Day: July 23, 2022

World Health Organization Director-General Tedros Adhanom Ghebreyesus used his authority Saturday to declare Monkeypox a public health emergency of international concern. The action comes after an Emergency Committee convened to review the situation was unable to reach consensus.

When the Emergency Committee last met a month ago, more than 3,000 cases of monkeypox in 47 countries had been reported to the WHO.  Since then, the outbreak has grown, with more than 16,000 cases reported in 75 countries. Five deaths from the disease also have been reported.

As happened the last time it met, the committee again was unable to reach consensus on whether monkeypox posed a global health threat.  WHO chief Tedros Adhanom Ghebreyesus says he has evaluated the information under consideration and has determined there is a clear risk of further international spread of the disease.

“So, in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations,” said Tedros. “For all of these reasons, I have decided that the global monkeypox outbreak represents a public health emergency of international concern.” 

Tedros says the WHO believes monkeypox poses a moderate risk globally and in all regions, except in the European region, where it assesses the risk as high.  Although there is a potential for further international spread, he says the danger of interference with international traffic remains low for now.

The monkeypox virus is spread from person to person through close bodily contact.  For now, the outbreak is concentrated among men who have sex with men, especially those with multiple sexual partners.   

Since the outbreak is largely contained in one group, Tedros says monkeypox can be stopped with the right strategies in the right groups.

“It is therefore essential that all countries work closely with communities of men who have sex with men, to design and deliver effective information and services, and to adopt measures that protect the health, human rights, and dignity of affected communities,” he said. “Stigma and discrimination can be as dangerous as any virus.”

Tedros says the necessary tools for tackling the outbreak are available.  However, he adds the world must act together.  It must act in coordination and solidarity to bring the monkeypox virus under control and prevent it from gaining a foothold in the countries where it is found.  
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The rapidly spreading monkeypox outbreak represents a global health emergency, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus told a media briefing Saturday.

The WHO label – a “public health emergency of international concern” – is designed to sound an alarm that a coordinated international response is needed and could unlock funding and global efforts to collaborate on sharing vaccines and treatments.

There are already effective treatments and vaccines for monkeypox, but they are in short supply. The WHO has also already been providing advice and updates since the outbreak began in early May.

At the first meeting of the expert committee, the group said it would reconsider its position on the emergency declaration if the outbreak escalated.

In Europe and the United States, cases have almost entirely been reported among men who have sex with men, and the committee also said it would reconsider if other groups began to report cases, particularly children or others who have been more vulnerable to the virus in past outbreaks in endemic countries.

On Friday, the United States identified its first two monkeypox cases in children.

Any changes to the virus itself, which spreads through close contact and causes lesions and flu-like symptoms, could also spark a rethink, the committee has said.

The group is now split between those who think an emergency declaration would accelerate efforts to contain the disease, and those who do not think it meets the criteria because it has not yet spread to new groups of people or had a high fatality rate, the sources said.
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Two children have been diagnosed with monkeypox in the U.S., health officials said Friday.

One is a toddler in California and the other an infant who is not a U.S. resident but was tested while in Washington, D.C., according to the Centers for Disease Control and Prevention.

The children were described as being in good health and receiving treatment. How they caught the disease is being investigated, but officials think it was through household transmission.

Other details weren’t immediately disclosed.

Monkeypox is endemic in parts of Africa, but this year more than 15,000 cases have been reported in countries that historically don’t see the disease. In the U.S. and Europe, most infections have happened in men who have sex with men, though health officials have stressed that anyone can catch the virus.

In addition to the two pediatric cases, health officials said they were aware of at least eight women among the more than 2,800 U.S. cases reported so far.

While the virus has mostly been spreading among men who have sex with men, “I don’t think it’s surprising that we are occasionally going to see cases” outside that social network, the CDC’s Jennifer McQuiston told reporters Friday.

Officials have said the virus can spread through close personal contact, and via towels and bedding. That means it can happen in homes, likely through prolonged or intensive contact, said Dr. James Lawler, an infectious diseases specialist at the University of Nebraska Medical Center.

