Thread by @EckerleIsabella

#monkeypox: sorry, but lot's of mistakes from early 2020 are just repeated - many assumptions currently that delay action: 1) "no evidence the virus has changed" = in fact there are mutations vs. earlier genomes - we just don't know what they mean, but we can't exclude a change

2) "it's mild" = you don't want it, neither your loved ones, some groups can get very sick, plus limited treatment options available, people under 40-50 years not vaccinated anymore 3) "it's linked to sex parties" = this was probably a superspreader event, but everyone can get it

4) "it's only spread by sex, condoms prevent it" = there's no much evidence of additional sexual transmission at the moment, but lots of evidence of transmission through close (skin) contacts of all sorts (non-sexual), also clothes, bedsheets, surfaces, role of aerosols debated

5) "there's a vaccine" = true, but the "old" vaccinia vaccine is a live virus vaccine & not possible for everyone, a newer version exists but indication for use remains to be defined 6) "but it's an endemic virus, known for many years" - true, but we have never seen such large

spread outside of the endemic area & this is human-to-human spread now, not repeated spillovers from a reservoir. Never good to give viruses a chance to adapt 7) "it's a DNA virus, so it can't mutate quickly" - it's DNA but poxviruses do have strategies to adapt to new conditions

I really do think we can contain this but we need to hit hard & early, now. We need to coordinate efforts and need stop the transmission chains by appropriate isolation, quarantine & shielding risk groups from infected cases. Risk of virus release into environment/to animals

The risk for the general population is currently very low & it should stay like this. Majority of people do not have to worry about an infection risk right now but the known clusters need extremely good, clear & detailed health education on how to prevent further transmission

Important that people understand they don't have to be in fear of an infection right now but I also think honest & transparent communication is key for trust & respect. Therefore I think we should also communicate that this is an unusual outbreak & we must be take it seriously.