(Brownstone)—Public health responses are most effective when they are grounded in reality. This is particularly important if the response is intended to address an ‘emergency,’ and involves the transfer of large amounts of public money. When we reallocate resources, there is a cost, as the funds are taken from some other program. If the response involves buying lots of products from a manufacturer, there will also be a gain for the company and its investors.
So, clearly, there are three obvious requirements here to ensure good practice:
- Accurate information is required, in context.
- Those gaining financially can have no role at all in decision-making.
- The organization tasked with coordinating any response would have to act with transparency, publicly weighing costs and benefits.
The World Health Organization (WHO), tasked by countries to help coordinate international public health, has just proclaimed Mpox (monkeypox) an international emergency. They considered an outbreak in the Democratic Republic of Congo (DRC) and nearby Central African countries to be a global threat, requiring an urgent global response. In declaring its emergency, WHO stated there were 537 deaths among 15,600 suspected cases this year. In its 19th August Emergency Meeting on Mpox, WHO clarified its figures:
…during the first six months of 2024, the 1854 confirmed cases of Mpox reported by States Parties in the WHO African Region account for 36% (1854/5199) of the cases observed worldwide.
The WHO reiterated that there had been 15,000 “clinically compatible” cases, and about 500 suspected deaths. The implications of these 500 unconfirmed deaths, equaling just 1.5% of the malaria deaths in DRC over the same period, are discussed in a previous article.
Journals such as the Lancet have dutifully towed the WHO’s ‘emergency’ line, though intriguingly noting that the mortality could be far lower if “adequate care” had been provided. Africa CDC agrees, with more than 17,000 cases (2,863 confirmed) and 517 (presumably suspected) deaths of Mpox have been reported across the continent.
Mpox is endemic to central and west Africa, being present in species of squirrels, rats, and other rodents. While it was identified in monkeys in a Danish lab in 1958 (hence the misnomer ‘monkeypox’), it has probably been around for thousands of years, causing intermittent infections in humans between whom it is spread by close physical contact.
Small outbreaks in Africa mostly went unnoticed by the rest of the world, mainly because they were (as now) small and confined. Mass Smallpox vaccination may also have suppressed numbers still further a few decades ago, as Smallpox is in the same Orthopoxvirus genus of viruses. So, we may be seeing an upward trend of this generally milder illness (fever, chills, and a vesicular rash) over recent decades since Smallpox vaccination ceased. The Smithsonian magazine put an informative summary together in 2022, after the first out-of-Africa outbreak which was spread by sexual contacts within a limited demographic group.
So, here we are in 2024, on the tail of a massively profit-driving (and impoverishing) outbreak called Covid-19 that enabled the largest transfer of wealth from the many to the few in human history. The WHO’s announcement that 5,000 (or less) suspected Mpox cases is a Public Health Emergency of International Concern (PHEIC) allows it to fast-track vaccines through its Emergency Use Listing (EUL) program, bypassing the normal rigor required to approve such pharmaceuticals, and is suggesting Pharma start lining up.
At least one drugmaker is already discussing a supply of 10 million doses before year-end. The business case for this approach, from the corporate viewpoint, is well-proven. So are the harms in countries like DRC, as a mass vaccination program of this nature requires redirection of millions of dollars and thousands of health workers who would otherwise be addressing diseases of far larger burden.
The WHO is a large organization, and while some there have been on the hustings asking for money, others have been working hard to accurately inform the public (a core responsibility of the WHO, which retains some dedicated people). Like much of the WHO’s work in the past, this is thorough and commendable. Some of this information is summarized in the following graphics:
These charts provide data on confirmed cases, where someone with somewhat non-specific symptoms has been tested and shown to have evidence of Mpox virus in blood or secretions. Clearly, not everyone suspected can be tested, as Mpox is a very small issue for people facing civil wars, mass poverty, and vastly more dangerous diseases.
However, the WHO has absorbed a lot of money for outbreak investigation, and so have partner organizations, so we can assume there is a fairly good effort going on to detect and confirm numbers (or where has this money gone?).
In the past 2.5 years, the WHO has confirmed 223 deaths in the whole world, with just six in July 2024 (the time when the WHO Director-General warned the world of a rapidly increasing threat). Note here that 223 deaths are just 0.2% of the 102,997 confirmed cases. In Africa, just 26 deaths have been confirmed in 2024 among 3,562 cases (0.7%), spread across 5 countries (and 12 countries with cases). They are influenza-like mortality rates, not Ebola-like.
As severe cases are more likely to be tested than mild cases, the infection fatality rate may be far lower. We also don’t know (though someone does and should tell us) what the characteristics of those dying are. Most in Africa are reported to be children, so it is likely they are malnourished, otherwise immunocompromised (e.g. HIV), and have susceptibilities that could be addressed.
