Monkeypox

[najaB]

This is not just advising people to reducing close contact that is being discussed, the point you were replying to was legislation to totally deprive people of even the basic liberty to leave their home for weeks on end

At no point have I suggested that there should be new legislation.

 

[DelayRepay]

It's worth remembering that at the moment there are no restrictions in the UK, only advice. I think it's sensible advice. Unlike Covid, there are relatively few cases in the UK, and it doesn't spread easily, so it's entirely possible we can eliminate the virus.

One could argue, however, that mandatory isolation may be better if it entitled people to sick pay. Some people will find the recommended 21 days tough financially if they're not paid.

It's also worth noting that neither the BBC or the Guardian currently have any reference to Monkeypox on their home pages. I'd suggest this shows how much interest people have in the subject!

 

[Dent]

Some clearly will. Personally, while I know close contacts* can be debated, I think going on with your normal life while knowingly infected with a very unpleasant communicable disease (rather than a cold) is just a bit antisocial.

* In this case a "close contact" means same household or prolonged bodily contact e.g. sex, not just people you've been to the pub with. So very few people.

== Doublepost prevention - post automatically merged: 24 May 2022 ==



I think staying at home when you know you have a serious communicable disease (rather than e.g. a cold) is simply the act of a reasonable person, never mind any legislation.

This isn't a "seriously communicable disease" if it requires prolonged contact to spread, not merely someone being outside of their home.

 

[Bletchleyite]

This isn't a "seriously communicable disease" if it requires prolonged contact to spread, not merely someone being outside of their home.

OK, so you're wearing a short sleeved shirt and sit next to someone on a 3+2 train. That'd be enough.

It's simply consideration of others. No law should be needed. If you've got something nasty, stay away from others as much as you practically can. Basic consideration, both before and after COVID.

 

[ainsworth74]

Where did you get "any restrictions being utterly unacceptable"?

Because some people are talking about:

rushing headlong into a barbaric totalitarian state

At the suggestion that there might be some requirement to isolate if you've been in contact with someone with a communicable infectious disease. You'll forgive me but that's pretty extreme stuff in response to one, unsourced, report coming from Belgium.

 

[najaB]

his isn't a "seriously communicable disease" if it requires prolonged contact to spread, not merely someone being outside of their home.

The problem isn't them being outside their home, the issue is what they do, along with who and how they interact with. And it doesn't require prolonged contact, but rather close enough contact to allow the exchange of the virus.

 

[philosopher]

Where did you get "any restrictions being utterly unacceptable"? It's more a case of any restrictions should be proportionate and subject to cost/benefit analysis, rather than rushing headlong into a barbaric totalitarian state all over again.

Asking those who have Monkeypox to isolate is quite a sensible measure, as is vaccinating contacts. The issue is that if there is clamour for more restrictions, then disproportionate measures could easily be imposed.

A return to lockdowns or widespread business closures I think is very unlikely for this virus. However, if there is pressure for restrictions we could end up a situation where there are measures such as strong messaging not to shake hands or hug others, closure of nightclubs where bodily contact is common and restricting capacity on public transport so that people are not sitting next to each other.

Given the events of the last two and half years, if such measures were imposed they would go down like lead balloon for quite a few people.

 

[Cdd89]

I wonder how long this can live on a bogseat? That could be a form of contact spread if it can for a while.

OK, so you're wearing a short sleeved shirt and sit next to someone on a 3+2 train. That'd be enough.

One of the mistakes we made with Covid was focussing on unlikely routes of spread while underemphasising the likely routes, due to a combination of lack of knowledge, and the belief that we could (or needed to) attain zero risk.

I am sure both of the above are correct, just as Covid can spread through surfaces or shared ventilation systems. However, if this (or other indirect/passing contact) were a significant way it spreads, we’d be seeing a majority of untraceable cases, surely?

I would not support isolation of incidental or indirect contacts until there is clear evidence that this is a significant method of spread.

 

[AlterEgo]

Where did you get "any restrictions being utterly unacceptable"? It's more a case of any restrictions should be proportionate and subject to cost/benefit analysis, rather than rushing headlong into a barbaric totalitarian state all over again.

We aren’t going into lockdown because of monkeypox. It is very difficult to catch because it requires very close contact, which at the moment has required you to have sex with someone infected to actually contract.

 

[Bletchleyite]

We aren’t going into lockdown because of monkeypox. It is very difficult to catch because it requires very close contact, which at the moment has required you to have sex with someone infected to actually contract.

