May 2023

Zimbabwe officials hope vaccinations will tame a cholera outbreak as citizens continue to drink unsafe water. As Columbus Mavhunga reports from Harare, authorities are urging people to practice good hygiene to contain the waterborne disease. Camera: Blessing Chigwenhembe    
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The mpox health emergency has ended, but U.S. health officials are aiming to prevent a repeat of last year’s outbreaks.

Mpox infections exploded early in the summer of 2022 in the wake of Pride gatherings. More than 30,000 U.S. cases were reported last year, most of them spread during sexual contact between gay and bisexual men. About 40 people died.

With Pride events planned across the country in the coming weeks, health officials and event organizers say they are optimistic that this year infections will be fewer and less severe. A bigger supply of vaccine, more people with immunity and readier access to a drug to treat mpox are among the reasons.

But they also worry that people may think of mpox as last year’s problem.

“Out of sight, out of mind,” said Dr. Demetre Daskalakis, who is advising the White House on its mpox response. “But we are beating the drum.”

Last week, the Centers for Disease Control and Prevention issued a health alert to U.S. doctors to watch for new cases. On Thursday, the agency published a modeling study that estimated the likelihood of mpox resurgence in 50 counties that have been the focus of a government campaign to control sexually transmitted diseases.

The study concluded that 10 of the counties had a 50% chance or higher of mpox outbreaks this year. The calculation was based largely on how many people were considered at high risk for infection and what fraction of them had some immunity through vaccination or previous infection.

At the top of the list are Jacksonville, Florida; Memphis, Tennessee; and Cincinnati — cities where 10% or fewer of the people at highest risk were estimated to have immunity. Another 25 counties have low or medium immunity levels that put them at a higher risk for outbreaks.

The study had a range of limitations, including that scientists don’t know how long immunity from vaccination or prior infections lasts.

So why do the study? To warn people, said Dr. Chris Braden, who heads the CDC’s mpox response.

“This is something that is important for jurisdictions to promote prevention of mpox, and for the population to take note — and take care of themselves. That’s why we’re doing this,” he said.

Officials are trying to bring a sense of urgency to a health threat that was seen as a burgeoning crisis last summer but faded away by the end of the year.

Formerly known as monkeypox, mpox is caused by a virus in the same family as the one that causes smallpox. It is endemic in parts of Africa, where people have been infected through bites from rodents or small animals but was not known to spread easily among people.

Cases began emerging in Europe and the U.S. about a year ago, mostly among men who have sex with men, and escalated in dozens of countries in June and July. The infections were rarely fatal, but many people suffered painful skin lesions for weeks.

Countries scrambled to find a vaccine or other countermeasures. In late July, the World Health Organization declared a health emergency. The U.S. followed with its own in early August.

But then cases began to fall, from an average of nearly 500 a day in August to fewer than 10 by late December. Experts attributed the decline to several factors, including government measures to overcome a vaccine shortage and efforts in the gay and bisexual community to spread warnings and limit sexual encounters.

The U.S. emergency ended in late January, and the WHO ended its declaration earlier this month.

Indeed, there is a lower sense of urgency about mpox than last year, said Dan Dimant, a spokesman for NYC Pride. The organization anticipates fewer messages about the threat at its events next month, though plans could change if the situation worsens.

There were long lines to get shots during the height of the crisis last year, but demand faded as cases declined. The government estimates that 1.7 million people — mostly men who have sex with men — are at high risk for mpox infection, but only about 400,000 have gotten the recommended two doses of the vaccine.

“We’re definitely not where we need to be,” Daskalakis said, during an interview last week at an STD conference in New Orleans.

Some see possible storm clouds on the horizon.

Cases emerged this year in some European countries and South Korea. On Thursday, U.K. officials said an uptick in mpox cases in London in the last month showed that the virus was not going away.

Nearly 30 people, many of them fully vaccinated, were infected in a recent Chicago outbreak. (As with COVID-19 and flu shot, vaccinated people can still get mpox, but they likely will have milder symptoms, officials say.)

Dr. Joseph Cherabie, associate medical director of the St. Louis County Sexual Health Clinic, said people from the area travel to Chicago for events, so outbreaks there can have ripple effects elsewhere.

“We are several weeks behind Chicago. Chicago is usually our bellwether,” Cherabie said.

Chicago health officials are taking steps to prevent further spread at an “International Mr. Leather” gathering this weekend.

Event organizers are prominently advising attendees to get vaccinated. Chicago health officials put together social media messages, including one depicting three candles and a leather paddle that reads: “Before you play with leather or wax get yourself the mpox vax.”
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Britain’s health minister, Steve Barclay, said on Sunday that the government would not negotiate on pay with the nurses’ union, as the threat of further strikes looms.