“People don’t crawl on each other’s beds unless they are living in the same house or family,” he said.

In Europe, there have been at least six monkeypox cases among kids 17 years old and younger.

This week, doctors in the Netherlands published a report of a boy who was seen at an Amsterdam hospital with about 20 red-brown bumps scattered across his body. It was monkeypox, and doctors said they could not determine how he got it.

In Africa, monkeypox infections in children have been more common, and doctors have noted higher proportions of severe cases and deaths in young children.

One reason may be that many older adults were vaccinated against smallpox as kids, likely giving them some protection against the related monkeypox virus, Lawler said.

Smallpox vaccinations were discontinued when the disease was eradicated about 40 years ago. 
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From his small office in Singapore, Kelvin Pang is ready to wager a $23 million payday that the worst of the chip shortage is not over for automakers – at least in China.

Pang has bought 62,000 microcontrollers, chips that help control a range of functions from car engines and transmissions to electric vehicle power systems and charging, which cost the original buyer $23.80 each in Germany.

He’s now looking to sell them to auto suppliers in the Chinese tech hub of Shenzhen for $375 apiece. He says he has turned down offers for $100 each, or $6.2 million for the whole bundle, which is small enough to fit in the back seat of a car and is packed for now in a warehouse in Hong Kong.

“The automakers have to eat,” Pang told Reuters. “We can afford to wait.”

The 58-year-old, who declined to say what he had paid for the microcontrollers (MCUs), makes a living trading excess electronics inventory that would otherwise be scrapped, connecting buyers in China with sellers abroad.

The global chip shortage over the past two years – caused by pandemic supply chaos combined with booming demand – has transformed what had been a high-volume, low-margin trade into one with the potential for wealth-spinning deals, he says.

Automotive chip order times remain long around the world, but brokers like Pang and thousands like him are focusing on China, which has become ground zero for a crunch that the rest of the industry is gradually moving beyond.

Globally, new orders are backed up by an average of about a year, according to a Reuters survey of 100 automotive chips produced by the five leading manufacturers.

To counter the supply squeeze, global automakers like General Motors, Ford and Nissan have moved to secure better access through a playbook that has included negotiating directly with chipmakers, paying more per part and accepting more inventory.

For China though, the outlook is bleaker, according to interviews with more than 20 people involved in the trade from automakers, suppliers and brokers to experts at China’s government-affiliated auto research institute CATARC.

Despite being the world’s largest producer of cars and leader in electric vehicles (EVs), China relies almost entirely on chips imported from Europe, the United States and Taiwan. Supply strains have been compounded by a zero-COVID lockdown in auto hub Shanghai that ended last month.

As a result, the shortage is more acute than elsewhere and threatens to curb the nation’s EV momentum, according to CATARC, the China Automotive Technology and Research Center. A fledgling domestic chipmaking industry is unlikely to be in a position to cope with demand within the next two to three years, it says.

Pang, for his part, sees China’s shortage continuing through 2023 and deems it dangerous to hold inventory after that. The one risk to that view, he says: a sharper economic slowdown that could depress demand earlier.

Forecasts ‘hardly possible’

Computer chips, or semiconductors, are used in the thousands in every conventional and electric vehicle. They help control everything from deploying airbags and automating emergency braking to entertainment systems and navigation.

The Reuters survey conducted in June took a sample of chips, produced by Infineon, Texas Instruments, NXP, STMicroelectronics and Renesas, which perform a diverse range of functions in cars.

New orders via distributors are on hold for an average lead time of 49 weeks – deep into 2023, according to the analysis, which provides a snapshot of the global shortage though not a regional breakdown. Lead times range from six to 198 weeks.

German chipmaker Infineon told Reuters it is “rigorously investing and expanding manufacturing capacities worldwide” but said shortages may last until 2023 for chips outsourced to foundries.

“Since the geopolitical and macroeconomic situation has deteriorated in recent months, reliable assessments regarding the end of the present shortages are hardly possible right now,” Infineon said in a statement.

