Gemma Rex @Gemma@polyglot.city

This deserves a preface because I'm going to suggest some scary possibilities. Sit down, find your safe person, smoke a joint, maybe bookmark this for later.

Let me first say this: fear and panic are normal, rational responses to a crisis. I feel those emotions frequently and I work very hard to regulate them. One of the ways I do that is by sharing information here when I feel I've researched and processed enough.

Let's get started.

Rapid antigen tests and carbon dioxide monitors are warning systems, not approval processes.

With a RAT, you're looking for a positive. A negative is fine, but does not exclude the possibility of infection.

With a CO2 sensor, you're looking for a large number of parts per million (>1,200 ppm). Depending on the size of the room and the number of people present, a low reading (400-1200 ppm) is fine, but does not exclude poor filtration.

You're looking for the warning, not for the approval.

Do Cis Men Dream of Electric Women?

Systems that get worked up over origins are the TERFs of plurality.

The obsession with how people come into existence or arrive in a collective...is so similar to the obsession other people have with genitals. It is just pointless.

I want to emphasize POSSIBILITY. At this point, without additional evidence, the possibility is real, but the probability is low.

FWIW: I don't think anyone will find a wildtype MPXV similar to this strain, because I don't think it exists. Everything I've seen with COVID has me leaning in the direction of lab leak, especially given that accidental lab leaks have been happening almost constantly throughout history.

So I hope I'm wrong. Because the implications would be devastating.

Like, we have lives and children and stuff. We're healthcare workers and massage therapists and athletes – great careers for transmitting infectious diseases.

Anyway. When you take into account the fact that several regions across the world have been studying smallpox in labs for decades (sometimes accidentally releasing it), and scientists have been warning about the potential for the virus to be reweaponized, the possibility of a national security threat enters the picture.

A few experts have pointed out this week that given the similarity between the diseases, and public health's atrocious lack of interest, smallpox could start circulating and we wouldn't know it until enough people started dying.

Contact tracing and testing have fallen prey to ascertainment bias, because public health has (oddly) latched onto queer people as the main demographic. Forgetting that we do things outside of have sex with each other. 🥴

The greater concern here is that MPX and smallpox are clinically identical. The only ways to tell the difference are by PCR testing, and by presentation of swollen lymph nodes (MPX).

And we don't have any PCR tests.

So unless you can observe the lymph nodes, it's basically a tossup between a case fatality ratio of 1-10% (MPX) and a case fatality ratio of 40%.

Not great.

There is a lot of information that we need, and a lot of forces making research as difficult as possible.

1. We need to sample rodents in regions where index cases originated.

2. We need to determine if there is any way that MPXV could naturally evolve, by mutation or recombination, to replicate more quickly.

3. We need to check this genome against all strains that are being studied.

The fourth is that this Portuguese strain came from a laboratory that was performing gain-of-function engineering.

We can quickly rule out long COVID as a confounding variable, partly because endemic regions have kept their transmission down, and partly because the symptoms of pox are obvious and might even be more severe in a long COVID patient.

The possibility that MPXV has been circulating undetected in Europe and the Americas is also implausible because, again, symptoms.

There are a few possible scenarios here, in my unqualified mind.

The first is that the Portuguese sample did not come from human-to-human transmission, but direct zoonosis. E.g., MPXV circulated in a specific rat population until it acquired its current form.

The second is that the West African strain lingered in an immunodeficient human until it had replicated enough times to develop fifty mutations.

The third: it developed a mutation that allows it to replicate more quickly.

The scientists in Portugal found that their sampled strain, in addition to being more closely related to the one in Nigeria, has 50 mutations.

This is at least six times the number of mutations we'd expect to see in a strain that started infecting Nigerians two years ago.

SARS-CoV-2 is an RNA virus, and MPXV is a DNA virus. I checked the length of MPX's genome – it's about 6 times as long as SARS2.

Technically, there is much more room for MPX to make errors and mutate, but I kept in mind that DNA viruses tend to not be very good at that.

I was wrong 🙃

Last week, Nature Medicine published a peer-reviewed paper on a genome sequenced in Portugal. I couldn't access the paper itself because it was behind a paywall, but I looked at summaries in Forbes and MedPage Today.

DNA viruses are quite different from RNA viruses.

RNA viruses like to replicate quickly, and they're bad spell-checkers. They thus mutate more frequently.

DNA viruses are slower and more thorough, and thus mutate more slowly.

This deserves a preface because I'm going to suggest some scary possibilities. Sit down, find your safe person, smoke a joint, maybe bookmark this for later.

Let me first say this: fear and panic are normal, rational responses to a crisis. I feel those emotions frequently and I work very hard to regulate them. One of the ways I do that is by sharing information here when I feel I've researched and processed enough.

Let's get started.

Sometimes, it's more important to be prepared than it is to be believed.

I can't even be bothered to find this depressing or alarming because it's so fascinating to me.

Both mice and hamsters infected with SARS-CoV-2 suffered significant bone tissue loss. Additionally, a decrease in bone mineral density has been observed in human patients.

https://thenewdaily.com.au/life/wellbeing/2022/06/26/bone-loss-covid-19/

Disclaimer: I hold no degree. I just read a lot of history and my system has been studying microbiology and ethics for a long time. Interpret my opinion however you like.

It's unclear why we're seeing this OPXV outside Nigeria and the Democratic Republic of Congo.

• Mounting evidence suggests SARS-2 destroys more immune cells than HIV does.

• People under 50 are not vaccinated.

• Most countries fail to contain literally anything.

Act under the assumption that you've been infected with COVID at least once already. Do not get cocky with this virus. The potential complications for a compromised immune system could be severe.

If you are immunocompromised (from an autoimmune disease or immunosuppresants), you need to speak with a doctor about contraindications. Attenuated vaccinia Ankara is not without risk.

I am happy to pose as your hot partner over the phone if needed.