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As is obvious from the third graphic below, nearly all the global deaths listed above were from the previous outbreak in 2022. This was a different clade (variant) and mostly occurred outside of Africa.
It is important to note a few things here. It is difficult to confirm all cases in areas with poor infrastructure and security. Mpox symptoms and signs are also frequently mild and overlap other diseases (e.g. chickenpox or even flu) so many cases may go unnoticed. Notification of results can also lag. However, the 19 confirmed DRC Mpox deaths amongst roughly 40,000 DRC malaria deaths so far this year is about 1 versus 2000. Whichever way you count it, it is not going to become much more significant. That is what the new international emergency looks like in actual data, or if you are the population of DRC at Mpox ground zero. It is likely you would not notice anything at all.
Why has the WHO declared an international emergency? Some claim it helps mobilize resources, which is a bit pathetic. Firstly, grownups should be able to discuss a situation that has persisted for two years in a rational manner and decide what might be needed, without banging a drum. Secondly, an outbreak that is killing a tiny fraction of malaria (or tuberculosis, or HIV) deaths, and far less than those currently dying in war, may not be an international emergency.
And what should be done? Diverting resources from DRC’s major priorities would undoubtedly kill far more than are currently dying from Mpox. It is quite probable that direct adverse events from vaccination alone will kill more than the 19 DRC Mpox victims confirmed this year. We likely undercount Mpox deaths, but we also undercount pharmaceutical deaths.
Perhaps a useful response would be to improve immune competence through nutrition, providing very broad benefits (but completely failing in terms of Pharma profit). Gavi’s half-billion dollars would provide vast and broad-based benefits if applied to sanitation. Perhaps limited, well-targeted vaccination may also help some communities, but there is no business case for such approaches.
What is clear, as noted above, is the following:
1. The data on Mpox, and other competing priorities, must continue to be shown in context, along with costs and opportunity costs of the response.
2. Those who will gain financially from vaccinating millions of people must not be part of the decision-making process (whether or not such a huge resource transfer can possibly be supported for such a small disease burden).
3. The WHO should continue to act with transparency, as the public has an absolute right to know what they are paying for, and the harm (and perhaps benefit) they can expect from it.
The number of Mpox deaths will rise as more are infected, and perhaps as some suspected cases are confirmed. However, we are facing a small problem in an area with far larger ones. It is posing low local risk and minimal global risk. It is not a global emergency, by any sane, rational, public health-based definition.
The rest of the world can respond by sending vaccines and lots of foreigners who need looking after, diverting local health and security personnel and almost certainly killing more DRC residents overall. Or, we can recognize a local problem, support local responses when local populations ask, and concentrate, as the WHO once did, on addressing the underlying causes of endemic disease and inequality. They are the things that make the lives of people in DRC so difficult.
About the Author
David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. He is a former medical officer and scientist at the World Health Organization (WHO), Programme Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, WA, USA.
Five Things New “Preppers” Forget When Getting Ready for Bad Times Ahead
The preparedness community is growing faster than it has in decades. Even during peak times such as Y2K, the economic downturn of 2008, and Covid, the vast majority of Americans made sure they had plenty of toilet paper but didn’t really stockpile anything else.
Things have changed. There’s a growing anxiety in this presidential election year that has prompted more Americans to get prepared for crazy events in the future. Some of it is being driven by fearmongers, but there are valid concerns with the economy, food supply, pharmaceuticals, the energy grid, and mass rioting that have pushed average Americans into “prepper” mode.
There are degrees of preparedness. One does not have to be a full-blown “doomsday prepper” living off-grid in a secure Montana bunker in order to be ahead of the curve. In many ways, preparedness isn’t about being able to perfectly handle every conceivable situation. It’s about being less dependent on government for as long as possible. Those who have proper “preps” will not be waiting for FEMA to distribute emergency supplies to the desperate masses.
Below are five things people new to preparedness (and sometimes even those with experience) often forget as they get ready. All five are common sense notions that do not rely on doomsday in order to be useful. It may be nice to own a tank during the apocalypse but there’s not much you can do with it until things get really crazy. The recommendations below can have places in the lives of average Americans whether doomsday comes or not.
Note: The information provided by this publication or any related communications is for informational purposes only and should not be considered as financial advice. We do not provide personalized investment, financial, or legal advice.
Secured Wealth
Whether in the bank or held in a retirement account, most Americans feel that their life’s savings is relatively secure. At least they did until the last couple of years when de-banking, geopolitical turmoil, and the threat of Central Bank Digital Currencies reared their ugly heads.
It behooves Americans to diversify their holdings. If there’s a triggering event or series of events that cripple the financial systems or devalue the U.S. Dollar, wealth can evaporate quickly. To hedge against potential turmoil, many Americans are looking in two directions: Crypto and physical precious metals.
