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The Canadian bid to turn the tide against monkeypox

From the Toronto Star article

As cases of monkeypox continue to grow in Canada and globally, academics and advocates are urging governments to bring in paid sick days for all, as illnesses like monkeypox are unpredictable and can require extended periods of isolation.

And with rising cases, observers in Canada are welcoming a World Health Organization move to declare monkeypox a global health emergency, saying they hope it will lead governments and institutions to take the outbreak seriously and improve care.

Researchers are quickly studying the virus and its impact on Canadian patients, including concerns around stigma, to help inform patient care and public policy.

That declaration by the WHO has been overdue, says Dr. Darrell Tan, an infectious diseases physician at St. Michael’s Hospital. Tan is a co-principal investigator and operational co-lead of the monkeypox rapid research response led by the Emerging and Pandemic Infections Consortium (EPIC) at the University of Toronto.

“Monkeypox has been spreading to more and more non-endemic countries countries at a really rapid pace in the last two months,” said Tan. “The rapidity of that spread was alarming to those of us who work in this field. And we’re seeing these patients suffering.”

Monkeypox should have been deemed a global health emergency weeks ago, he said, and stigma toward gay and bisexual men, whom the virus is currently affecting in large numbers, is likely a reason for the delay.

“It was perhaps not perceived as ‘important enough’ of a threat,” and that can be read as quite problematic, stigmatizing and hurtful to our communities who have been suffering.”

Tan hopes the WHO announcement will lead more institutions to mobilize on a global scale, and spark funding for front-line community organizations that are engaging with public health and stretching shoestring budgets to care for the LGBTQ+ community.

“There’s tremendous research that needs to happen at breakneck speed,” he said.

“I hope it can enable more support for people who are living with this infection. One of the key points that myself, my colleagues have observed … is that people have difficulty adhering with public health requirements because of the financial toll.”

Dr. Sharmistha Mishra is an assistant professor at the Institutes of Health Policy Management and Evaluation at the U of T and also a co-principal investigator and operational co-lead of EPIC’s monkeypox research initiative. She said supporting individuals and households with isolation is a public health necessity with a virus such as monkeypox, and that means paid sick leave.

Mishra, Tan and colleagues are engaged in cohort studies to understand symptoms, viral shedding (when a person releases a virus’s particles through pathways like talking or eating), examining how the immune system responds to monkeypox, how the virus is transmitted, and looking at the virus’s genetic code.

Though research is at its early stages, they have learned that the virus’s incubation period can be from five to 21 days (with an average of about seven), as well as of difficulties isolating, she said.

Community leadership and working with researchers has allowed them to study the virus more quickly, know what issues to prioritize and understand that more supports need to be in place, she said.

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