Monkey Flu

[m98b5e]

Jesus there's a monkey flu now? These health issues are either picking up stream and we weren't paying as much attention/had as much access to information before.

[riser4]

Jesus there's a monkey flu now? These health issues are either picking up stream and we weren't paying as much attention/had as much access to information before.

Yes.

[SumJongGuy]

So how are the murder hornets doing this season?

[PB]

Under the worst is yet to come: wait 'til you start to really get old.

[riser4]

Ya think?

[mcski]

Monkey Rectum? Suddenly shingles sounds pleasant

https://apple.news/ACNmXkbpDQlKzh6lyHGc_Jw

[PB]

JFC ....Dejavu all over again.

[::: :::]

my sis is a doc at a university health program & they had a monkeypox case to deal with two weeks ago

[Core Shot]

Monkey Rectum? Suddenly shingles sounds pleasant

https://apple.news/ACNmXkbpDQlKzh6lyHGc_Jw

Don’t let some stranger fuck you in the ass.

Monkey rectum pox solved.

[Jong Lafitte]

Don’t let some stranger fuck you in the ass.

Monkey rectum pox solved.

Is this your homework, Larry?


Sent from my iPhone using TGR Forums

[dunfree]

Phew, all of those acquaintances deepdicking cumshot in the ass have zero chance of giving him monkey pox, because obviously they respect him

[Core Shot]

I only get fucked in the ass by known partners.

Random stranger ass fucking ain’t my game.

[dunfree]

“I respect you chem trail, I’d never lie to you”

[LongShortLong]

I bet this reaches pandemic status. Looks like a steady growth rate with cases doubling every 12 days or so.

https://ourworldindata.org/monkeypox
I looked at 7 day average and log scale.

For comparison, Covid seemed to double every 4 days or so. So it's slower, but it is not slowing down. If current growth rates continue, we can expect to a million cases per day by Christmas.

The math:
When will we have 1,000,000 daily cases?
1,000,000/300 (300 daily cases today) = 3,333. 3,333 is 11 or 12 doublings (2^11 = 2048, 2^12 = 4096). 12 doublings at 12 days to double is 144 days, or about 5 months.

[summit]

There are not that many MSM and there is minimal vaccine deployment. Vaccine deployment is being stepped up for the high risk community in the US. There is no reason for this to be a pandemic

[Core Shot]

There are not that many MSM and there is minimal vaccine deployment. Vaccine deployment is being stepped up for the high risk community in the US. There is no reason for this to be a pandemic

300 cases per day aren’t a pandemic? We need more fear porn asap. And stop rawdogging. Wtf. I hate the media.

[Mofro261]

I bet this reaches pandemic status. Looks like a steady growth rate with cases doubling every 12 days or so.

https://ourworldindata.org/monkeypox
I looked at 7 day average and log scale.

For comparison, Covid seemed to double every 4 days or so. So it's slower, but it is not slowing down. If current growth rates continue, we can expect to a million cases per day by Christmas.

The math:
When will we have 1,000,000 daily cases?
1,000,000/300 (300 daily cases today) = 3,333. 3,333 is 11 or 12 doublings (2^11 = 2048, 2^12 = 4096). 12 doublings at 12 days to double is 144 days, or about 5 months.

No, agree w summit on this. Requires direct skin contact with pustules or direct contact with clothing/ towels/sheets to have onward transmission by all indicators. Yes it tripled in 2 weeks to 5,100 cases now world wide in 51 countries, with 99% of those being male 25-45 demographic. The 1% of women and kids thus far are household contacts. It's going to have to start spreading outside that demographic to become a pandemic, nearly all people over 50 have immunity already via small pox vaccination and the current pox vaccines are highly cross reactive to the circulating and much less lethal west African strains. Contagiousness requires skin blister formation so it shouldn't have high potential for asym spread.

We are still going forward with couple detection assay development strategies with guidance and input from cdc...just in case.

[LongShortLong]

Predicting is inherently difficult. I just projected a month long trend, that's been steady for the whole month.

Too many experts who should know better failed to do basic math in the last pandemic. Exponential growth is misunderstood, but not that hard to understand. Having preventative measures available is of limited use if we don't get them widely implemented. And soon. Change the trend or live the prediction.

[summit]

As you said, exponential growth is not hard to understand conceptually, but it is very easy to misunderstand in the context of epidemiological modeling if you are applying it via back of the napkin math like above.

Cryptic and distant transmission with short incubation defined COVID so there was never a real post exposure prophylaxis. There were no cheap and easy transmission modifiers that were also sufficiently effective to sustainably manage the R0 of the evolving pathogen.

