This text brings together part of the content of our health newsletter, published on Tuesdays at 4:00 p.m.
The World Health Organization has launched a emergency of international public health concern for mpox. Does this mean that a new pandemic resembling that of COVID is upon us? This seems unlikely: the virus in question is less contagious and less dangerous than the one that causes COVID, it does not mutate all the time and, above all, there are already vaccines. Still, we have no interest in ignoring this alert.
MPOX, also called monkeypox, is caused by an orthopoxvirus. It produces fever and a rash and, in rare cases, causes death. It appeared in humans in 1970 and is now endemic in Central and West Africa, where approximately 20,000 cases were recorded in the decade 2010-2019.
In July 2022, a first international emergency was declared by the WHO when the virus spread outside Africa. More than 100,000 cases had occurred in a few months in 116 countries, including Canada, mainly among men who have sex with other men. In rich countries, only a few deaths had been recorded and, quickly, the vaccine against smallpox, which is effective against mpox, had managed to limit its spread. The WHO had lifted the emergency in May 2023. In Canada, the vaccine remains recommended to certain people, on the recommendation of public health authorities.
Since then, another clade of the virus (a cousin strain of the first) is spreading in Africa. It appears to be more contagious, even through casual non-sexual contact, and more dangerous. Since January, the Democratic Republic of Congo has recorded more than 15,600 cases and 537 deaths, mostly among children. This clade, called 1b, is now present in 16 African countriesand cases have already been found in Pakistan and Sweden. It would be very surprising if it did not arrive in Canada.
Rich countries have a priori ways to quickly identify sick people and vaccinate their contacts to limit the spread, but this may be more complicated than in 2022, because of the characteristics of this clade.
The WHO’s emergency is primarily aimed at mobilizing rich countries and vaccine manufacturers to organize themselves and come to the aid of African countries. It would take 10 million vaccines to stem the epidemic, but we are very far from there. Without a major shift, the number of cases and deaths risks continuing to increase exponentially in Africa, which would also expose the rest of the planet. Will we all have to be vaccinated against COPD one day? We are not there yet, but do we really want to take the risk of getting there? The time to react is now.
The good news
The rise of anti-racist psychotherapy
Three researchers from the University of Ottawa have just published the first guidelines to adapt cognitive behavioural therapy (CBT) to treat racialized people. Systemic discrimination, hostility towards them by certain people or microaggressions they may experience must be taken into account in the treatment of their mental health problems, say the researchers. CBT is considered one of the most effective treatments for anxiety disorders, depression and addictions, among others. The researchers propose a new intervention model as well as tools and tips to enable psychologists to better help their patients, whether children or adults, to counter the effects of racism on their mental health.
The data
49 %
That’s the rate of correct answers that ChatGPT obtained when Ontario researchers asked this artificial intelligence software to make a diagnosis on 150 complex clinical cases. Excerpts from Medscapea website that doctors regularly use to test their knowledge, all of these cases contain the information a doctor might need to make a diagnosis—a description of the patient, their symptoms, and the results of lab or imaging tests. The idea is to identify the disease in question or choose the best treatment by checking one of four possible answers. The researchers tested the artificial intelligence on cases that were described only in text, with no images or graphs to analyze, to make it easier for them. The conclusion: this tool is absolutely no substitute for a real doctor. In their studythe researchers point out that ChatGPT has particular difficulty interpreting numerical data and distinguishing between two diseases that are similar. It also sometimes ignores some of the information provided and sometimes gives completely absurd answers. Good to know if you are tempted to submit your case to it online…
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