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The BulletinSeptember 12, 2024

Should we be more worried about mpox?

The Bulletin editor
(Getty Images – stock)
(Getty Images – stock)
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Two new cases have been confirmed and the green light has now been given for easier vaccine access, writes Stewart Sowman-Lund in today’s extract from The Bulletin.

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Two cases confirmed, more likely

Mpox, once called monkeypox, is back in the country. There are now two confirmed cases, both with links to the Winter Pride Festival in Queenstown. And as with any infectious disease, there could be more to come. But while the arrival (or in this case, the return) of mpox may instantly bring back unwanted thoughts of the Covid-19 pandemic, we’re unlikely to see any of the widespread health measures from that period reinstated. As microbiologist Siouxsie Wiles explained in a 2022 piece for The Spinoff, “elimination [of mpox cases] means getting at risk people vaccinated, making it easy for people to get tested and to self-isolate, and using contact tracing to break any chains of transmission”.

But the question is, are we doing any of that sufficiently? While the virus, wrote RNZ’s Katie Kenny, isn’t the “new Covid”, that doesn’t mean it should be ignored. Contracting mpox, which is primarily spread through close contact, can cause flu-like symptoms and painful rashes, and can still be fatal, though the mortality rate is relatively low. It is especially dangerous for immunocompromised people. So what’s being done to stop its spread, and should we be doing more?

A global outbreak

First, some context. As mentioned, this isn’t the first time mpox has been detected in New Zealand. Since 2022, there have been 55 cases of the “clade 2” variant of mpox in New Zealand. An outbreak of the more severe clade 1 variant in multiple African nations prompted the World Health Organisation to declare it a global health emergency in August, the second time it has made that call since 2022. The new cases detected in Queenstown are unrelated to that outbreak, reported RNZ’s Samuel Robinson, meaning the risk of a widespread outbreak still remains low. No cases of clade 1 have been detected in New Zealand or neighbouring nations.

In the Democratic Republic of Congo, reported NPR, there have been more than 20,000 suspected cases of the virus this year, causing hundreds of deaths as health workers plea for further shipments of vaccine. That outbreak has other countries on high alert. The United States is preparing for the clade 1 variant to arrive, while cases have been detected in disparate countries like Thailand and Sweden.

Wider access to vaccine confirmed

Mpox affects primarily, but not exclusively, gay, bisexual and other men who have sex with men. As Wiles noted in her 2022 piece, “stigma and prejudice surrounding homosexuality can stop people seeking a test or treatment, getting vaccinated, or self-isolating if they need to”. But that can be easier said the done. The Post’s Rachel Thomas reported this week that the wait time for a vaccination in Wellington was 10 months, unless people pay $85 to be seen faster. “I thought [that] was a really large amount for a preventative vaccine and a little bit outside my means,” said a concerned member of the public.

More Reading

    In welcome news for those seeking the vaccine, the government confirmed yesterday it would make it easier for people to access it. Since last year, explained Thomas in a follow-up report, the mpox vaccine has been administered under a special provision in the Medicines Act. However, it had not been given Medsafe approval and so could not be promoted and nor could it be given without a detailed consultation with the patient. Associate health minister David Seymour said Medsafe had now given provisional approval for the vaccine and established an advisory group to determine which groups were at greatest risk.

    What else can we be doing?

    Edwin Reynolds, medical advisor at the Immunisation Advisory Centre, in comments to the Science Media Centre, said that wider access to the vaccine was welcome. “The mpox vaccine is being delivered to the most at-risk via sexual health clinics but this announcement means other providers will be able to access the vaccine for their patients,” he said.

    But while that will assist with controlling the current outbreak here, professor Michael Baker believed we should be doing more to assist other countries. With the nastier clade 1 variant spreading rapidly, it may only be a matter of time before it arrives here. “Aotearoa New Zealand should also review its overseas aid contribution and support for programmes that could assist prevention and control of the severe mpox epidemic in Africa,” Baker said.

