Monkeypox reporting has been atrocious. Alternatively, I've lost the ability to use Google and am now all alone in the universe. I'll let you decide.
The question I have on my mind is whether the CDC has responded to monkeypox with an effective testing regime. According to the bulk of the news media, along with LGBT activists everywhere, the answer is a very loud no. The problem is that testing has been tightly constrained by the CDC's insistence on having it done through federal labs, which bury doctors in stupid paperwork and have limited capacity anyway. Only recently have they begun to authorize commercial labs to perform monkeypox testing, something that should have been done long ago. It's COVID-19 all over again. Has the CDC learned nothing?
I have my doubts about that. Even if you think poorly of the CDC, they aren't full-on morons. If they had a good alternative they wouldn't mindlessly repeat the exact same testing strategy that got them in so much trouble two years ago.
But how do I find out? The first obvious bit of data I'd like is the number of monkeypox tests that have been performed weekly since the first case was discovered. I can find that nowhere.
The second bit of data that would be useful is the number of monkeypox tests performed in Europe, which would provide some clue about whether we're doing significantly worse than our peers. But I can find that nowhere.
The third bit of data is an explanation from the CDC about why they do things the way they do. Is it because they're stupid? Is it because there's value in being super careful in the early testing stages of a disease outbreak? Or is it because there's inherently limited testing capacity for any new disease outbreak and it takes time for commercial labs to ramp up? I can find an answer to this nowhere.
The fourth bit of data I'd like to get—please stay with me here—is how valuable testing is in the first place. After all, monkeypox is not like COVID. If you have a bunch of new lesions on your body, you probably have monkeypox. No test needed, really. Nor is there anything much you can do about it except isolate and wait for it to go away.
I'll acknowledge up front that I'm inclined to think the CDC may have problems but is not literally filled with idiots. But you never know! Answers to these basic questions would help me figure it out, but I did quite a bit of searching last night and literally came up with nothing. AITI?
Slightly off topic, smallpox vaccine confers immunity to momkeypox, so those of us who are old enough to have been vaccinated against smallpox have nothing to worry about.
This doesn't pass the smell test. Smallpox was eradicated with a global vaccination campaign. The number of people who haven't been vaccinated against smallpox is minuscule.
Do you have an authoritative source for your assertion?
We stopped vaccinating everyone in the US against smallpox in the 80's, after it was declared eradicated. Most other countries have followed suit.
OK, I was wrong. I found this:
"Vaccination against smallpox also protects against monkeypox," Hannah Newman, MPH, director of epidemiology at Lenox Hill Hospital, told Health. "People who were vaccinated against smallpox years ago may have some immunity, or at least have some protection against milder illness if infected."
The U.S. officially stopped routine smallpox vaccination in 1972, after the disease was eradicated, but because of concern for bioterrorism, the government has a large stockpile of the smallpox vaccine—enough to vaccinate all Americans who would need protection, should a future outbreak occur.
So what does this all mean for the current uptick in monkeypox cases? How much protection does a previous smallpox vaccination give to older adults at risk of monkeypox? And how does the U.S. plan to distribute these vaccines for the current outbreak? Here's what to know.
https://www.msn.com/en-us/health/medical/does-the-smallpox-vaccine-protect-against-monkeypox/ar-AAY0kuf
I thought that smallpox was still part of the vaccine regimen routinely given to children.
No. Its been dead longer than I've been alive
One of the tv reports has a closeup of the vaccine bottle. It said “smallpox/monkeypox”.
Also: active duty servicemembers in the aftermath of 9/11/01.
I'm an idiot who doesn't do many internet abbreviations... So...
What's AITI?
FWIW I'll guess "am I a total idiot." But IANAL or an internet philologist so you should caveat that.
"automated interchange of technical information," according to Google....
Am I The Idiot?
Thank you and Steve_OH for the answer as well as explanation.
Am I the Idiot. It's a play on AITA (Am I the Asshole), a popular Reddit discussion group, where people post stories of personal situations where they believe they behaved reasonably, but everyone around them accused them of being an asshole, and they want to get an outside opinion.
I'm a bit surprised at the rate of spread of monkeypox. I thought it made people pretty miserable - at least miserable enough to want to stay home for a while.