Not necessarily true; any skin to skin contact is likely to be sufficient.

 

[AlterEgo]

One of the mistakes we made with Covid was focussing on unlikely routes of spread while underemphasising the likely routes, due to a combination of lack of knowledge, and the belief that we could (or needed to) attain zero risk.

I am sure both of the above are correct, just as Covid can spread through surfaces or shared ventilation systems. However, if this (or other indirect/passing contact) were a significant way it spreads, we’d be seeing a majority of untraceable cases, surely?

I would not support isolation of incidental or indirect contacts until there is clear evidence that this is a significant method of spread.

I quite agree. HIV can be spread by two open wounds coming into contact but “two people next to each other with bare arms” isn’t how, in practice, the disease is spread. Talking around the reality of how the diseases spread in order to be “sensitive” cost a vast number of lives in the early stages of covid. People coming from China should have been banned from entering Europe back in January, for example. This suggestion was decried as racist at the time.

== Doublepost prevention - post automatically merged: 24 May 2022 ==

Not necessarily true; any skin to skin contact is likely to be sufficient.

Any cases of that so far? Is that the main route of transmission? The WHO are very clear about the activities that have led to the current flare up.

 

[Bletchleyite]

I quite agree. HIV can be spread by two open wounds coming into contact but “two people next to each other with bare arms” isn’t how, in practice, the disease is spread.

It's not HIV. There are diseases that can spread from simple skin to skin contact, such as the herpes virus. This is another one.

 

[AlterEgo]

It's not HIV. There are diseases that can spread from simple skin to skin contact, such as the herpes virus. This is another one.

I never said it was HIV. But rather it is important to focus on what are evidentially the main routes of transmission and the behaviour that is causing it.

 

[Bletchleyite]

Any cases of that so far? Is that the main route of transmission? The WHO are very clear about the activities that have led to the current flare up.

Risk assessment: Monkeypox multi-country outbreak

Cases of monkeypox (MPX) acquired in the EU have recently been reported in nine EU Member States (Austria, Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the Netherlands).

www.ecdc.europa.eu

This is what it says:

Monkeypox (MPX) does not spread easily between people. Human-to-human transmission occurs through close contact with infectious material from skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites. The predominance, in the current outbreak, of diagnosed human MPX cases among men having sex with men (MSM), and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse.

So it may transmit more easily by contact between mucous membranes than between outer skin (which is understandable).

== Doublepost prevention - post automatically merged: 24 May 2022 ==

I never said it was HIV. But rather it is important to focus on what are evidentially the main routes of transmission and the behaviour that is causing it.

No, what is necessary is to deal with ALL routes of transmission.

I'm still picking up a strongly homophobic tone in your posts, I'm afraid. If it is being sexually transmitted it'll only take one bisexual person and it'll be bouncing between straight people, too.

A sensible message, monkeypox or not, is that if having sex with someone who is not your regular partner you should wear a condom. There is absolutely nothing gained by pointing fingers at specific groups in the manner that you are seeking to do. That message applies to everyone in that position and always has from the day they were invented.

 

[Dent]

OK, so you're wearing a short sleeved shirt and sit next to someone on a 3+2 train. That'd be enough.

That could be easily mitigated by, for example, wearing a long-sleeved shirt if you have sores on your arms. It does not require total solitary confinement.

The problem isn't them being outside their home, the issue is what they do, along with who and how they interact with.

That's my point, just being outside their home is not a problem, so why is it appropriate to prohibit anyone from just being outside their home?

 

[Bletchleyite]

That could be easily mitigated by, for example, wearing a long-sleeved shirt if you have sores on your arms.

Gloves too, just in case you share it via a doorhandle or similar?

 

[najaB]

It is very difficult to catch because it requires very close contact, which at the moment has required you to have sex with someone infected to actually contract.

You have stated that several times now, but I haven't seen any official source saying that every case has been transmitted sexually. The official NHS page says:

Monkeypox can also be spread through:

• touching clothing, bedding or towels used by someone with the monkeypox rash
• touching monkeypox skin blisters or scabs
• the coughs or sneezes of a person with the monkeypox rash

That's my point, just being outside their home is not a problem, so why is it appropriate to prohibit anyone from just being outside their home?

Nobody has suggested prohibitions as yet, just advice. But, if it was to get to the stage where prohibitions were being actively considered, which is the easier prohibition to explain, implement and police: "Stay at home" or "You can leave home but don't do x, y or z while you are out"?