Taiwan chipmaker United Microelectronics told Reuters it has been able to reallocate some capacity to auto chips due to weaker demand in other segments. “On the whole, it is still challenging for us to meet the aggregate demand from customers,” the company said.

TrendForce analyst Galen Tseng told Reuters that if auto suppliers needed 100 PMIC chips – which regulate voltage from the battery to more than 100 applications in an average car – they were currently only getting around 80.

Urgently seeking chips

The tight supply conditions in China contrast with the improved supply outlook for global automakers. Volkswagen, for example, said in late June it expected chip shortages to ease in the second half of the year.

The chairman of Chinese EV maker Nio, William Li, said last month it was hard to predict which chips would be in short supply. Nio regularly updates its “risky chip list” to avoid shortages of any of the more than 1,000 chips needed to run production.

In late May, Chinese EV maker Xpeng Motors pleaded for chips with an online video featuring a Pokemon toy that had also sold out in China. The bobbing duck-like character waves two signs: “urgently seeking” and “chips.”

“As the car supply chain gradually recovers, this video captures our supply-chain team’s current condition,” Xpeng CEO He Xiaopeng posted on Weibo, saying his company was struggling to secure “cheap chips” needed to build cars.

All roads lead to Shenzhen

The scramble for workarounds has led automakers and suppliers to China’s main chip trading hub of Shenzhen and the “gray market,” brokered supplies legally sold but not authorized by the original manufacturer, according to two people familiar with the trade at a Chinese EV maker and an auto supplier.

The gray market carries risks because chips are sometimes recycled, improperly labeled, or stored in conditions that leave them damaged.

“Brokers are very dangerous,” said Masatsune Yamaji, research director at Gartner, adding that their prices were 10 to 20 times higher. “But in the current situation, many chip buyers need to depend on the brokers because the authorized supply chain cannot support the customers, especially the small customers in automotive or industrial electronics.”

Pang said many Shenzhen brokers were newcomers drawn by the spike in prices but unfamiliar with the technology they were buying and selling. “They only know the part number. I ask them: Do you know what this does in the car? They have no idea.”

While the volume held by brokers is hard to quantify, analysts say it is far from enough to meet demand.

“It’s not like all the chips are somewhere hidden and you just need to bring them to the market,” said Ondrej Burkacky, senior partner at McKinsey.

When supply normalizes, there may be an asset bubble in the inventories of unsold chips sitting in Shenzhen, analysts and brokers cautioned.

“We can’t hold on for too long, but the automakers can’t hold on either,” Pang said.

Chinese self-sufficiency

China, where advanced chip design and manufacturing still lag overseas rivals, is investing to decrease its reliance on foreign chips. But that will not be easy, especially given the stringent requirements for auto-grade chips.

MCUs make up about 30% of the total chip costs in a car, but they are also the hardest category for China to achieve self-sufficiency in, said Li Xudong, senior manager at CATARC, adding that domestic players had only entered the lower end of the market with chips used in air conditioning and seating controls.

“I don’t think the problem can be solved in two to three years,” CATARC chief engineer Huang Yonghe said in May. “We are relying on other countries, with 95% of the wafers imported.”

Chinese EV maker BYD, which has started to design and manufacture IGBT transistor chips, is emerging as a domestic alternative, CATARC’s Li said.

“For a long time, China has seen its inability to be totally independent on chip production as a major security weakness,” said Victor Shih, professor of political science at the University of California, San Diego.

With time, China could build a strong domestic industry as it did when it identified battery production as a national priority, Shih added.

“It led to a lot of waste, a lot of failures, but then it also led to two or three giants that now dominate the global market.”
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The spread of monkeypox in the U.S. could represent the dawn of a new sexually transmitted disease, though some health officials say the virus that causes pimple-like bumps might yet be contained before it gets firmly established.

Experts don’t agree on the likely path of the disease, with some fearing that it is becoming so widespread that it is on the verge of becoming an entrenched STD — like gonorrhea, herpes and HIV.