There are huge advantages to cryptocurrencies, but there are also inherent risks because “virtual” money can become challenging to spend. Add in the push by central banks and governments to regulate or even replace cryptocurrencies with their own versions they control and the risks amplify. There’s nothing wrong with cryptocurrencies today but things can change rapidly.
As for physical precious metals, many Americans pay cash to keep plenty on hand in their safe. Rolling over or transferring retirement accounts into self-directed IRAs is also a popular option, but there are caveats. It can often take weeks or even months to get the gold and silver shipped if the owner chooses to close their account. This is why Genesis Gold Group stands out. Their relationship with the depositories allows for rapid closure and shipping, often in less than 10 days from the time the account holder makes their move. This can come in handy if things appear to be heading south.
Lots of Potable Water
One of the biggest shocks that hit new preppers is understanding how much potable water they need in order to survive. Experts claim one gallon of water per person per day is necessary. Even the most conservative estimates put it at over half-a-gallon. That means that for a family of four, they’ll need around 120 gallons of water to survive for a month if the taps turn off and the stores empty out.
Being near a fresh water source, whether it’s a river, lake, or well, is a best practice among experienced preppers. It’s necessary to have a water filter as well, even if the taps are still working. Many refuse to drink tap water even when there is no emergency. Berkey was our previous favorite but they’re under attack from regulators so the Alexapure systems are solid replacements.
For those in the city or away from fresh water sources, storage is the best option. This can be challenging because proper water storage containers take up a lot of room and are difficult to move if the need arises. For “bug in” situations, having a larger container that stores hundreds or even thousands of gallons is better than stacking 1-5 gallon containers. Unfortunately, they won’t be easily transportable and they can cost a lot to install.
Water is critical. If chaos erupts and water infrastructure is compromised, having a large backup supply can be lifesaving.
Pharmaceuticals and Medical Supplies
There are multiple threats specific to the medical supply chain. With Chinese and Indian imports accounting for over 90% of pharmaceutical ingredients in the United States, deteriorating relations could make it impossible to get the medicines and antibiotics many of us need.
Stocking up many prescription medications can be hard. Doctors generally do not like to prescribe large batches of drugs even if they are shelf-stable for extended periods of time. It is a best practice to ask your doctor if they can prescribe a larger amount. Today, some are sympathetic to concerns about pharmacies running out or becoming inaccessible. Tell them your concerns. It’s worth a shot. The worst they can do is say no.
If your doctor is unwilling to help you stock up on medicines, then Jase Medical is a good alternative. Through telehealth, they can prescribe daily meds or antibiotics that are shipped to your door. As proponents of medical freedom, they empathize with those who want to have enough medical supplies on hand in case things go wrong.
Energy Sources
The vast majority of Americans are locked into the grid. This has proven to be a massive liability when the grid goes down. Unfortunately, there are no inexpensive remedies.
Those living off-grid had to either spend a lot of money or effort (or both) to get their alternative energy sources like solar set up. For those who do not want to go so far, it’s still a best practice to have backup power sources. Diesel generators and portable solar panels are the two most popular, and while they’re not inexpensive they are not out of reach of most Americans who are concerned about being without power for extended periods of time.
Natural gas is another necessity for many, but that’s far more challenging to replace. Having alternatives for heating and cooking that can be powered if gas and electric grids go down is important. Have a backup for items that require power such as manual can openers. If you’re stuck eating canned foods for a while and all you have is an electric opener, you’ll have problems.
Don’t Forget the Protein
When most think about “prepping,” they think about their food supply. More Americans are turning to gardening and homesteading as ways to produce their own food. Others are working with local farmers and ranchers to purchase directly from the sources. This is a good idea whether doomsday comes or not, but it’s particularly important if the food supply chain is broken.
Most grocery stores have about one to two weeks worth of food, as do most American households. Grocers rely heavily on truckers to receive their ongoing shipments. In a crisis, the current process can fail. It behooves Americans for multiple reasons to localize their food purchases as much as possible.
Long-term storage is another popular option. Canned foods, MREs, and freeze dried meals are selling out quickly even as prices rise. But one component that is conspicuously absent in shelf-stable food is high-quality protein. Most survival food companies offer low quality “protein buckets” or cans of meat, but they are often barely edible.
Prepper All-Naturals offers premium cuts of steak that have been cooked sous vide and freeze dried to give them a 25-year shelf life. They offer Ribeye, NY Strip, and Tenderloin among others.
Having buckets of beans and rice is a good start, but keeping a solid supply of high-quality protein isn’t just healthier. It can help a family maintain normalcy through crises.
Prepare Without Fear
With all the challenges we face as Americans today, it can be emotionally draining. Citizens are scared and there’s nothing irrational about their concerns. Being prepared and making lifestyle changes to secure necessities can go a long way toward overcoming the fears that plague us. We should hope and pray for the best but prepare for the worst. And if the worst does come, then knowing we did what we could to be ready for it will help us face those challenges with confidence.
