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2/ What does it mean that the WHO has declared monkeypox a public health emergency of international concern (PHEIC)? A PHEIC is not the same thing as a pandemic. Monkeypox was pandemic in June. It's a novel virus that has been causing outbreaks across multiple continents.
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4/ Had the declared monkeypox a PHEIC back in June, more might have been done sooner to contain monkeypox, both in Western & Central Africa as well as among gay and bisexual men & trans women in the US/Europe/etc, among whom the virus is actively spreading.
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5/ But a public health emergency of international concern is no guarantee that countries will share vaccine. We've seen really inequitable distribution of COVID vaccines. Only a quarter of people living in Africa have gotten a single dose of COVID vaccine.
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10/ And too many health care providers remain uneducated about monkeypox &/or choose not to do the work of testing for monkeypox.
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More on the patient in the thread🧵below: newyorker.com/news/dispatch/ Commercial labs helped ramp up monkeypox testing capacity in the last couple of weeks, but too many clinicians aren't aware or don't want to deal with the hassle of testing for monkeypox.👇🏾
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11/ Note that just because someone tests positive for another sexually transmissible infection doesn't mean they don't have monkeypox. Many are testing positive for monkeypox + another infection.
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Data from the UK on demographic & clinical characteristics of monkeypox cases: thelancet.com/journals/lanin 1 in 4 patients had a concurrent sexually transmissible infection. Just because someone tests positive for another STI doesn't mean you shouldn't also test them for monkeypox.
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12/ We needed a lot more monkeypox vaccine supply a lot sooner. Should we have been more aggressive about stockpiling Jynneos monkeypox vaccine sooner (not specifically for the monkeypox outbreak, but for smallpox bioterrorism preparedness) in the strategic national stockpile?
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14/ What's driving these infectious disease outbreaks? It's a combination of things: 🔹childhood vaccination rates⬇️⬇️⬇️during the COVID pandemic, in part due to disruption caused by COVID & because people became more skeptical about vaccines during that time
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16/ continued 🔹a lack of investment in public health in the US🇺🇸 & around the world🌎, so we don't have the capacity to respond to these crises Infectious disease outbreaks will very much be part of our new normal moving forward.
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