But maybe we're suffering from pandemic fatigue, and people are going to say FU to any CDC advice no matter what. It's a bit like the mudslides that follow California fires. People are so exhausted from the fire-related evacuations that they stay home when the mudslide warnings are issued...and then a bunch of people die.
There are lots of smart, dedicated people at the CDC and the FDA; however, the covid pandemic has revealed some serious organizational flaws in both agencies. And their inability to coordinate well with state and local public health agencies turned out to be catastrophic.
A study in 2019 ranked the US and the country best prepared for a pandemic:
https://www.washingtonpost.com/health/2019/10/24/none-these-countries-us-included-is-fully-prepared-pandemic-report-says/
Yet, our performance was abysmal. Most of the countries in the Asia-Pacific region did far better than the US or Europe. Perhaps that's because of their experiences with SARS and MERS -- they bolstered their public health systems while we basked in our supposed superiority. The lack of a national public health system was our Achille's heal.
The CDC was under attack during Trump's administration, budget being zeroed out only to have it restored by Congress, etc. Basically, those that could, left. When covid hit, it was being hollowed out.
The national emergency stockpiles were bought after 9/11 when bio-terrorism was a major fear--then left to dry rot. Again, budget fights. The back up plan was to buy more stuff from China.
Our national back up hospital system, the VA, has been and in under attack for a long time--privatize it!!! And that argument is still being made....
The lack of a national public health system was our Achille's heal.
The CDC is a national outfit. So is homeland security. So is health and human services. So is the office of the Surgeon General. There was a national apparatus available. We were just blocked from taking advantage of it by the then president.
The main reason the US did so poorly was that the government of the US in the main did little to protect its citizens, going so far in many cases as to actively hinder and undermine efforts to mitigate the pandemic—which is another way of saying the government in question actively took steps to spread the disease as widely as possible.The government of the US is powerful! If it's trying to hinder something, that "something" is likely to be hindered.
Once vaccines began rolling out, of course, one of the country's two dominant political parties began doing everything in its power to impede vaccination efforts.
Given all the above, it's a minor miracle the country's not in worse shape than it actually is.
As much as I blame Trump for hundreds of thousands of COVID deaths, what the comment said is basically true. Even under Democratic presidents we do not have a national public health authority that can deliver services to most Americans or can compel compliance with health orders. That is left up to the states, who often defer to county health departments. Yeah, Trump made it worse, but so did Republican governors who would have obstructed a Democratic president (and have done so under Biden). The system is a mess and set up for failure.
James Lee Witt erasure.
Covid hit many countries, who responded in many different ways.
It's far from clear that there's a single best response that is both
-efficacious
-acceptable to the US public.
There's no obvious pattern to which countries did better or worse. For example Sweden went to one extreme and did somewhat better than the US. Likewise there's no obvious pattern to which states or cities did better or worse in the US.
NZ and Taiwan did *OK* -- under conditions that probably could not be replicated in the US (island PLUS extremely aggressive quarantining) and it remains to be seen how this will play out long term.
China did OK, but using techniques of forced control that would be impossible to replicate even in somewhere like Russia, let alone the US.
The primary message being conveyed by these sorts of posts is "I don't actually care about any of the details of covid, I just want to express my dislike of Trump". Because if you actually cared about the disease aspects rather than the Trump aspects, and were actually willing to put your hypotheses to the test (comparisons across various populations, by geography and time) you'd see just how little we know.
The one *unqualified* statement we can make is that science and industry did an incredible job in putting together vaccines so fast that work as well as they do. But science and industry can't be used in any sort of obvious way to attack Trump or anyone else, so they're no part of the discourse. God forbid we learn *anything* from this one *unqualified success*, like how to ramp up the slower parts of the covid vaccine experience (testing, mass manufacturing, distribution) so that next time maybe we can go from zero to mass immunization in a year rather than two years...
Sweden DIDN'T do better than the US on Plandemic response. & it definitely didn't do better than neighbor countries Finland, Norway, & Denmark.
No matter what our Swedish friend Sture Stuhl says.
US death rate was 310/100K population
Sweden death rate was 190/100K population.
Looks like doing better to me...
https://coronavirus.jhu.edu/data/mortality
From a Google search on monkeypox testing:
CDC published its FDA approved protocol for Monkey Pox testing on June 22.
Three days ago, Quest Diagnostics started offering testing.
