⁣Monkeypox

New Microbes and New Infections

https://www.ncbi.nlm.nih.gov/pmc/arti...

it is believed that African squirrels and other rodents might be the primary reservoirs

Current epidemiological situation as of 10 October 2022

https://www.gov.uk/government/publica...

Confirmed cases, 3,523

Highly probable cases, 150

Scotland, 94

Northern Ireland, 34

Wales, 46

England, 3,499

Cases were confirmed in England from 6 May 2022

The outbreak has mainly been in gay, bisexual, and men who have sex with men,

without documented history of travel to endemic countries.

https://www.gov.uk/government/publica...

Level 2
Transmission within a defined sub-population.
Out of 3,390 cases with known gender,

99% are men, and there are 45 women.

Nowcast and growth

Incidence remains low.

Multiple factors in reduction

Vaccination, (moderate confidence)

Behavioural modification, (low confidence)

(Reduction in some other sexually transmitted infections)

Route of transmission

Close or sexual contact

Monkeypox virus has been detected in air and environmental samples

(hospital room of infected patients)

No confirmed instances of airborne transmission

Limited household transmission

Assessment (confidence): Transmitting primarily through close or sexual contact (moderate)

Observed clinical severity

No reported deaths in the UK

Morbidity amongst people admitted to hospital, severe pain, secondary bacterial infection

Encephalitis, reported, appears uncommon

US situation

https://www.cdc.gov/poxvirus/monkeypo...

Confirmed cases, as of 11th October 2022 = 26,778

Vaccinations = 873,552

(as of 4th October)

UK ethnicity data

US Ethnic mix

https://www.medscape.com/viewarticle/...

Kaiser Family Foundation

https://www.kff.org/racial-equity-and...

MPX case rates among Black people are over five times those of White people (14.4 vs. 2.6 per 100,000)

Hispanic people account for larger shares of cases compared with their shares of the population

American Indian or Alaska Native

⁣WHO and YT

https://www.who.int/teams/digital-hea...

WHO works with social media policy departments to ensure company policy and guidelines for content providers are fit for purpose.

John’s e mail

enquiries@drjohncampbell.co.uk

https://www.who.int/campaigns/connect...

WHO provide a helpful guide on how to report misinformation online

Inaccurate information spreads widely and at speed,

making it more difficult for the public to identify verified facts and advice from trusted sources, such as their local health authority or WHO.

https://support.google.com/youtube/an...

As a starting point in the UK, only NHS organisations are being invited to self-certify against the NHS Standard for Creating Health Content.

By completing the self-certification process, an NHS organisation channel will be eligible for information panels indicating NHS credibility.

From FDA to MHRA: are drug regulators for hire?

https://www.bmj.com/content/377/bmj.o...

Regulatory agencies, large proportions of their budgets,

funded by the industry they are sworn to regulate

US Food and Drug Administration (FDA)

1992, Prescription Drug User Fee Act, allowing industry to fund the US Food and Drug Administration (FDA) directly through “user fees”

Net PDUFA fees collected

$29m in 1993

$884m in 2016 (65% of budget)

FDA, 9 out of 10 of its past commissioners between 2006 and 2019 went on to secure roles linked with pharmaceutical companies

European Medicines Agency (EMA)

Industry fees funded 20% European Medicines Agency (EMA), in 1995

By 2010, 75%

Today, 89%

Medicines and Healthcare Products Regulatory Agency (MHRA)

86% of funding from Pharmaceutical Industry

Australia

https://www.tga.gov.au

Proportion of TGA budget derived from industry, 96%

WHO funding

https://app.powerbi.com/view?r=eyJrIj...

https://www.weforum.org/agenda/2020/0...

The second-largest funder is the Bill and Melinda Gates Foundation, which provides 9.8% of the WHO's funds

Appendix

https://genius.com/George-orwell-nine...

https://www.orwell.ru/library/novels/...

It was expected that Newspeak would have finally superseded Oldspeak (or Standard English, as we should call it) by about the year 2050

The purpose of Newspeak was not only to provide a medium of expression for the world-view and mental habits proper to the devotees of Ingsoc, but to make all other modes of thought impossible.

The C vocabulary was supplementary to the others and consisted entirely of scientific and technical terms. These resembled the scientific terms in use today, and were constructed from the same roots, but the usual care was taken to define them rigidly and strip them of undesirable meanings.

War is peace, freedom is slavery, ignorance is strength

⁣China, the first and the last, alpha and omega of the covid pandemic with omicron

Abrupt U-turn on COVID controls on 7th December

Cases + 5,000

December, 248 million infections, (18%)

Deaths, + 3 = 5,253

When is a covid death a covid death?

http://www.nhc.gov.cn/xcs/s3574/20221...

Prof Wang Guiqiang, National Health Commission

Only fatalities caused by pneumonia and respiratory failure

Not deaths caused by cardiovascular, cerebrovascular diseases, blood clots, sepsis

the main cause of death from infection with Omicron is the underlying diseases

UK Department of Health

Covid pre-departure, 48 hours, as from 5th January

(Spain, the US, Italy, India, Taiwan, South Korea, Malaysia and Japan)

Health Security Agency, surveillance of arrivals from 8th January

Fitter variants have always got through in the past

Joint Committee on Vaccination and Immunisation, Professor Andrew Pollard

Imposition of travel curbs was unlikely to stop variants reaching the UK

Health Secretary Steve Barclay

to gain rapid insight into potential new variants circulating in China

The best defence against the virus, however, remains the vaccine

Direct from China

I can confirm a lot of what you said in your broadcast

Many being treated at home due to very busy hospitals

Crematoriums are backed up by about two weeks in many cities

More than 60% of my work and social contacts, young and old have had COVID in the last three weeks.

