Monkeypox: What Do Experts Predict Will Happen Next?

Concern over monkeypox has increased after it was declared a global health emergency on Saturday. 

This is the seventh public health emergency since 2007 – it has only been used to describe Covid and Polio before.

With consequences of the coronavirus pandemic still being felt more than two years later, the rapid spread of another virus is causing further worries.

What’s more, the virus is usually found in parts of Africa, and tends tends to travel from rodents to humans, but this outbreak has seen it pass between people through close contact.

But, experts do not believe it is comparable to Covid. Here’s what they predict will happen.

How quickly is monkeypox spreading?

More than 16,000 people around the world have been infected.

In the UK – as of July 21 – there were 2,208 confirmed cases, although there is concern that there is undetected community spread with several people saying they did not know the source of the infection.

Monkeypox can cause both mild and severe symptoms, including a fever, headache, muscle aches, low energy and swollen lymph nodes, usually followed by a rash (also known as lesions). 

People remain infectious until all lesions have crusted over and scabs have come off, usually in around three weeks.

What does the World Health Organisation say?

A panel of advisers for the World Health Organisation (WHO), couldn’t decide whether it should be classed as a “public health emergency of international concern” last week.

The WHO’s director general Tedros Adhanom Ghebreyesus subsequently overruled them and made it a global health emergency, meaning there needs to be a co-ordinated international response.

He said: “We have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little.”

So, what might happen next?

Dr James Lawler, co-director of the University of Nebraska’s global centre for health security, suggested it might take a year or more to control the outbreak.

He told the New York Times: “We’ve now unfortunately really missed the boat on being able to put a lid on the outbreak earlier. Now it’s going to be a real struggle to be able to contain and control spread.”

By then it might have set down roots in other countries and infected hundreds of thousands of people.

But, monkeypox is not comparable to Covid, according to professor of health studies at the university of Richmond, Kathryn Jacobsen. 

Writing for The Conversation, she pointed out that monkeypox spreads through person-to-person contact, rather than through the air, meaning it’s much less likely to spread as quickly.

It is also less deadly than Covid. The international outbreak has caused less than one death per 1,000 adult cases. That’s lower than the percentage of unvaccinated people who die after contracting Covid.

Dr Luis Sigal, an expert in poxviruses at Thomas Jefferson University in Philadelphia, also said that while a lot more needs to be understood about the current outbreak, DNA viruses like monkeypox evolve slowly compared to RNA viruses like Covid.

This means we are less likely to see subsequent waves of infection from different variants.

What about treatment?

When Covid became a global health emergency, there was no vaccine for it. That’s not the case with monkeypox.

Gay and bisexual men who have sex with men are being called up to receive one dose of a vaccine originally used to tackle smallpox. It has been used against monkeypox in the past and helps your body produce antibodies.

It does not contain the smallpox virus.

There is only a limited supply of this vaccine – called the Modified Vaccinia Ankara (MVA) although it is sold by different brands – which is why just the one dose is being offered right now, but to as any many eligible people as possible.

A second dose may be offered later if the outbreak continues.

Could people start calling it an STI?

Some campaigners are calling for the virus to be declared as a sexually transmitted infection, even though it is actually spread through close contact.

This would increase awareness around the virus, and help reduce transmission.

Author and journalist, Dr Steven Thrasher, tweeted: “I reject the premise that if some matter of health has to do with sex, it’s ‘dirty’ or bad or casts aspersions on the character of the people living with the matter. Sex is a part of life, sex is a part of health, it doesn’t make anyone good or bad.”

He pointed out that outside of the “endemic” countries where animals with the virus pass it to people, most of the cases pass from person to person.

He also flagged other infections and diseases that are officially called STIs, despite it being possible to catch them through other means as well as having sex. These includes herpes, HIV, hepatitis and HPV.

He tweeted: “Like other STIs, MPX can be transmitted other ways. I think we are doing a disservice to people in not calling it an STI (out of embarrassment? Shame? Fear)”

Dr Thrasher said to tackle the virus effectively,  the communication around it needs to be clearer – and that means prioritising those at the highest risk when it comes to vaccines.

Thrasher was far from the only person calling for a change in the way the monkeypox is discussed.

How can people reduce transmission rates?

Dr Meera Chand, director of clinical and emerging infections at the UK Health Security Agency, said: “Before you go to a party or event, check yourself for monkeypox symptoms, including rashes and blisters.

“If you have monkeypox symptoms, take a break from attending events or sex until you’ve called 111 or a sexual health service and been assessed by a clinician.”

If you are offered the vaccine, you are recommended to take it.

Most health workers and those in clinics were exposure to the virus is high will be offered the jab.

Anyone who thinks they may have caught the virus are advised to avoid international travel if possible, and avoid close contact with children under the age of five, pregnant people or those who are immuno-compromised. 

Many of the methods to cut down on monkeypox comes down to the same techniques used to reduce Covid, such as social-distancing.

Will there be more viruses in the future?

Deforestations, globalisation and climate change mean it is more likely for pathogens to jump from animals to people.

Tom Inglesby, director of the John Hopkins Centre for Health Security at the Bloomberg School of Public Health, said: “As much as the world is tired of infectious disease crises, they are part of a new normal that is going to demand a lot of ongoing attention and resources.

“We need global vaccine and therapeutics production and stockpiling approaches that don’t yet exist.”