Monkeypox and STDs - it isn't just sex, it's promiscuity

 kw: medicine, medical musings, disease, monkeypox, std's, sti's

At one time diseases such as syphilis and gonorrhea were called Venereal Diseases, or VD's. "Venereal" refers to Venus, the Roman goddess of "love", actually, "lust." A generation or two later the preferred term vacillated between Sexually Transmitted Diseases (STD's) and Sexually Transmitted Infections (STI's). These days the political correctness police don't know quite what to call these "social diseases." Also, in the past generation more diseases have attained this status, including Chlamydia, venereal warts, genital herpes, and, of course, HIV/AIDS.

The most recent disease to be tentatively added to the list is Monkeypox. It has mainly afflicted those in central Africa, particularly Nigeria. In those areas, it afflicts people of all ages, including children, and while more men than women are afflicted, the difference is not huge. In the rest of the world, now that it is spreading everywhere, the picture is different. Particularly in the West, most victims, 90% or more, are gay men. Thus there is a huge outcry in some quarters against those who would call Monkeypox a STD or STI, calling them "homophobic". What is Monkeypox, really?

The virus that causes Monkeypox is related to the Smallpox virus. Smallpox was very transmissible, but usually required contact. However, even the briefest contact, such as brushing by someone in a crowd, was often sufficient. Monkeypox is apparently not nearly that transmissible.

There used to be fears that one could catch syphilis from a solid handshake. That turns out to be slightly true, but only if both persons have very sweaty hands, and the person originally infected has been touching disease lesions (they do itch). It is actually quite hard to catch syphilis. It is easier to catch Monkeypox.

Let's step back a moment to consider a point nearly always missed: EVERY infectious disease can be transmitted by sexual contact. The small list of "STD" infections consists of those diseases that are so hard to catch, sex is required for transmission. 

Is Monkeypox such an infection? It is probably almost that hard to catch. It may inhabit a borderland, a near-STD-but-not-quite. That is, while it's safe to say that anyone who has syphilis caught is sexually, there are apparently a small percentage of cases of Monkeypox that were caught by less intimate contact. But the number is small.

The fact remains that in Western countries, more than 90% of those who have caught Monkeypox are gay men. The very few women who have caught it all seem to have a bisexual boyfriend.

What is it about gay men that has made them so susceptible? I point out the "Gay culture", characterized in the 1980's by the "San Francisco bathhouse" phenomenon, where a designated "receiver" (I don't know the real term, and I don't care what it is) would be sodomized by 30-60 men, one after another. One can imagine that any diseases found in that crowd would spread and spread and spread, week after week. Such practices fueled the early spread of AIDS. That culture may have died down somewhat since, but it is not extinct, and it is fueling the spread of Monkeypox.

The heterosexual spread of AIDS in Africa in the 1980's was fueled by both men and women having numerous partners, just not as intensely as in the bathhouses. Monkeypox in Africa is following a similar course.

The obvious conclusion is that we need a new term. Monkeypox and the other "social diseases" that came before are actually diseases of promiscuity. Someone who has either zero or one sexual partner for one's whole life will never catch any of such diseases (Rape counts as adding one more sexual partner, however unwilling the victim).

I tentatively propose the term Promiscuity Diseases, PD's, to give the medical establishment and society in general time to mull over what we have here, and possibly coin a better term.

Is Omicron the new Cowpox?

 kw: medical musings, pandemic, omicron, delta, sars-cov2, covid-19, omicold

These data from Worldometer show Covid-19 cases and deaths from about Memorial Day 2021 to today, January 5, 2022, for the US as a whole. The scale lines on the left represent 250,000 and 500,000 cases per day. Those on the right represent 2,000 and 4,000 deaths per day. The solid lines are 7-day running averages.

Wave 5, mainly from the Delta variant, peaked at about 167,600 cases on Sept. 2, and just over 2,000 deaths on and around Sept. 18, 2021, 2½ weeks later.

Wave 6, transitioning from Delta to Omicron, recently rose through 615,000 daily cases around the turn of the year, but the recent death rate is about 1,200 per day.

Clearly, the Omicron variant is quite different from Delta. The Wave 6 death rate is hard to estimate with the case rates rising so rapidly, but it appears to be in the range 0.1% to 0.25% of known cases. That is very similar to the average death rates for recent strains of influenza. 

The Wave 5 death rate was 1.2% of known cases. A complicating factor is that between 25% and 40% of the cases in Wave 6 are Delta, and it is likely that most of the deaths can be attributed to Delta. I sincerely hope so, because that would mean that Omicron is less than 1/10th as deadly as Delta, maybe less than 1/100th. It may be no deadlier than getting a cold!

It may take a few more weeks for Wave 5 to crest, if it hasn't already. Prior waves took two to three months to crest. A cautious forecast puts the crest in mid-February, with a peak rate of 1.5-2 million new cases per day. The Omicron variant could infect half the US population by the middle of March. If it infects less than that, it will most likely be because the mRNA agents being touted as vaccines provide robust cross-variant protection. About 2/3 (62%) of American adults are "fully vaccinated" (I don't count "booster" shots as adding anything useful), and another 15-20% have had at least one injection. Another thirty million (9%) have recovered from Covid-19; they were "vaccinated by God." That doesn't leave very many "unvaccinated" Americans. This implies something very hopeful!

A little history: The word "vaccine" traces back to the Latin word vaccinus, meaning "cow". The word "vaccination" was coined in 1800 by Edward Jenner to describe his method of injecting people with the virus that causes cowpox, and this protected them from the much deadlier disease smallpox.

Dr. Marty Makary of Johns Hopkins calls the current variant "Omicold," saying its effect is similar to a common cold caused by several other coronaviruses that have been circulating for many years. The Omicron variant, being similar to the Alpha and Delta variants, but much less virulent, is likely to be a "cowpox clone", philosophically speaking. I know twelve people, including my son and his wife, who have contracted Covid-19 during the past month. I presume they all caught the Omicron variant, because all have told me it is like a bad cold: a day or two or three of mostly bed rest, with lots of fluids, had them up and about again, and in another day or so their symptoms were over.

I pray that this pandemic has nearly run its course. The Omicron variant is likely to break the back of more damaging variants. Only time will tell if it will also break the back of the totalitarian impulse shown by many in government who have assumed draconian powers by taking advantage of our fears.