What Puts Someone at Risk of Catching Monkeypox?

“As monkeypox spreads across the United States, it may be giving people flashbacks to the days of wiping down counters and groceries to get rid of the coronavirus. But for most people, the risk of getting monkeypox remains low. Almost all cases in the current outbreak — 98% — have been in adult men who have sex with men.

So how is the virus spreading? Studies of previous outbreaks suggest that the monkeypox virus is transmitted in three main ways: through direct contact with an infected person’s rash, by touching contaminated objects and fabrics or by respiratory droplets produced when an infected person coughs or sneezes. There is also evidence that a pregnant woman can spread the virus to her fetus through the placenta.

Scientists are still trying to understand if the virus can spread through semen, vaginal fluids, urine or feces and if people can be contagious before they develop visible symptoms.”

“The activities that put a person at highest risk of catching the virus involve close, intimate contact with another infected individual. This includes the kind of skin-to-skin contact that occurs during sex as well as when cuddling, hugging, massaging or kissing another person. Condoms probably add a layer of protection during sex, but they are unlikely to prevent contact with lesions on an infected person’s groin, thighs, buttocks or on other parts of their body.

Roommates and family members in the same house are also at significantly higher risk of getting monkeypox compared to any other individuals a patient may come into close contact with, said Dr. Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System.

Household contacts can catch monkeypox through contaminated clothes, towels and bedding. Shared utensils that may carry an infected person’s saliva should also be considered high risk, said Saskia Popescu, an infectious disease epidemiologist at George Mason University.”

Don’t Panic Over Monkeypox

“in the past 10 days, cases have been reported in the United States, as well as in Australia, Belgium, Canada, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, and the U.K. Typically, monkeypox is rare outside West and Central Africa.

In total, there were 92 confirmed cases and 28 suspected cases as of yesterday, the World Health Organization (WHO) reports.

On the upside, there’s little reason to think monkeypox will wreak the kind of havoc that COVID-19 did. It does not spread as easily or cause severe symptoms in most people. And it’s not novel—we already know what monkeypox is and how to fight against it.”

“In addition, we already have a vaccine that provides some protection against monkeypox: the smallpox vaccine. And the U.S. has “enough to deal with the likelihood of a problem,” said President Joe Biden in Tokyo this week.

“I just don’t think it rises to the level of the kind of concern that existed with COVID-19,” said Biden. He says he does not expect quarantine requirements even for people infected.”

What’s the Herd Immunity Threshold for the COVID-19 Coronavirus?

“Herd immunity is the resistance to the spread of a contagious disease that results if a sufficiently high proportion of a population is immune to the illness. Some people are still susceptible, but they are surrounded by immune individuals, who serve as a barrier preventing the microbes from reaching them. You can achieve this through either mass infection or mass vaccination.”

“Most the evidence so far suggests that people who recover from a COVID-19 coronavirus infection do, at least for a time, develop immunity to the microbe. If that’s true, what is the disease-induced herd immunity threshold for the COVID-19 coronavirus? Various epidemiologists offer different answers, depending upon their estimates for the disease’s R0 and other variables, but most have converged on a threshold at around 60 to 70 percent.

More recently, some researchers have suggested that this threshold may be too high. In a new preprint, three mathematicians from Sweden and the United Kingdom, using an R0 of 2.5, calculate a reduction in the herd immunity threshold from 60 percent to 43 percent by incorporating some assumptions with respect to populations’ social activity levels and age structures.

A couple of new reports speculatively lower the possible herd immunity threshold for the coronavirus to just 10 to 20 percent of the population. This conjecture depends chiefly on assumptions about just how susceptible and connected members of the herd are.”

“There are no solid estimates for the percentage of the U.S. population that has already been infected by the coronavirus, but Youyang Gu and his team at COVID19-Projections estimate that right now the number is between 2.2 to 4.7 percent. That would mean that somewhere between 7.3 and 15.5 million Americans have been infected. A similar result emerges from a very rough calculation that multiplies the number of confirmed cases at 1.4 million by a 10-fold factor of undiagnosed cases and infections. (The 10-fold factor is derived from data recently reported by Indiana University researchers.)
The upshot: The U.S. as a whole is not yet close to achieving even the speculatively low estimate of the herd immunity threshold.”

The meat we eat is a pandemic risk, too

““Factory farms are the best way to select for the most dangerous pathogens possible,” said Rob Wallace, an evolutionary biologist at the Agroecology and Rural Economics Research Corps in St. Paul, Minnesota. To explain why, he offered a crash course in zoonotic transmission, from the point of view of the pathogen.
“If you’re a pathogen in a host,” Wallace said, “you don’t want to kill your host too fast before you can get into the next host — otherwise you’re cutting off your own line of transmission. So there’s a cap on how much of a badass you can be. The faster you replicate, the more likely you end up killing your host before the next host can come along.”