 

[Cdd89]

No, what is necessary is to deal with ALL routes of transmission.

The problem with dealing with all routes (no matter how unlikely) is that you lose clarity of messaging. If there are 50 things the public are told to be careful about, the most important items on that list will be deprioritised (even if the public are told that X is the most important item).

If X is 100 times more significant than Y, but the public treats it as only 50 times more significant, you can see how that would have direct negative consequences in terms of action relating to X.

 

[AlterEgo]

So it may transmit more easily by contact between mucous membranes than between outer skin (which is understandable).

That’s amazing isn’t it? And what sort of sex is the most risky to have when we are talking about diseases spread between mucous membranes? I’m not going to get graphic or personal but there is a strongly increased risk of this type of transmission among the MSM community for reasons which can’t be detailed on a family oriented forum.

I'm still picking up a strongly homophobic tone in your posts, I'm afraid. If it is being sexually transmitted it'll only take one bisexual person and it'll be bouncing between straight people, too.

It has nothing to do with people’s sexuality or identity and everything to do with the behaviours that people engage in. Many MSM do not identify or consider themselves bisexual or gay but rather engage in recreational (and often risky) sex.

If you believe a post is homophobic, which you have mentioned twice now, I encourage you to report it for breaking the forum rules instead of trying to police the tone yourself.

You have stated that several times now, but I haven't seen any official source saying that every case has been transmitted sexually.

Or rather through sexual contact. But there are no cases reported which have come from other routes, and the messaging from the WHO and others is focused most strongly around recreational sex.

This is an endemic disease normally of low concern to the West and there are strong efforts to find out why, this time, we are getting outbreaks which are linked to raves, risky sexual contact and MSM parties. That’s where we are at the moment.

== Doublepost prevention - post automatically merged: 24 May 2022 ==

The problem with dealing with all routes (no matter how unlikely) is that you lose clarity of messaging. If there are 50 things the public are told to be careful about, the most important items on that list will be deprioritised (even if the public are told that X is the most important item).

If X is 100 times more significant than Y, but the public treats it as only 50 times more significant, you can see how that would have direct negative consequences in terms of action relating to X.

Indeed, see how fomite transmission caused absolute brain rot for the first half of covid. It just wasn’t a transmission route of concern. Messaging has to be specific and frank, as it has been in the past for drug users and recreational sex participants for HIV.

 

[Bletchleyite]

The problem with dealing with all routes (no matter how unlikely) is that you lose clarity of messaging. If there are 50 things the public are told to be careful about, the most important items on that list will be deprioritised (even if the public are told that X is the most important item).

If X is 100 times more significant than Y, but the public treats it as only 50 times more significant, you can see how that would have direct negative consequences in terms of action relating to X.

So here's a really clear message that applies to everyone, always, doesn't single out specific groups and reduces transmission of a whole raft of stuff, not just monkeypox.

If you have sex with someone who isn't your committed, regular partner, wear a condom.

Dead simple. Mentioning specific groups reduces its effectiveness.

 

[Dent]

Nobody has suggested prohibitions as yet, just advice. But, if it was to get to the stage where prohibitions were being actively considered, which is the easier prohibition to explain, implement and police: "Stay at home" or "You can leave home but don't do x, y or z while you are out"?

Whether prohibition or "advice", the point still stands that just being outside their home is not a problem. Are you suggesting that administrative convenience is a valid justification for sweeping deprivation of personal liberty for no scientific reason? That doesn't sound like very good moral reasoning.

 

[Bletchleyite]

Whether prohibition or "advice", the point still stands that just being outside their home is not a problem. Are you suggesting that administrative convenience is a valid justification for sweeping deprivation of personal liberty for no scientific reason? That doesn't sound like very good moral reasoning.

Choosing to stay at home if you have a communicable disease is very good moral reasoning to me. There shouldn't be a need to legislate anything, people should just do it. Even with colds, it makes more sense for one person to stay off work for a couple of days than it does for it to run riot through a whole business's staff, damaging productivity as it does.

Does it matter if you go for a walk on your own at 5am? Not really, but just use a bit of sense and think of others before yourself.

 

[najaB]

Or rather through sexual contact. But there are no cases reported which have come from other routes, and the messaging from the WHO and others is focused most strongly around recreational sex.

Most strongly, but not exclusively.

