatment or isolation, and there was one admission to intensive care.

Given the early dominance of cases in the MSM community, many countries do not test others with monkeypox symptoms, leading to a risk of skewed infection numbers and further uncontrolled spread – which in turn leads to a risk of many more people being infected with severe cases.

A new study also suggests the virus may be mutating 12 times faster than expected and could lead to 60,000 new cases a day in the UK alone by the end of 2022. Other models suggest that we might conceivably see 100,000 cases worldwide by August and 500,000 to 1 million cases by the end of September.

WHO was founded with a vision to coordinate global efforts to promote good health and keep the world safe, just what we need right now. Health workers and frontline workers are critically scarce and there is insufficient talk about targeted prevention. By failing to sound the precautionary alarm, the WHO is putting countless lives at risk – just as the delay in the classification of Covid-19 played a crucial role in the failure to effectively control the global explosion of this virus.

We must use the full spectrum of prevention and diagnostics to contain the spread, rule out the development of local disease reservoirs in rodents, and prevent suffering and possible death, especially in the immunocompromised, pregnant humans and young children.

Governments and public health officials worldwide should educate the public about protective measures and provide support with harm reduction, rapid case identification, early detection, contact tracing and isolation. Although a reliable monkeypox vaccine exists based on previous research, it will take many months to ramp up production to the world.

Here in the United States, the federal government has already ordered 1.6 million doses for 800,000 Americans, but those won’t be available until late 2022. By then it will be too late if we don’t act now with other containment measures. The Centers for Disease Control and Prevention must lead by example and promote science-based precautions to protect Americans.

We at the World Health Network have taken action to issue an early warning. On June 22, we declared monkeypox a pandemic emergency and issued public health guidance with measures to contain the spread. We invite WHO to join us and hope they will reconsider and act soon. WHO Director-General Tedros Adhanom Ghebreyesus recently acknowledged the growing threat of monkeypox.

We should all refuse to walk blindly and allow the present to become the prologue to an even greater catastrophe. Global health authorities must commit to and implement a unified, coherent approach to combating the monkeypox pandemic before it reaches Covid-19 proportions. If we act and let the lessons of the last two years guide us, we can avoid the mistakes that have cost the world millions of lives.

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