If you’re deep in the wilderness or on a small farm, you (the pathogen) are not going to regularly come across hosts, so you’ve got to keep your virulence, or harm inflicted on the host, pretty low so that you don’t run out of hosts. “But if you get into a barn with 15,000 turkeys or 250,000 layer chickens, you can just burn right through,” Wallace said. “There’s no cap on your being a badass.”

This is part of why factory farms are a bigger risk for zoonotic outbreaks than the natural world or small farms.

The biologist added that because we’re increasingly trading poultry and livestock across international borders, we’re ramping up the danger even more. Strains that were previously isolated from each other on opposite sides of the world can now recombine.

“Take influenza,” Wallace said. “It has a segmented genome, so it trades its genomic parts like card players on a Saturday night. Usually, most hands are not too terrible, but some hands come out much more dangerous. An increase in the rate of recombination means an explosion in terms of the diversity of pathogens that are evolving.”

The world has already seen a really frightening example of this. Between 1997 and 2006, highly pathogenic strains of H5N1 bird flu were linked to poultry farms in China.

“Our entire understanding of how bad a pandemic could potentially be changed in 1997 with the emergence of the H5N1 avian influenza virus. All of a sudden, there was a flu virus that was killing over half the people it infected,” Greger said.

When people became infected with H5N1, it had a 60 percent mortality rate. For comparison, experts estimate that Covid-19’s mortality rate is probably somewhere in the neighborhood of 1 percent to 3 percent, though these estimates continue to evolve and vary widely by country and by age. (If you’re wondering why H5N1 didn’t become as big a deal as Covid-19, it’s because it mostly infected poultry rather than people; it wasn’t as good at infecting humans as the coronavirus unfortunately is.)”

“The other pandemic risk associated with factory farms has to do with “highly drug-resistant forms of bacterial pathogens,” as Shah put it — that is, antibiotic resistance.

When a new antibiotic is introduced, it can have great, even life-saving results — for a while. But as we start to use and overuse antibiotics in the treatment of humans, crops, and animals, the bacteria evolve, with those that have a mutation to survive the antibiotic becoming more dominant. Gradually, the antibiotic becomes less effective, and we’re left with a disease that we can no longer treat.”

““We have abundant evidence documenting the fact that when you put animals in crowded, unsanitary conditions and use low-dose antibiotics for disease prevention, you set up a perfect incubator for spontaneous mutations in the DNA of the bacteria,” said Robert Lawrence, a professor emeritus of environmental health at John Hopkins University.

“With more spontaneous mutations,” he explained, “the odds increase that one of those mutations will provide resistance to the antibiotic that’s present in the environment.” Those resistant bacteria could become strains that spread all over the world. “That’s the biggest human health risk of factory farms.””

” factory farming presents us with a double bacterial risk. Say a bacterial outbreak emerges among chickens. The poultry can pass that bacteria on to us humans, causing serious infection. We’d normally then want to use antibiotics to treat that infection, but precisely because we’ve already overused antibiotics on our farmed animals, the bacteria may be resistant to the antibiotic. If the infection happens to be one that transmits well between people, we can end up with an untreatable bacterial pandemic.”

“Laborers in meat plants are typically stationed very close together along processing lines, which makes social distancing all but impossible.”

“We can absolutely have a meat production system that is better for human health, the climate, and animal welfare — if we’re willing to abandon factory farming.

“The de-intensification of the livestock industry would go a long way toward reducing pandemic risk,” Greger said. “I mean decreasing long-distance live animal transport, moving toward a carcass-only trade, and having smaller and less-crowded farms. Basically, the animals could use a little social distancing, too.””

“We also need to reintroduce more biodiversity into our farms. Raising animals that are slightly different from each other genetically (rather than selecting for specific genes) will build in immunological firebreaks to help prevent the spread of infectious diseases”

COVID-19 Could Force City Planners To Rethink Their Priorities

“For years, urban planners have been singing the praises of population density.”

“”Density is a factor in this pandemic, as it has been in previous ones,” wrote Richard Florida in the CityLab website. “The very same clustering of people that makes our great cities more innovative and productive also makes them, and us, vulnerable to infectious disease.” Some big cities have handled the crisis better than others. Some rural areas have high infection rates, too. But, as an urban studies professor, he’s distressed at big-city vulnerability.”