Again, from the NHS:

Things you can do to avoid getting monkeypox
Although monkeypox is rare, there are things you can do to reduce your risk of getting it.

Do

• wash your hands with soap and water regularly or use an alcohol-based hand sanitiser
• only eat meat that has been cooked thoroughly

Don’t

• do not go near wild or stray animals, including dead animals
• do not go near any animals that appear unwell
• do not eat or touch meat from wild animals (bush meat)
• do not share bedding or towels with people who are unwell and may have monkeypox
• do not have close contact with people who are unwell and may have monkeypox

Again, nobody is denying that the highest risk of transmission is intimate contact, but there is a danger that the focus on male-male sex causes complacency in other at-risk groups. The message should be a simple "Avoid intimate contact as much as possible".

== Doublepost prevention - post automatically merged: 24 May 2022 ==

Are you suggesting that administrative convenience is a valid justification for sweeping deprivation of personal liberty for no scientific reason? That doesn't sound like very good moral reasoning.

To borrow a saying "Your right to swing your fist ends where my nose starts".

If it becomes necessary then yes, the health of the wider public is a valid reason to temporarily limit individual personal liberties.

And it's not just about administrative convenience, but also about people's understanding of what they can and cannot do. In general, a simple rule that slightly over-reaches is better than a more precise rule that is too complex to be understood.

 

[Bletchleyite]

Again, nobody is denying that the highest risk of transmission is intimate contact, but there is a danger that the focus on male-male sex causes complacency in other at-risk groups. The message should be a simple "Avoid intimate contact as much as possible".

An interesting question here is whether the likes of Grindr/Tinder should voluntarily close down in affected areas temporarily in order to have an impact on the amount of transmission by people using those apps for "hookups" as they often do.

 

[Cdd89]

Indeed, see how fomite transmission caused absolute brain rot for the first half of covid. It just wasn’t a transmission route of concern

Yes, I was going to cite that example, and it definitely distracted people from more effective measures. Even more significant was the fact that indoor and outdoor mixing were equally discouraged in the first few months. That clearly led to more indoor mixing.

So here's a really clear message that applies to everyone, always, doesn't single out specific groups and reduces transmission of a whole raft of stuff, not just monkeypox

No disagreement there; I’m with you in terms of not stigmatising specific groups. My only objection was to listing 10 other things to ‘be careful about’ alongside it, from loo seats to door handles.

The other reason sexual transmission is so important, relative to other methods, is because it’s a context where people may not be being entirely honest (eg: affairs) or may be stigmatised from being able to discuss (gay people who are not out). That makes contact tracing less effective and voluntary measures much more important.

 

[AlterEgo]

Again, nobody is denying that the highest risk of transmission is intimate contact, but there is a danger that the focus on male-male sex causes complacency in other at-risk groups. The message should be a simple "Avoid intimate contact as much as possible".

No disagreement there. The level of focus is the main concern. To repeat lest I be misunderstood by others, it’s not a “gay disease” (there is no such thing), but it is important to focus on exactly which routes are showing cases at the very outset of this outbreak. It is possible that the virus has changed how it is known to behave, or it could be that the outbreak is just a matter of chance and will go away on its own.

I do think however that when I see my (female) masseuse on Monday I am putting myself at much lower risk than if I was engaging in a risky sexual practice. We have to be honest with ourselves. What activities put ourselves at the highest risk right now?

It may be in the future - and let us hope it doesn’t happen - that monkeypox spreads to a more general section of the population than those who engage in MSM, and again the risk factors will change there too. Perhaps in the future it will become risky to get a deep tissue massage in a salon. That does seem very unlikely at the moment though.

 

[DarloRich]

what is MSM? I mean I am fairly broadminded and experienced guy but havent heard that before.

 

[Eyersey468]

what is MSM? I mean I am fairly broadminded and experienced guy but havent heard that before.

Mainstream Media

 

[DarloRich]

Mainstream Media

i dont think it is in this regard! I have heard it called many things but not that!

 

[Bletchleyite]

what is MSM? I mean I am fairly broadminded and experienced guy but havent heard that before.

It's "Men who have Sex with Men", a bit of a mouthful really. It's sort of different from "gay or bisexual men" partly because there are a lot of letters in LGBTQIA+ which could be applicable rather than just the "G" or "B", and partly because it doesn't encompass gay/bi men who for whatever reason don't have sex with other men (or at all).

Only other context I've seen it in is in the rules about who can give blood. They don't want mine anyway as it's full of rat poison, regardless of all that