Also gave link to this article:
https://www.cnbc.com/2022/07/15/monkeypox-cdc-expects-outbreak-to-grow-as-vaccine-demand-outstrips-supply.html
The test involves swabbing the lesion to confirm it's due to monkeypox. In other words, we don't have a test to show you're infected before the obvious symptoms show up.
That article didn't pick up the fact that the vaccine manufacturing plant has been inspected.
Hatred for America's government technocrats cannot fail. It can only be failed.
The CDC expanded testing to 5 commercial labs a couple weeks ago.The companies include Aegis Science, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics and Sonic Healthcare.
Since the test is not possible until after lesions develop it is unable to detect non-symptomatic infections. With only 193 confirmed cases, it seems like the CDC has responded quickly enough. A test that could detect the virus earlier might improve surveillance, but would likely result in more false positives than actual case detections, resulting in misdiagnosis and unnecessary treatments.
It sounds like the arguments are that there's too much paperwork, and it takes too long to get results. But if you have lesions, you should isolate and inform anyway.
"With only 193 confirmed cases..." As of today, 1469 confirmed cases in the US, and it is present in almost every state. And this with the (still) greatly restricted testing regime. If you don't test much, you won't see many cases! Epidemiologists agree that there are probably many more cases that have gone undetected, but I have't seem any of them hazard a guess as to whether that is 2x, 5x or more than the confirmed numbers.
Maybe I'm just a selfish SOB, or pandemic fatigued, or much more worried about having to fly next week in a 12 foot wide aluminum tube among 200 unmasked strangers with Omicron version 5? circulating, I can't seem to get worked up about Monkey Pox. I can't get Monkey Pox flying on a plane, or eating at a restaurant, or walking through a store, so why should I worry about it? As an old guy, I may have some protection from the smallpox vax I received 60 years ago anyway.
The whole country is going to hell anyway, so I guess I just don't fucking care anymore.
Smallpox was not eradicated through a campaign of universal vaccination. That worked in some countries, like the US, because we were able to get very high vaccine coverage. But in the countries where smallpox was persistent, and then was finally eradicated in the 1960s, it was done through ring vaccination (on top of some variable amount of population coverage with vaccine.) Because smallpox is only infectious when there are visible lesions, and because the incubation period is a couple of weeks, it was feasible to build on active surveillance for smallpox -- rapid early detection of likely cases -- then vaccination of close contacts AND THEIR CONTACTS, so that if any of the first ring of contacts gets the disease they don't spread it to anyone else. Rinse and repeat if any of the first ring of contacts gets smallpox, and vaccinate THEIR primary and secondary contacts. This was logistically easier than trying to immunize the whole population, and ended up working really well. A similar strategy worked reasonably well for Ebola in West Africa much more recently.
Also, public health surveillance for monkeypox (case-finding) has to depend first on clinical recognition, backed up by testing. Fortunately, unlike COVID, this is a very clinically distinctive illness -- nothing else really looks like monkeypox, though clinical experience does help. We should not be finding cases by testing people willy-nilly -- people with suspicious illnesses are the ones who should be tested, especially if they have high-risk exposure histories. More testing is not always the answer for case-finding.
Monkey Pox is just a nothing. Nobody cares and Gays only do because they are prone to it.
You are not the only one. NPR says "The CDC would not divulge to NPR how many tests have been performed across the country, nor will the agency say where community transmission is likely occurring in the U.S. (NPR emailed the agency multiple times about these questions but the press person declined to comment or provide an interview.)"
Why would anyone share anything with NRR (National Review Radio)? Dipshits like Steve Inskeep would just turnaround & tut-tut over government overreach & impotence with David Brooks & Ramesh Ponnuru.
Numbers are low, but do have totals:
https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html
Unfortunately, they do not have trends or time frame.
I do see people trying to treat the monkeypox outbreak like Covid. It's not. Tests do not pickup asymptomatic people. It's transmitted when people have symptoms, unlike Covid, and it requires close contact with the person or their contaminated clothes/bedding.
Gay dudes are embarrassed to be the source of this STD. Let it be. It’s like the herpes. No one cares.
It's not an STD.
I’m a gay dude and so…
https://www.cdc.gov/poxvirus/monkeypox/sexualhealth/index.html
Minor risk and not worth all the media attention. No one dies. Ever.
