It has slowed down over Summer, but there were still 153 cases in the 4 weeks to 5th August (mostly in London), and 2,278 cases across England since the start of the year.
Measles is nasty and almost entirely preventable by vaccination. Babies, infants and people with less robust immune systems are most at risk of serious illness, permanent damage and death. By taking your child for their MMR, or catching up with your own, you aren't only protecting one person, you are protecting all of those they come into contact with. The MMR has been considered safe and used around the world since 1971 (1988 in the UK).
The world is anticipating a substantial number of Mpox cases in light of the subclade 1b outbreak in Africa.
In 2024 up to 23rd August the Democratic Republic of the Congo (DRC) reported 19,667 cases (16,706 suspected and 2,961 confirmed) including 575 deaths. Confirmed Mpox cases due to the more catchy and dangerous subclade Ib, and the 'original' subclade 1a have also been reported in 5 of the 8 countries neighbouring DRC:
- Congo (21 confirmed/141 suspected
- Central African Republic (45 confirmed)
- Burundi (190 confirmed/512 suspected)
- Rwanda (4 confirmed)
- Uganda (3 confirmed)
Additionally cases of Mpox 1b have been confirmed in the following countries: Kenya (2), Gabon (1), Sweden (1) and Thailand (1).
Testing is very limited in poorer nations, so case numbers and even fatalities will not show the whole picture.
Health Authorities in several countries have moved to 'high alert', watching for Mpox symptoms in arrivals to their country and generally just being more aware of a disease that previously was virtually non-existent outside DRC. Spanish authorities are taking it very seriously, hoping to prevent Mpox entering, rather than deal with it if and when it happens. Putting their money where their ideals are, Spain have pledged to send 500,000 vaccinations to Africa.
Mpox vaccinations are a modified version of the first ever vaccine, which was created in 1796 by Edward Jenner to treat Smallpox. Smallpox is the only human disease to have been completely eradicated.
Mpox vaccines are currently very expensive, around £50-£75 ($70-$100) each, mainly because they haven't been made in huge numbers for some time, and richer countries are already stockpiling what there is. The World Health Organisation has put together a Strategic Preparedness And Response Plan, expecting US$135 million is needed to fight Mpox over the next 6 months. They estimate 10 million doses of vaccine given to the right people can nip this thing in the bud.
As well as Spain's vaccine pledge, Japan has pledged a massive 3 million doses of their Mpox vaccine LC16m8, which is also recommended for children. The European Commission has pledged 215,000 doses, Germany and France 100,000 doses each, and the US 50,000 doses. The UK Government has pledged a package worth £3.1 million.
If we play fair and sensible, we can shut this down before it spreads around the world. In truth, we should always have been fair and sensible, this is a preventable disease, and when we already had all the tools we needed, we shouldn't ever have let it continue anywhere on Earth.
Talking of prevention, bit late but tourists to Greece are being warned to avoid mosquito bites whenever possible, as West Nile Virus is affecting a lot more people this year. If bitten by an infected mosquito around 1 in every 5 people will become quite ill, and in rare cases it can be more serious. At least 12 people have died from West Nile Virus in Greece this Summer.
As of 29th August Highly Pathogenic Avian Influenza (HPAI) or bird flu has been confirmed in 193 US dairy cattle herds across 13 states. 3 herds in California are currently suspected to be infected and awaiting test results - which will be the first for the largest milk producing state in the USA. As cases elsewhere seem to be slowing down, it probably wouldn't be wise to just pretend you don't have a problem and avoid testing, not as I'm accusing California of any such move. Honest.
Right through 2020, 2021, 2022 and 2023 the UK lost more people than anticipated. That has stabilised finally, although metrics have changed to reflect our aging community and changes to population, so it's harder to make a direct comparison. We aren't the only ones, this is worldwide.
Bloomberg had a financial article last week looking at the US stock market in regards to funerals, cremations and burials - they're doing incredibly well.
In 2019 there were roughly 869.7 deaths for every 100,000 Americans. That went well above 1,000 in 2020 and 2021, before dropping to 984 in 2022. In 2023 it dropped further, but was still at 927.4 deaths per 100,000 people.
COVID has directly and indirectly fuelled excess deaths. It led to increased alcohol consumption and drug use, less physical exercise and more stress, and obviously the physical damage to the body when people catch COVID. One of the striking points - and again this is true around the world, including in the UK and Australia - is that unlike at the height of the pandemic, a lot of the excess deaths more recently are in younger age groups. Middle aged people and younger adults are having more strokes, heart problems and diabetes. Health services are still under pressure, and that isn't changing, nor is it likely to very quickly.
As we've said many times, COVID is incredibly costly.
"The cumulative global incidence of Long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion—equivalent to about 1% of the global economy."
Ziyad Al-Aly, Director of the Clinical Epidemiology Center, Clinical Epidemiologist at Washington University, and possibly the world’s most knowledgeable person on the subject of Long COVID. He is being proven correct with his warnings time and time again.
The Federal Reserve Bank of St Louis released an analysis using data from the US Current Population Survey (CPS) last week, and Mr Al-Aly had some very clear comments:
"Since 2019, the number of disabled individuals has surged beyond the expected trend by nearly 2 million. This isn't just a statistical anomaly—it's a huge indicator of a deeper, underlying health crisis."
These people are not all very elderly, once again younger age groups have the big jumps - the working age population.
"Most alarming is the rise in cognitive disabilities. The population reporting only a cognitive disability has grown by nearly 1 million—a 43% increase since 2019."