Monkeypox is not cryptic, it is not airborne, and it has a long enough incubation period that you can effectively offer post exposure prophylaxis and ring vaccination with an extremely effective vaccine that we already have stocked in quantity for literally every American. You can make Reff <1 pretty easily and your high risk S pool in a SIR model is pretty small and targetable for vaccine.

You can contact trace contact exposures drastically more easily than airborne exposures.

Monkeypox is not a regularly circulating disease in African cities with good reason.

Drugged up MSM grinding privates in dimly lit raves was the Monkeypox superspeading event, not a choir singer at the megachurch or a big wedding.

[LongShortLong]

As you said, exponential growth is not hard to understand conceptually, but it is very easy to misunderstand in the context of epidemiological modeling if you are applying it via back of the napkin math like above.

Cryptic and distant transmission with short incubation defined COVID so there was never a real post exposure prophylaxis. There were no cheap and easy transmission modifiers that were also sufficiently effective to sustainably manage the R0 of the evolving pathogen.

Monkeypox is not cryptic, it is not airborne, and it has a long enough incubation period that you can effectively offer post exposure prophylaxis and ring vaccination with an extremely effective vaccine that we already have stocked in quantity for literally every American. You can make Reff <1 pretty easily and your high risk S pool in a SIR model is pretty small and targetable for vaccine.

You can contact trace contact exposures drastically more easily than airborne exposures.

Monkeypox is not a regularly circulating disease in African cities with good reason.

Drugged up MSM grinding privates in dimly lit raves was the Monkeypox superspeading event, not a choir singer at the megachurch or a big wedding.

So far, the countermeasures appear inadequate. The exponential growth is steady for a month now. The countermeasures are (and have been) available in wealthy countries where much of the transmission is occurring. If the countermeasures start working, monkeypox may be contained. As you mention, the early covid countermeasures worked in only a few countries and weren't enough. It's still early for monkeypox. Early-ish. I agree we probably can stop monkeypox. We also probably could have stopped Covid, and didn't.

Victim blaming humans who like drugs and sex is unlikely to work. Almost all of us do. Despite drug wars, prohibitions, and puritans, we have not changed. Just ask the choir singer at the megachurch.

[summit]

We also probably could have stopped Covid, and didn't.

The failure of the communist Chinese to stop COVID in mid-January proved to anyone watching that a global pandemic was inevitable. The reasons were so entirely different that Monkeypox, as I enumerated above, that they are incomparable.

Victim blaming humans who like drugs and sex is unlikely to work. Almost all of us do. Despite drug wars, prohibitions, and puritans, we have not changed. Just ask the choir singer at the megachurch.

Proportionally very few people get high and have multiple sex partners at raves, no matter their sexual orientation.

Casting the activities of a very small number of high risk individuals in a population as "victim blaming" is just silly. The R0 in the high risk group is drastically different than in the general population.

The megachurch example repeats at weddings, restaurants, lecture halls, offices, birthdays, old folks homes, raves with no sex etc. High reproduction rates are maintained across populations in COVID. Monkeypox transmission in highly promiscuous subcommunities, including sex orgies and raves, are not comparable or translatable. That is the point and it is not about blame nor judgement. It is the very reason why the threat is high for a very small segment of the population (a subpopulation of MSM) but not for the rest, and why there is a global outbreak that won't need to result in pandemic anymore than previous African outbreaks.

[LongShortLong]

Sort of like HIV is a pandemic, eh?

As I recall, China stopped a major outbreak of Covid in late Jan/early Feb. Several other countries in that region did as well. If more countries had chosen to stop Covid in its early days, it may never have reproduced enough to adapt as it has. Sorta like we did to OG SARS. Maybe we should be doing to monkeypox.

I question whether you have a good definition of the susceptible population for monkeypox, or the size of that population. If it's truly a small sub-population, it should have self-limited by now or very soon. Also, that population has been aware of the risks for weeks now, and presumably taking precautions, and yet there's no change in rate of spread. Experts pooh-poohed the small number of covid infections too, ignoring the rate of spread (and e.g. CDC defined a small susceptible population). It's the rate of spread that makes a pandemic, unless it's sufficiently reduced.

[summit]

I'm not sure where you are getting reading to generate such dire comparisons, but let's start with this HIV/AIDS comparison. It is again a TERRIBLE analogy.

HIV/AIDS was NEVER pandemic in the US.

Peak annual US HIV incidence was perhaps 130K PER YEAR 35 years ago at its peak. Now it is under 40K. It still is HIGHLY concentrated in small high risk groups with over 70% of new cases being MSM and/or IDU. It is what it is because the virus is what it is: a STD/BBP. Luckily, it is now a manageable chronic illness in the US, not a death sentence like 30+ years ago.

HIV is persistently endemic because transmission is cryptic. You can't look at someone and tell they have transmissible HIV. Even still, there are behavior modifications across all populations resulting from HIV, just as there are for Monkeypox.