But the media loves the name… monkey pox. Gays are like animals. Another chance to throw the gays under the bus. HIV. Clap. Been there, done that. Fuck you.
You're aa gay as Sture Stuhl is Swedish.
I guess I'm with Kevin asking why testing is such a concern here. I can understand wanting a vaccine or treatment made available more quickly, but unlike Covid, where a lot of people are asymptomatic spreaders, or the symptoms are very similar to a variety of other illnesses, monkeypox has very distinctive symptoms and is only contagious when those symptoms present. Because this disease is primarily affecting the LGTBQ community, perhaps they are pulling out old AIDS response plans, where regular testing was a key component.
1. Doing worse or better than Europe doesn't mean anything if Europe is also doing bad at testing. Then the FDA and CDC would be conventionally incompetent instead of uniquely incompetent.
2 lesions can come from various sources and may not appear everywhere. In addition it is believed that sometimes in this outbreak you can be contagious WITHOUT lesions or least the lesions maybe small and in your mouth so you don't notice.
"If you have a bunch of new lesions on your body, you probably have monkeypox. No test needed, really'
Wrong. and Wrong.
Lots of diseases cause skin lesions, and how many doctors are clinically trained to recognize monkeypox from other lesions? A case in point... A friend in a nursing home (!) was tested for monkeypox because the staff (including the doctor) panicked when he developed skin lesions, which it turned out were a side effect of medicines given to treat COVID (hence other signs such as swollen lymph nodes and fever were present). The chance of him being exposed to monkeypox was nil, but they tested him anyway -- finding an ER that would take the sample (crazy, I know), waiting several days for the results from the CDC, and costing who knows how much. Unless of course they DID have a good reason that they didn't tell him, such as contaminated bedclothes or careless, infected staff. Even then, having a saner protocol, such as taking a swab in the nursing home and sending it to a local lab would have made everything run much smoother.
On the second matter -- if you are diagnosed early they can give you the monkeypox vaccine and it will shorten the course of the disease, reduce the likelihood of serious complications if you are immune compromised, and also reduce the likelihood of you spreading the infection.
I forgot about the non-traditional manifestations of the disease. Though the tests require swabs of the lesions.
As for scares, the long wait times are very annoying--but that is being fixed now.
Thankfully that should be the case now. But as this example showed, sometimes it is just easier for a doctor to get a test than to do a proper differential diagnosis and that is the route they will take. The medical system is not always rational and doctors are not always up to date. Perhaps they had read that the presentation of monkeypox during this outbreak was not as described in the textbooks. As you point out, with this outbreak some of the manifestations have been only a few bumps and they were not that distinctive, at least according to the accounts I have read recently. One journal article I read said that only about half the monkeypox cases they saw even had fever (usually a definitive sign), and about half had swollen lymph nodes (also considered a definitive sign). But they were probably just as contagious.
https://www.theguardian.com/technology/2022/jul/16/cryptomining-energy-use-investigation-carbon-emissions
The Bitcoin boys all have monkey pox.
Good news, everyone!
The covid vaccines can increase your menstrual flow,
https://www.technologynetworks.com/vaccines/news/menstrual-cycle-changes-associated-with-covid-19-vaccine-363710
Bloody hell!
I see what you did there....
Probably first real study done on this for any vaccine. Should point out effect is short term. Write up did not mention any problems requiring medical intervention, and did point out the vaccination does not affect fertility.
Exactly.
It also makes some sense since the Rona is a vascular disease that triggers from a lung infection.
Anyway, I think most girls & women of an certain age would rather a redder pad than a deader heart.
It lasted a lot longer than 2 months for my spouse but it did eventually go away.
Say, Kevin, how much testing should be done? Setting up testing centers and encouraging the entire population of NYC to get tested doesn't seem all that useful. Testing contacts of a person known to have MonkeyPox seems like a reasonable protocol. In this case, for a virus spread by direct contact with legions, seems like the number of contacts would tend to be small. So I could see 2,000 tests per day as being a reasonable amount of testing. Is that number so small as to make it hard to capture in statistics about testing?
I'm trying to decide what the right comparison against Covid testing would be. The target amount of Covid testing might be ten times higher. When we were seeing 20 cases of Covid per day in the U.S., did we have good statistics on the number of tests per day?