More on excess data and Sweden’s response to the pandemic

A very interesting paper, important for understanding the role of excess deaths data in understanding the impact of #COVID19 and the non-pharmaceutical interventions:

The most important consequence is that we must be very careful when interpreting these data. In particular, direct comparison of countries on the total number of excess deaths can be very misleading, as pointed out in the following tweet:

Thanks to @ikashnitsky

Monkeypox – a zoonotic disease

‘If we have allowed monkeypox to become an endemic virus in the U.S. … it will be among the most unfortunate public health failures in recent times.’

Declan Garvey and Esther Eaton, The Dispatch
BROOKLYN, NYC, US, October 1 2013: Street art in Brooklyn. Old paper billboard saying welcome to New York, with scary drawings of mouse, roaches and pigeon. New York, US.

As monkeypox continues to spread both within and between countries, it is worth reminding that it is a zoonotic disease.

In parts of Africa, where monkeypox outbreaks are much more frequent, the virus appears to persist in other mammal populations. Although it was first discovered in a monkey (hence the name), rodents are thought to be a more likely reservoir.

Monkeypox is not as infectious as COVID-19 and not as dangerous as smallpox. It currently spreads largely in an MSM community (men having Sex with Men), but it is properly not a Sexually Transmitted Disease (STD).

Rather, it spreads through close personal contact, mainly through skin contact. Hence, there have been cases among women and children.

It is disappointing that we did not manage to stop it early. Unlike COVID-19 virus (SARS-CoV-2), monkeypox is not a new disease, it does not spread very fast and easily, we do have relatively safe and sterilising vaccines, and we know how to use them.

Monkeypox has been spreading in a relatively limited network with only sporadic breakthroughs to the general population. Although the long incubation period makes contact tracing somewhat problematic, it would not have been difficult to implement “ring” vaccination.

Once monkeypox becomes established in the ubiquitous rodent population, it will be almost impossible to eradicate. The risk to humans might not be very high,

Is there still a chance to stop it? Yes, but (as with COVID-19) it needs a swift action built on trust with the affected community. We must make sure that we work with the MSM community and not against them.

We must not end up stigmatising the infection but rather encouraging those most at risk to take appropriate actions.

COVID-19: The new summer wave

Tourist crisis in the summers of 2020-22

Back in April 2022, I was talking to Mark McLaughlin @mark_mclaughlin about the future developments for the #COVID-19 epidemic in the UK. I made a prediction:

Coronavirus hospital admissions have dropped sharply but waning immunity means that Scotland faces a resurgence this summer, an epidemiologist has warned.

Covid in Scotland: Hospital admissions fall ‘but cases could surge again in summer’ | Scotland | The Times

I really hate to be a bearer of bad news but I am afraid my prophecy has turned true. The UK in general, and Scotland in particular have followed many other countries into a new coronavirus wave.

What I perhaps did not fully appreciate at that time was the rise of new variants, but I think they simply added to the general picture. I suspect the summer wave would have come anyway, fueled by immunity waning. And, remember that we have practically no restrictions.

What does it tell us for the future? The virus itself is now basically “endemic” in the sense that it does not disappear – or even go significantly down – between peaks. We actually entered this “endemic” state in May-June 2021, as the graph above (from the ZOE reporting) shows.

While the vaccines (and immunity from past infections) help in reducing hospitalisation and deaths, the virus is simply refusing to go away.

COVID-19 reported death rates per million, for 5 waves, centred at the peak. Note logarithmic vertical scale.

However, not only has the #COVID-19 been “normalised”, but I think the risk of getting (repeatedly) ill with possible complications has now become “priced in” by the general population.

In many “usual” everyday activities we take risks. Some people, who for example do extreme sports, take very serious risks but even crossing the road, or jogging in the park, might be (and often is) dangerous.

But we accept these risks – consciously, or subconsciously, or because others do it.

Of course, with infectious diseases, there is a problem that my actions – of not masking, not getting vaccinated, or not staying at home despite clear #COVID-19 symptoms – often have a severe impact on others. But, this is a topic for another post…