Cognitive disabilities include permanent, long or short term problems with a person's ability to think, learn, remember, use judgement and make decisions. Usual examples and causes would be things like intellectual disability, Alzheimer’s and dementia, traumatic events, brain injury and stroke.
"To put this in context: from 2014 to 2019, the average annual growth in cognitive disabilities was about 28k. Since 2019, that number has skyrocketed by more than one million. This is a huge increase and deserves attention."
Is it due to Long COVID, or is something else happening? Either way, it is going to place increased stress on governments, social care and health infrastructure, the individuals affected and the people they live and work with. The upside is that once the big guns start to worry about their profits shrinking, they may start putting more effort into finding out what's going on and how to fix it.
The number of people in England and Wales who took their own lives in 2023 was the highest since 1999. 10 years ago we lost one of our teenagers and it has taken us 10 years to pick ourselves up to a level of normal. We are never without her loss, every minute of the day and night, she is always missing.
It won't be the worst of times forever, and it won't be easier without you. Don't be scared or embarrassed to ask for help. You matter.
I for one am very glad you are still here.
In better news (in fact fantastic news), masking, distancing and generally being a lot more aware of how viruses spread isn't just helpful for COVID. On the advice of the World Health Organisation and the FDA, the US flu vaccination this Autumn will be trivalent 3 pronged rather than quadrivalent 4 pronged. This is because one of the world's major flu strains, Influenza B/Yamagata, hasn't been positively detected since 2020.
This is a major win for the world.
It's the weekend and I'll be having a lie in. I finally finished the third coat of woodworm treatment in my loft yesterday morning and promptly fell all the way down the stairs, so sitting down is not very relaxing at the moment! I didn't break anything though, so bruised and swollen as I am, it's a win - and we can put things in the loft again. Woohoo. (Obviously when I say "we", I mean everyone else. None of my family are going to let me back up there for a while, nor am I very speedy just now).
My main job this weekend is cutting grip tape for the wooden loft staircase, but I'll also make time for something nice - I very much think I've earned it. Hopefully you haven't injured yourself, but I'm sure you've earnt it too - so don't forget to spoil yourself.
I'll be back in 2 weeks, when the academics and the Government return from Summer holidays, so there'll no doubt be more to tell you and some fresh research results - and hopefully more good news. Until then...
Watch Your Step, Play Outdoors While You Can, Save The NHS.
.
.
.
Sources:
https://www.gov.uk/coronavirus
Cardiac arrest image
https://x.com/DHSCgovuk/status/1829058906292642220?t=899EqPlOWER2atCtZGFb8g&s=09
Measles warning as children head back to school
https://www.nhsinform.scot/campaigns/mmr-against-measles/
https://www.upday.com/uk/measles-warning-as-children-head-back-to-school
Mpox
Spain put on 'high alert' and 'everyone should get prepared'.
https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-smallpox-vaccination
https://www.birminghammail.co.uk/travel/spain-put-high-alert-over-29793947
https://www.ecdc.europa.eu/en/news-events/epidemiological-update-mpox-due-monkeypox-virus-clade-i
https://www.coventrytelegraph.net/news/coventry-news/suspected-mpox-cases-mapped-international-29782850
https://www.theguardian.com/commentisfree/article/2024/aug/30/worldwide-alert-mpox-spreading-three-steps-gordon-brown
https://www.gbnews.com/health/mpox-virus-outbreak-lockdown
https://x.com/UNICEF/status/1829096919055917089?t=OeVHn4qDtcKWrRT_-uoR9g&s=09
https://worldhealthorg.shinyapps.io/mpx_global/#1_Overview
West Nile Virus
https://www.birminghammail.co.uk/travel/uk-tourists-greek-issued-urgent-29793193
https://www.who.int/news/item/26-08-2024-global-strategic-preparedness-and-response-plan-launched-by-who-to-contain-mpox-outbreak/
https://x.com/WHO/status/1828080641348440156?t=e1bXKPZBBi8aTo92uMUk7Q&s=09
HPAI in dairy cows
https://www.statnews.com/2024/08/29/california-nations-largest-milk-producer-discloses-possible-bird-flu-outbreaks-in-three-dairy-cow-herds/
https://x.com/HelenBranswell/status/1829295685965115756?t=QCLO_KPNloBRlivDb_nbFA&s=09
https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock
Post COVID deaths
https://www.thelancet.com/journals/landia/article/PIIS2213-8587%2824%2900159-1/fulltext
https://www.bloomberg.com/news/newsletters/2024-08-19/deaths-are-up-post-covid-and-so-are-funeral-stocks-prognosis?s=09
Long COVID Ziyad Al-Aly
https://www.nature.com/articles/s41591-024-03173-6?s=09
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cognitive-impairment
https://www.fcc.gov/cognitive-disabilities
https://www.stlouisfed.org/on-the-economy/2024/aug/changing-composition-of-disability-among-workers#authorbox
https://x.com/zalaly/status/1828080885478183323?t=zYWjtVxTeKxfWlIe8FJ7Fw&s=09
Flu vaccinations US
https://www.instagram.com/reel/C_K_Q-IREQ9/?igsh=cjBrMGh1Zm42ank1
https://www.cdc.gov/media/releases/2024/s-t0627-vaccine-recommendations.html
England and Wales
https://x.com/ONS/status/1829080194390352075?t=tOlPsfY36wgdklElM__oOA&s=09