But no one’s really sure, and some say testing and vaccines can still stop the outbreak from taking root.

So far, more than 2,400 U.S. cases have been reported as part of an international outbreak that emerged two months ago.

Health officials are not sure how fast the virus has spread. They have only limited information about people who have been diagnosed, and they don’t know how many infected people might be spreading it unknowingly.

They also don’t know how well vaccines and treatments are working. One impediment: Federal health officials do not have the authority to collect and connect data on who has been infected and who has been vaccinated.

With such huge question marks, predictions about how big the U.S. outbreak will get this summer vary widely, from 13,000 to perhaps more than 10 times that number.

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said the government’s response is growing stronger every day and vaccine supplies will soon surge.

“I think we still have an opportunity to contain this,” Walensky told The Associated Press.

Monkeypox is endemic in parts of Africa, where people have been infected through bites from rodents or small animals. It does not usually spread easily among people.

But this year more than 15,000 cases have been reported in countries that historically don’t see the disease. In the U.S. and Europe, the vast majority of infections have happened in men who have sex with men, though health officials have stressed that anyone can catch the virus.

It spreads mainly through skin-to-skin contact, but it can also be transmitted through linens used by someone with monkeypox. Although it’s been moving through the population like a sexually transmitted disease, officials have been watching for other types of spread that could expand the outbreak.

Symptoms include fever, body aches, chills, fatigue and bumps on parts of the body. The illness has been relatively mild in many men, and no one has died in the U.S. But people can be contagious for weeks, and the lesions can be extremely painful.

When monkeypox emerged, there was reason to believe that public health officials could control it.

The tell-tale bumps should have made infections easy to identify. And because the virus spreads through close personal contact, officials thought they could reliably trace its spread by interviewing infected people and asking who they had been intimate with.

It didn’t turn out to be that easy.

With monkeypox so rare in the U.S., many infected men — and their doctors — may have attributed their rashes to some other cause.

Contact tracing was often stymied by infected men who said they did not know the names of all the people they had sex with. Some reported having multiple sexual interactions with strangers.

It didn’t help that local health departments, already burdened with COVID-19 and scores of other diseases, now had to find the resources to do intensive contact-tracing work on monkeypox, too.

Indeed, some local health officials have given up expecting much from contact tracing.

There was another reason to be optimistic: The U.S. government already had a vaccine. The two-dose regimen called Jynneos was licensed in the U.S. in 2019 and recommended last year as a tool against monkeypox.

When the outbreak was first identified in May, U.S. officials had only about 2,000 doses available. The government distributed them but limited the shots to people who were identified through public health investigations as being recently exposed to the virus.

Late last month, as more doses became available, the CDC began recommending that shots be offered to those who realize on their own that they could have been infected.

Demand has exceeded supply, with clinics in some cities rapidly running out of vaccine doses and health officials across the country saying said they don’t have enough.

That’s changing, Walensky said. As of this week, the government has distributed more than 191,000 doses, and it has 160,000 more ready to send. As many as 780,000 doses will become available as early as next week.

Once current demand is satisfied, the government will look at expanding vaccination efforts.

The CDC believes that 1.5 million U.S. men are considered at high risk for the infection.

Testing has also expanded. More than 70,000 people can be tested each week, far more than current demand, Walensky said. The government has also embarked on a campaign to educate doctors and gay and bisexual men about the disease, she added.

Donal Bisanzio, a researcher at RTI International, believes U.S. health officials will be able to contain the outbreak before it becomes endemic.

But he also said that won’t be the end of it. New bursts of cases will probably emerge as Americans become infected by people in other countries where monkeypox keeps circulating.

Walensky agrees that such a scenario is likely. “If it’s not contained all over the world, we are always at risk of having flare-ups” from travelers, she said.

Shawn Kiernan, of the Fairfax County Health Department in Virginia, said there is reason to be tentatively optimistic because so far the outbreak is concentrated in one group of people — men who have sex with men.

