Dr Chris van Straten, Global Health Advisor Clinical Governance, International SOS
While monkeypox is currently simply an outbreak – not an epidemic and certainly not a pandemic – what it is demonstrating is that we are living in an era of increasing health concerns of pandemic-prone diseases. More evidently it suggests that such zoonotic infections and the risk of pandemics could potentially increase over the coming decades, possibly causing significant economic and financial distress.
Human settlements and activity increasingly encroaching upon wild and natural habitats will potentially lead to new infection transmissions from animals to humans and vice-versa. Recent outbreaks of zoonotic infections on the continent are not limited to monkeypox but also include Ebola and the plague.
These outbreaks emphasise the need to strengthen public health systems to include among other things an ability to track and monitor zoonotic pathogens with suitable laboratories and infrastructure. Continued education and emphasis on basic interventions such as mask wearing, handwashing and hygienic practices don’t just protect people from COVID-19 but can protect them from many other infectious diseases. The hope is that we can respond to any future outbreak quickly by collaborating, sharing information, and offering immediate health and safety guidance.
For now, even if this outbreak can be contained and consequently extinguished, monkeypox should still be of concern to the business world given its rapidly evolving nature.
While there have been no deaths in non-endemic areas outside West and Central Africa from monkeypox, the virus is spreading not because it is highly transmissible, or is mutating, but simply because travel restrictions are being lifted – which creates an above-average susceptibility for businesspeople.
Therefore, my advice to the business community is to stick to the basics. We need to keep focus and ensure that we have the appropriate policies, procedures, and systems in place even if the disease is not a highly transmissible one like COVID-19.
Organisations’ priority is to protect the health of their employees whether they are travelling or live-in various locations in the world. To achieve that, they need to implement a risk assessment and a health incident plan. An assessment would consist of:
- Understanding the risks associated with the country being visited or where they are based;
- Being aware of travel restrictions;
- Knowing the healthcare facilities and quarantine facilities in the various countries where you operate;
- Ensuring you have a trusted health-partner with the expertise and experience to guide you and assist your planning strategy;
- Ensuring you have updated and appropriate policies and procedures such as pandemic preparedness in place to mitigate the risks and ensure you are truly compliant when it comes to duty of care.
One such policy is a strong vaccination programme. Vaccines have saved millions of lives. We need to ensure that the community and business leaders truly understand the benefits of vaccination and encourage vaccination programmes. Effective vaccines for smallpox eradicated the disease in 1977, and anyone vaccinated at birth prior to 1977 against smallpox will have 85% protection from monkeypox.
Provided monkeypox continues to ‘behave’ in the same manner it has historically done, we don’t expect rapid and extensive spread. Monkeypox is usually a mild disease in healthy individuals; antiviral medications and effective vaccines are available in some countries (but not widely so) and will be used for at-risk individuals such as immune suppressed patients.
However, we do need to remain vigilant and in the interim, hygiene measures, appropriate isolation, contact tracing and quarantine are all still useful. Social distancing, on the other hand, is less important as one must be in close proximity to an affected individual for monkeypox to spread.
Travelling even to endemic countries currently carries a low risk. However, some countries such as Belgium have already introduced quarantine rules for people known to be infected, and this may be increased to screening of symptoms at international airports, including isolation facilities.
As with prior outbreaks disinformation and misinformation are spreading and it is prudent to ensure all staff have access to trusted and reliable sources if information. The outbreak of monkeypox, shortly after we have begun resuming our pre-COVID lives, therefore makes it clear that communities and organisations need to concentrate their efforts on having strong and flexible healthcare policies in place to be prepared for any eventuality.