    Keep going!
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    The BulletinSeptember 11, 2024

    The human face of the electricity crisis

    The Bulletin editor
    electricity-feat-850×510.jpg
    newsletter

    The closure of two mills near Ohakune will mean the loss of 230 jobs, writes Stewart Sowman-Lund in today’s extract from The Bulletin.

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    ‘This is all we know’

    Winstone Pulp International, the largest employer in the Ruapehu District, has confirmed it will close its two mills indefinitely, leading to the loss of over 230 jobs. As Glenn McConnell reported last night for ThreeNews, it’s a serious blow for the region and a decision staff now out of work had hoped desperately could be avoided, launching a petition to try and save the mill. Winstone boss Mike Ryan blamed high energy costs for the decision and warned that other businesses of a similar nature could follow suit. But that’s little comfort for the hundreds now looking for new jobs, many of whom have known nothing else. “I’ve been here almost 20 years. It’s become a second home,” one worker told 1News. “Now what do we do? This is all we know.”

    Mill closure just one part of the puzzle

    The writing has been on the wall for several weeks. The proposed closure was first put forward about a month ago. Then, in late August, a packed public meeting in Raetihi saw emotions run high. RNZ’s Alexa Cook was there, reporting that “one by one workers, their whānau, and other locals told the crowd, including the mill bosses and the National MP Suze Redmayne, that the closure is turning their lives upside down”. The Whanganui Chronicle reported that while the mill had pulled out “all the stops” to try and halt the closure, it was facing rising costs that were unsustainable.

    Against the backdrop of all of this, a broader and ongoing electricity crisis is being dealt with. As we talked about a few weeks ago, the government has announced steps to try and address this, including a full review of the electricity market. But, despite calls for “instant results” from regional development minister Shane Jones, many of the government’s proposals are longer term ambitions that may do little to address the current situation. The mill closure is one part of that larger puzzle, but it has provided a human face to the crisis. It might not be the only casualty either, with RNZ’s Robin Martin reporting on another possible factory closure in Auckland’s Penrose.

    Who is to blame?

    The Winstone Pulp lies within the Rangitīkei electorate. As the Herald’s Thomas Coughlan reported, the local MP, National’s Suze Redmayne, is “gutted” by the pulp’s closure and said there would be a trickle down effect. “We’ve got people with partners that work in the health service – at the moment, our health service is struggling to get staff, so it makes a massive difference,” she said. While Redmayne wasn’t prepared to “blame” anyone for the situation, others in the government were quick to react.

    On social media, Act’s Simon Court said it was the result of “economic vandalism” by Labour, adding rather brazenly that the former government had a “kamikaze approach” to climate change that had “crashed the reliability of our energy sector”. Despite having hard words in the past for the Electricity Authority, we’re yet to hear directly from Shane Jones. He’s due to speak to RNZ’s Morning Report shortly, if you’re interested.

    What can be done

    Labour’s manufacturing spokesperson Helen White told the Herald there were options to keep the mills open, blaming electricity gentailers for not investing sufficiently in new generation assets. The government, she said, should be intervening. That’s largely the same argument that’s been pushed previously by Shane Jones, and even the minister responsible for the electricity sector, Simeon Brown, but intervention hasn’t eventuated.

    Smaller players in the market are arguing for change, too. As reported by BusinessDesk’s Ian Llewellyn, independent retailer Octopus Energy said the government’s moves, including importing liquid gas, won’t help address the underlying issues. “The Electricity Authority has been warned for years by industry and exporters that market arrangements have made electricity uncompetitive and prices too high for our productive sector,” said the company’s chief operating officer Margaret Cooney. In comments to Newsroom, Electric Kiwi’s Huia Burt similarly argued that “full structural separation [of generation and retail] is the gold standard”, though acknowledged a complete break up was unlikely. Everyone seems to know what the issue is – will anyone do anything about it?