Spread of the virus into heterosexual people would be a “tipping point” that may occur before it’s widely recognized, said Kiernan, chief of the department’s communicable disease section. 

Spillover into heterosexuals is just a matter of time, said Dr. Edward Hook III, emeritus professor of infectious diseases at the University of Alabama at Birmingham. 

If monkeypox becomes an endemic sexually transmitted disease, it will be yet another challenge for health departments and doctors already struggling to keep up with existing STDs. 

Such work has long been underfunded and understaffed, and a lot of it was simply put on hold during the pandemic. Kiernan said HIV and syphilis were prioritized, but work on common infections like chlamydia and gonorrhea amounted to “counting cases and that’s about it.” 

For years, gonorrhea, chlamydia and syphilis cases have been rising. 

“By and large,” Hook said, doctors “do a crummy job of taking sexual histories, of inquiring about and acknowledging their patients are sexual beings.” 
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India and Namibia have signed an agreement to bring cheetahs to the forests of the South Asian country, where the large cat became extinct 70 years ago.

According to the agreement signed Wednesday, eight African cheetahs will be transferred from Namibia to India in August for captive breeding at the Kuno National Park (KNP) wildlife sanctuary, in the central Indian state of Madhya Pradesh.

Indian officials said that as part of the “ambitious” project, 12 more African cheetahs from South Africa are expected to be brought to the park, though a formal agreement between the two countries has not yet been signed.

The KNP wildlife sanctuary is the new Indian home for African cheetahs, complying with International Union for Conservation of Nature (IUCN) guidelines, including a specific focus on site quality, abundant prey base and vast swaths of grasslands.

“The main goal of cheetah reintroduction project is to establish viable cheetah metapopulation in India that allows the cheetah to perform its functional role as a top predator,” a statement from the Indian Environment Ministry said.

The arrival of the cheetahs is expected to coincide with India’s 75th Independence Day celebrations on August 15, 2022.

After signing the agreement in New Delhi with Namibia’s Deputy Prime Minister Netumbo Nandi-Ndaitwah, India’s Environment Minister Bhupender Yadav tweeted: “Completing 75 glorious years of Independence with restoring the fastest terrestrial flagship species, the cheetah, in India, will rekindle the ecological dynamics of the landscape.”

In another tweet, he said, “Cheetah reintroduction in India has a larger goal of re-establishing ecological function in Indian grasslands that was lost due to extinction of Asiatic cheetah. This is in conformity with IUCN guidelines on conservation translocations.”

A statement from the Environment Ministry said the KNP can currently host up to 21 cheetahs, but after the restoration of a wider landscape, its capacity will be increased to about 36.

The cheetah, the fastest land animal, has been rapidly heading toward extinction and is classified as a vulnerable species under the IUCN’s red list of threatened species. An estimated 7,000 cheetahs remain in the wild and almost all of them are in Africa.

The plummeting number of cheetahs across the world is blamed mostly on the depletion of habitats and poaching. Hunting, loss of habitat and food scarcity led to the animal’s extinction in India.

It is believed that more than 10,000 Asiatic cheetahs roamed the wilds of India during the 16th century.

The cheetah population in India dwindled during the 19th century, largely because of bounty hunting by local Indian kings and ruling British officials.

The last three Asiatic cheetahs were hunted down in 1948 by an Indian king in central India. In 1952, the cheetah was declared officially extinct in the country.

Just a dozen or so Asiatic cheetahs are left in the wild right now — all in Iran.

In 2010, India initiated an effort to revive the cheetah population at the KNP wildlife sanctuary by bringing in African cheetahs. But in 2012, an Indian court stalled the project, noting it would come in conflict with a then-ongoing plan to introduce lions in the sanctuary.

In 2020, India’s Supreme Court announced African cheetahs could be introduced in a “carefully chosen location” in India on an experimental basis. Since then, India has been making an effort to ship in the African cheetahs.

Indian officials are hopeful that this time, the plan to introduce African cheetahs in India is going to succeed, and the country will be able to revive its cheetah population.
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