Caitlin Rivers proposes three metrics to measure our progress: Number of individuals tested, proportion of cases coming from known contacts (or, at least, where we can point to a known contact, since you can never know for sure), and days from symptom onset to isolation.
That third one seems like it should be pretty close to zero already. Either you have pox on your skin or you don’t.
I think it’s a littlemore complicated than that. MPX lesions in this outbreak are sometimes solitary, and in hard-to-see places like the inside of the mouth or bottom of the penis. This is what they might look like:
They are reputedly painful prior to scabbing, then itchy until the scabs fall off.
It therefore seems possible in this outbreak that the average time between a person becoming infectious and realizing they have symptoms of MPX is significant. Perhaps this isn’t quite asymptomatic spread, but it would be sufficiently “low-symptomatic” spread to have a similar effect. I’d emphasize that this just a hypothesis, based on extrapolating from some reports from previous outbreaks of asymptomatic spread and current reports of having just one lesion in the mouth or on the genitals.
I think it’s a littlemore complicated than that. MPX lesions in this outbreak are sometimes solitary, and in hard-to-see places like the inside of the mouth or bottom of the penis. This is what they might look like:
They are reputedly painful prior to scabbing, then itchy until the scabs fall off.
It therefore seems possible in this outbreak that the average time between a person becoming infectious and realizing they have symptoms of MPX is significant. Perhaps this isn’t quite asymptomatic spread, but it would be sufficiently “low-symptomatic” spread to have a similar effect. I’d emphasize that this just a hypothesis, based on extrapolating from some reports from previous outbreaks of asymptomatic spread and current reports of having just one lesion in the mouth or on the genitals.