All has symptoms lasting 7 to 10 days

Last round of vaccinations in some areas 6 to 12 months ago

Body aches/headache - usually one of the first symptoms

Most people have a fever lasting 2-5 days

Cough - dry with no phlegm – (Lasting up to two weeks)

Running nose and congestion lasting about 5-7 days

Sore throat lasting 5-7 days

Some people suffering from diarrhea

(Chinese and other home remedies)

Most major symptoms are gone within 5-7 days

Tiredness/fatigue/dizziness lasting another 5-7 days.

Global times, official Chinese release

Most infections symptomatic

https://www.globaltimes.cn/page/20230...

About 1.75% of infections asymptomatic

N = 16,000

Attack rate

70% of Shanghai 70 % (25m)

Southwest China, Sichuan Province, more than 60%

South China, Hainan Province, more than 50%

Ordos, Inner Mongolia, 60%

N = 16,000

Fever, 79%

Headache, 69%

Cough, 65%

Muscle aches, 62%

Asymptomatic, 1.75%

Numbers seen

Seen in hospital clinics, 0.19%

Seen online, 0.78%

Took their own meds, 85%

Did not see a doctor or take meds, 85%

https://www.reuters.com/world/china/c...

People's Daily, CCP official newspaper

Tong Zhaohui, vice president of the Beijing Chaoyang Hospital

Illness caused by the virus, relatively mild for most people

Severe and critical illnesses account for 3% to 4% of infected patients currently admitted to designated hospitals in Beijing

Kang Yan, West China Tianfu Hospital of Sichuan University

In the past three weeks, a total of 46 patients had been admitted to intensive care units,

about 1% of symptomatic infections.

Emergencies area, Zhongshan Hospital, Shanghai

Packed

Beds in the corridor

WHO asking for detailed information, hospitalizations, deaths, vaccinations, variants.

Lee Kuan Yew School of Public Policy at National University of Singapore

but the problem is China’s transparency issue is always there

Lunar New Year holiday

Starts 22nd January

Infections will have already peaked in many places

⁣Self reported long covid

2.2 million (3.4% of the population)

Of those, as of 6 November 2022

87% more than 12 weeks

55% at least one year

27% at least two years

Symptoms

Fatigue 70%

Difficulty concentrating 48%

Shortness of breath 46%

Muscle ache 45%

Adversely affected the day-to-day activities, 1.6 million (75% of self-reported long COVIDs)

Self-reported long COVID more common

https://www.ons.gov.uk/peoplepopulati...

Aged 35 to 69 years

Females

Living in more deprived areas

Working in social care

Another activity-limiting condition or disability 

People not working and not looking for work

i.e.

If you are working or actively looking for work you are less likely to report long covid

Proportions of LC

Vaccination status not given

Cumulative change in number of people aged 16 to 64 years inactive because of long-term sickness

Long COVID is not the main factor

Working-age adults

(Economically inactive because of long-term sickness)

Has been rising since 2019

363,000 more since start of pandemic

ONS reasons

NHS waiting times

Long-term sick

other health problems or disabilities

(may include LC)

April to June 2022

97,000 higher than the same period in 2019

(a 41% increase)

Excess deaths, (ending 2 December 2022)

372 deaths involving COVID-19 registered in the UK

2.9% of all deaths

(400 in the previous week)

A total of 12,866 UK deaths

5.1% above the five-year average

Zoe symptoms as of this week (13th December)

Sore throat, 64%

Runny nose, 57%

Blocked nose, 57%

Headache, 54%

Sneezing, 53%

Cough, no phlegm 53%

Cough with phlegm, 44%

Hoarse, 40%

Muscle pains / aches 24%

Altered smell, 20%

Swollen neck glands, 19%

Dizzy, light headed, 19%

Fatigue, 17%

Loss of smell, 17%

Sore eyes, 17%

Shortness of breath, 15%

Chest pain / tightness, 15%

Earache, 15%

Chills or shivers, 13%

Wheezing, 11%

Full Zoe report

⁣Any unexplained bleeding

Haematuria, any blood in the urine is abnormal, frank or occult

Females, check again in 2 weeks

Haematemesis

Blood in sputum

Melaena / PR

Again, frank or occult

PV, between periods, after sex post menopause

(no matter how much blood or what colour it is)

Nasal

Bruising

Discharges

Usually indicate infection

Tumours distort and block normal anatomy

Chest infections

Chronic cough

Urethra

Nipple

Vaginal

Change in bowel or bladder habits

Changes in defecation, frequency, consistency, constipation, diarrhoea, shape, colour, mucous

Colour, dark or pale (head of pancreas)

Floaty

Dark urine

Abdominal bloating or swelling

Persistent heart burn / indigestion

Persistent bloating, anorexia

Changes in bladder emptying habits

LUTS

Thickening of tissue or a lump

Tumours near body surface

(Breast, testicular)

Swollen lymph nodes

Nagging cough or hoarseness

Lung, laryngeal cancer, thyroid

A sore / wound which does not heal

Malignant ulceration

Lesion getting bigger

Increasing pain

Unexpected bleeding

Basal cell carcinoma (rodent ulcer)

Non-melanoma skin cancers (NMSCs)

New mole or changes to a mole

Mouth or tongue ulcer (more than 3 weeks)

Obvious change in a wart or mole

A, asymmetry

B, borders

C, colour

D, more than 6mm or increasing

E, elevation

Malignant melanoma may demonstrate all of the above features.

Indigestion or difficulty in swallowing

Feeling of pressure, throat or chest

Dysphagia, oesophagus or fundus of the stomach.

Also

Night sweats or fever

Fatigue

Unexplained weight loss

Unexplained pains or ache

New blood clots, deep venous thrombosis

Bone pain

Intercurrent infection

⁣58% of covid US deaths now in the vaccinated