A. Flahault, 12/08/22
1/8 -
Jan 30, 2020 : #COVID19 has been declared PHEIC by the WHO, with 17,800 reported cases. Between Dec 15 and Mar 15, 217,000 cases were reported ; July 23, 22 Monkeypox declared as PHEIC, with 17,021 rep. cases. Between May 15 and Aug 15, up to 40,000 cases should be reported.

2/8 -
Doubling times :
COVID19 = 2-4 days in Jan, 4-14 days in Feb, 8-10 days Mar-Apr, 2020.
Monkeypox = 7-10 days in June, 12-15 days in July, 18 days in Aug, 2022.
– Will it accelerate/keep pace/decelerate in the coming weeks ?

3/8
Initially COVID19 has spread among religious communities with high promiscuity, then jumped to other segments of population, keeping heterogeneous spread during at least the first 6 months of the pandemic, until its 2nd wave (automn 2020).

4/8
Monkeypox spreads mainly in MSM communities with high promiscuity.
– Is it just its initial phase ? Will it soon jump to other segments of population ?
– How long will it keep this heterogeneous spread ?
Answers to these questions are key and depend on routes of transmission.

5/8
It took months to find scientific consensus on routes of transmission for SARSCoV2, which is now recognized as predominantly airborne.
– How long will it take to determine which are the predominant routes of transmission for #MonkeypoxVirus ?
Answer to this question is key.

6/8
Estimating severity of emerging infectious diseases takes time. First cases are often young, highly connected, active and healthy people. In a second stage, virus may jump to more vulnerable segments of population, and then severity figures can dramatically change.

7/8
Although, it may be too early to precisely ascertain lethality for #Monkeypox, it seems not to be same order of magnitude as for #COVID19 (0.02% vs 1%). We cannot however consider #Monkeypox as mild : 40% of cases experience complications, 20% are hospitalized. Heavy burden.

8/8
The term “pandemic” doesn’t belong to the International Health Regulation vocabulary.
COVID19 was declared as pandemic by WHO on March 11, 2020, with 149,000 reported cases.
– If, by mid-Sept. 2022, 150,000 cases of #Monkeypox are reported, will WHO declare it as pandemic ?