The government’s offer, which includes a one-off payment equivalent to 2% of salaries in the 2022/23 financial year and a 5% pay raise for 2023/24, was rejected by the members of the Royal College of Nursing in April.

When asked by Sky News whether the government would resume talks with the union, Barclay said, “Not on the amount of pay.”

The union is already balloting its 300,000 members on further strike action over the next six months.

The union did not immediately respond to Reuters’ request for a comment on Barclay’s remarks on Sunday. It has said that the government must pay National Health Service staff “fairly.”

The relationship between the union, which has staged multiple strikes that have disrupted patient care, and the government became strained in late April when the health department limited the length of a strike after legal action against the RCN.
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A meeting of a United Nations committee dedicated to eradicating plastic pollution begins in Paris Monday. Plastic piles up from ocean beds to landfills. Manufacturers have begun the shift to biodegradable materials, but the billions of tons of plastic waste already in our environment are here to stay, at least for now. VOA’s Arash Arabasadi has more.
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When Thomas Hertog was first summoned to Stephen Hawking’s office in the late 1990s, there was an instant connection between the young Belgian researcher and the legendary British theoretical physicist.

“Something clicked between us,” Hertog said.

That connection would continue even as Hawking’s debilitating disease ALS robbed him of his last ways to communicate, allowing the pair to complete a new theory that aims to turn how science looks at the universe on its head.

The theory, which would be Hawking’s last before his death in 2018, has been laid out in full for the first time in Hertog’s book “On the Origin of Time,” published in the UK last month.

In an interview with AFP, the cosmologist spoke about their 20-year collaboration, how they communicated via facial expression, and why Hawking ultimately decided his landmark book “A Brief of History of Time” was written from the wrong perspective.

The ‘designed’ universe

During their first meeting at Cambridge University in 1998, Hawking wasted no time in bringing up the problem bothering him.

“The universe we observe appears designed,” Hawking told Hertog, communicating via a clicker connected to a speech machine.

Hertog explained that “the laws of physics — the rules on which the universe runs — turn out to be just perfect for the universe to be habitable, for life to be possible.”

This remarkable string of good luck stretches from the delicate balance that makes it possible for atoms to form molecules necessary for chemistry to the expansion of the universe itself, which allows for vast cosmic structures such as galaxies.

One “trendy” answer to this problem has been the multiverse, an idea that has recently become popular in the movie industry, Hertog said.

This theory explains away the seemingly designed nature of the universe by making it just one of countless others — most of which are “crap, lifeless, sterile,” the 47-year-old added.

But Hawking realized the “great mire of paradoxes the multiverse was leading us into,” arguing there must be a better explanation, Hertog said.

Outsider’s perspective

A few years into their collaboration, “it began to sink in” that they were missing something fundamental, Hertog said.

The multiverse and even “A Brief History of Time” were “attempts to describe the creation and evolution of our universe from what Stephen would call a ‘God’s eye perspective’,” Hertog said.

But because “we are within the universe” and not outside looking in, our theories cannot be decoupled from our perspective, he added.

“That was why (Hawking) said that ‘A Brief History of Time’ is written from the wrong perspective.”

For the next 15 years, the pair used the oddities of quantum theory to develop a new theory of physics and cosmology from an “observer’s perspective.”

But by 2008, Hawking had lost the ability to use his clicker, becoming increasingly isolated from the world.

“I thought it was over,” Hertog said.

Then the pair developed a “somewhat magical” level of non-verbal communication that allowed them to continue working, he said.

Positioned in front of Hawking, Hertog would ask questions and look into the physicist’s eyes.

“He had a very wide range of facial expressions, ranging from extreme disagreement to extreme excitement,” he said.

“It’s impossible to disentangle” which parts of the final theory came from himself or Hawking, Hertog said, adding that many of the ideas had been developed between the pair over the years.

‘One grand evolutionary process’

Their theory is focused on what happened in the first moments after the Big Bang.

Rather than an explosion that followed a pre-existing set of rules, they propose that the laws of physics evolved along with the universe.

This means that if you turn back the clock far enough, “the laws of physics themselves begin to simplify and disappear,” Hertog said.

“Ultimately, even the dimension of time evaporates.”

Under this theory, the laws of physics and time itself evolved in a way that resembles biological evolution — the title of Hertog’s book is a reference to Darwin’s “On the Origin of Species.”

“What we’re essentially saying is that (biology and physics) are two levels of one grand evolutionary process,” Hertog said.

He acknowledged that it is difficult to prove this theory because the first years of the universe remain “hidden in the mist of the Big Bang.”

One way to lift this veil could be by studying gravitational waves, ripples in the fabric of space time, while another could be via quantum holograms constructed on quantum computers, he said.
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