Dr. B's Weekly Roundup: All about monkeypox

Welcome to the Dr. B Weekly Roundup, a curated weekly overview that cuts through the noise to deliver vetted reads on Covid-19 and beyond. OK, the good-ish news? Monkeypox is neither as contagious nor as deadly as Covid-19. And we have vaccines + treatment options that target it. But there are plenty of reasons to be informed + stay alert. So this week, we’ve got everything you need to know about monkeypox right now + historical pandemic treatments that we’re thankful no longer exist. Let’s get started with…

• The Checkup: balancing virus stress + wellness tips
• Another virus: monkeypox 101 + fascinating prior plagues
• Covid-19: masking efficacy + long Covid + pets (!)

The Check-Up: 

• Sigh. You need to be aware of polio again
• Why + how to (gently) break a toxic friendship
• Some lab techs are refusing monkeypox samples!
• Urge Congress to pass this life-saving heat-wave law
• How to talk (or not talk) to your kids about weight
• Not a fan of meditating? Try daydreaming instead
• How long does the current Covid variant stay airborne?
• Someone finally made an awesome period playlist
• How to talk about disabilities with sensitivity
• Chill out with these naturally sweet popsicle recipes

Let's talk monkeypox

Origin story: Discovered in 1958 in a Denmark animal facility, the first human infection was recorded in 1970 in the Democratic Republic of Congo. In rural areas of Africa, close proximity to animals has caused outbreaks. A recent clashing of events moved monkeypox global, and the Biden administration declared monkeypox a public health emergency.

What’s in a name? "Monkeypox" plays into historical stereotypes about Black and African people. It wrongly implies that only primates spread it. And it infers that monkeypox is primarily an African disease—which encourages stereotypes while denying the most affected nations the resources they need. Yet changing the name is still up for debate.

How it travels: Researchers have found the virus in saliva, urine, feces and semen. Anyone can get monkeypox through prolonged contact with an infected person's skin, scabs, or bodily fluids during kissing, cuddling or sex—though it’s not considered a specific STD. Fetuses can get the virus via the placenta. And while rare, touching fabric exposed to rashes or bodily fluids can transmit it, too. Unlike Covid-19, monkeypox is only contagious during active infection—it incubates for 1-2 weeks and becomes contagious when symptoms present.

Symptoms: The signature symptoms are sores on the body and face that look like blisters or pimples. They’re itchy and especially painful around the mouth and genitals. Fevers, chills, headaches, muscle aches, swollen lymph nodes and fatigue are common, too.

Timeline + Mortality: Active infection ranges from 2-4 weeks—so quarantine can last a month. The death rate in Africa ranges from 1-10% but the global outbreak is (so far) much lower. Risk is highest in young children and adults who are immunocompromised or pregnant.

Stigma: 98% of current infections are amongst men who have sex with men—but this is because of how the cards have fallen and not about who can get sick. The recent outbreaks trace to raves in Spain and Belgium where close proximity, skin-to-skin contact and sex spurred transmission. This community needs to be centered in healthcare outreach. But health officials worry the statistic will foster stigmatization that proved deadly during the AIDS crisis.

What to do...

Monkeypox is in the same genus as (globally eradicated) smallpox. So tests, vaccines and antiviral treatments exist. But national access is slow going. If you think you are at risk, here’s what to do:

• Get vaccinated: Two vaccines help prevent infection + work a few days after exposure. Nationally, you’re eligible for a vaccine if you’ve recently been in close contact with an infected person, have dermatitis or eczema or are immunocompromised. Adult men in New York who have had multiple sex partners in the last 2 weeks are eligible, too. Supplies are limited, so look to your local department of health for guidance.
• Get tested: You can get tested only when suspected sores present themselves. Go to your doctor, an urgent care center or sexual health clinic. They’ll swab a sample, and lab results usually return within 3 days.
• Talk to your doctor: Your doctor may prescribe medications for severe pain or if you have trouble swallowing or defecating. Get open sores tested for bacterial infection. And if you have a severe infection or are immunocompromised, your doctor may request the antivirals Tecovirimat or Brincidofovir from the government’s (limited) stockpile.
• Take care of yourself: Monkeypox infections are active until lesions crust over. Use Ibuprofen or Acetaminophen to reduce pain and fevers. Stay extra hydrated. A warm bath with colloidal oatmeal or Epsom salts can relieve itchiness—bandage sores after to prevent further spread. Avoid contact with pets—they can get sick from monkeypox, too! And if you need to be around others, cover your skin + wear a mask.

For the book nerds

If pandemic fatigue + monkeypox are testing your calm core, maybe diving into history will offer perspective? These page-turners honor those lost to past pandemics + remind us how far healthcare has come.

• The Great Mortality by John Kelly. The Black Plague was the most deadly in human history, killing up to 200 million people. In this gripping thriller, follow as it spreads unchecked … then disappears.
• Pale Rider: The Spanish Flu of 1918 and How It Changed the World by Laura Spinney. Patient documents + global touchstones blend into an evocative book akin to an eerie detective novel.
• How to Survive a Plague: The Inside Story of How Citizens and Science Tamed AIDS by Deckle Edge. Follow a closeted Wall Street trader-turned-activist + a South African physician + more in this pivotal account of everything it took to halt the AIDS crisis.
• Get Well Soon: History's Worst Plagues and the Heroes Who Fought Them by Jennifer Wright. The witty + accessible prose in this lively speed through physiological diseases will keep you swooning.
• The Ghost Map: The Story of London's Most Terrifying Epidemic by Steven Johnson. London's infrastructure was not prepared when cholera swept the city in 1854. Johnson tracks how citizens, politicians, scientists + more tackled the greatest riddle of their time.

The latest: pandemic

‘The next public health disaster in the making’: Studies offer new pieces of long Covid puzzle (CNN). 12.7% of infections may lead to long Covid, creating 23 million patients in the U.S. alone. To address this new public health disaster, 14 government departments + agencies are developing a whole-government approach to prevent, detect and treat it. Read above for details and head to HHS.gov for official reports.

How many animal species have caught COVID? First global tracker has (partial) answers (NPR). Remember when we mildly worried about pets getting Covid-19? New (limited) data confirms Covid has infected 27 species across 39 countries. Animals can feel sick or die from it. And while uncommon, they can spread it to humans. Animals like deer could also create “reservoirs” that hold + foster mutations, spurring outbreaks. Great.

Study shows probability of getting COVID for mask wearers vs. non-mask wearers (News Medical). A new report analyzing masking efficacy found that in community settings, only 6% of mask wearers tested positive for SARS-CoV-2 compared to 83% of non-maskers. In community + healthcare settings, 92% of masked subjects tested negative. Not yet peer-reviewed, researchers hope the findings will encourage further studies.