Preventing a Pandemic?

I said, "There were no cheap and easy transmission modifiers that were also sufficiently effective to sustainably manage the R0 of the evolving pathogen" for COVID. The recent Chinese lockdowns/tests/vaccinations in Shanghai do NOT meet that definition, even if you want to classify those actions as successful, which I don't, and I don't believe the PRC, and even if did, I have no illusion that such strategies would work outside of a communist police state.

Jumping back, in retrospect, the hope of stamping out COVID was lost by or before the end of 2019 when it was still only in Wuhan. It became clear to those paying attention by mid January that there would be no containment if the cordon sanitaire failed in Hubei because of cryptic transmission. If Monkeypox was COVIDeqsue in its threat, we are too late as it is in many on countries on every continent. Luckily, Monkeypox is not COVID, or even HIV.

Susceptible populations

A clarification of the nonspecific term "high risk population:" we can talk about high susceptibility or severe case risk. We are talking about the former for a subset of MSM regarding Monkeypox, while high risk in COVID usually referred to those at risk for severe illness. You could also have those who are both highly susceptible and at high risk for severe disease, such as immunocompromised for COVID who had poor seroconversion rates for vaccines.

There are many factors that go into basic epi models including the base reproduction rate for a pathogen vs population vs modifiers and various TCs vs incubation and transmission duration vs prevalence (I) vs ratio of susceptible (S) to recovered/immune (R). You can parlay those variables into doubling times but these are not static over time, or even over the short term, as the variables change.

When we talk about a high susceptibility (high risk for contraction) subpopulation with Monkeypox, it is pretty clear this is a small subset of a subpopulation and that the reproduction rate is high in that subgroup, much higher than in the general population. So if you plugged into a sim that ran SIR models for multiple internally and externally communicating populations, you'd see what we see now, cases escalating in the small high susceptibility population with minimal spillover, following by plateauing and exhaustion in that subpopulation and small sporadic outbreaks and eradication in the larger less susceptible population that are managed by traditional PH measures. You could model some worst case scenarios, but I don't see those as reasonable expectations, unlike the situation in January 2020.

tldr; summary

Monkeypox is already regionally endemic with an animal reservoir with a history of outbreaks in Africa that did not result in worldwide pandemic. What we are experiencing now is an unusual outbreak where the pathogen has entered a high susceptibility subgroup. The reproduction trends currently seen will not generalize to the global population resulting in the exponential spread you are concerned about, a forest fire COVID-like global pandemic. Instead Monkeypox will fizzle, spark, and smolder This is the case for all the reasons I already described. I have not seen any argument counter to that reasoning.

[LongShortLong]

There is no sign of monkeypox fizzling, or even slowing down. So if a model says we're running out of population, the model is wrong, or mis-parameterized. I think some experts get to wrapped up in their sophisticated model, and forget to sanity check with back of envelope calculations. It's happened repeatedly with Covid.

I think it's safe to say we'll see rising cases for at least the next few months. Will it continue all the way to December as per my crude forecast? I'd guess there's sufficient susceptibles to support that. Will we get our act together and contain it before then, maybe. Will it evolve to spread better, also maybe. The point of my forecast is to illustrate the risk we face. I don't think there will be a million cases a day on Christmas, that's not how exponential forecasts work. It could be sooner, could be later, might not happen at all. But that's the trajectory, and there's currently nothing to change it.

Appears some other folks have noticed that we're bungling another pandemic:
https://thehill.com/policy/healthcar...-on-monkeypox/

[LongShortLong]

I'm not sure where you are getting reading to generate such dire comparisons

Case data from ourworldindata, I provided the link. Math by me, I showed the work.

I said, "There were no cheap and easy transmission modifiers that were also sufficiently effective to sustainably manage the R0 of the evolving pathogen" for COVID. The recent Chinese lockdowns/tests/vaccinations in Shanghai do NOT meet that definition, even if you want to classify those actions as successful, which I don't, and I don't believe the PRC, and even if did, I have no illusion that such strategies would work outside of a communist police state.

And I was speaking of Wuhan in Feb 2020 for halting a large outbreak. And Australia, New Zealand, Taiwan, and others for halting small outbreaks. By example, Covid was contained in several countries. There's nothing special about those countries that prevent their approaches from working elsewhere. We chose not to stop Covid. We seem to be choosing not to stop monkeypox.

I haven't followed the Shanghai story and whether they were able to contain the recent outbreak. Regardless, it's a different disease now. We let it spread widely, and it evolved.

And I get that MSMs are immoral and deserve to get sick. During Covid's early days, it was the immoral liberals deserving sickness. (/s for anyone thick in the head)