Earlier this week, James Cameron’s Avatar: The Way of Water became the No. 5 highest-grossing movie ever worldwide, and, as expected, has now surfed to the No. 4 position on the all-time chart. In so doing, it leaves Star Wars: The Force Awakens in its wake with nearly $2.075B globally.
Through Friday, the worldwide gross on the 20th Century Studios/Disney/Lightstorm epic Avatar sequel is $2,074.8M, overtaking Force Awakens’ $2.071B. This means that Cameron has three of the top four movies ever globally alongside the original Avatar at No. 1 and Titanic at No. 3. Avatar: The Way of Water will top Titanic in the coming week or so on a global basis. However, Paramount is doing a Titanic domestic rerelease in time for Valentine’s Day, and Disney is also handling offshore before Ant-Man and The Wasp: Quantumania gets going, so there could be some jockeying ahead as we noted on Thursday.
For Disney, the recent Avatar milestones mean the studio has released three of the top five global titles ever (including Avengers: Endgame at No. 2, while Fox back in the day, before it was under the Disney umbrella, released the first Avatar).
At the international box office, Best Picture Oscar nominee Way of Water is still No. 4 of all time with $1,466.3M through Friday. Domestically, it is No. 13 at $608.5M.
Through Friday, the sci-fi adventure’s top overseas markets are: China ($235.4M), France ($133.2M), Germany ($120.2M), Korea ($101.5M), the UK ($83.5M), India ($58.3M), Australia ($57.5M), Mexico ($52.3M), Spain ($48.1M) and Italy ($45.8M).
Dow is slashing jobs and shutting down assets as it looks to make cost savings.
Photo:
Sean Proctor/Bloomberg News
Dow Inc.
DOW 0.40%
said it is laying off about 2,000 employees globally as job cuts that have so far been concentrated in the technology sector spread to other parts of the economy.
The Midland, Mich.-based chemicals company said it is targeting $1 billion in cost cuts this year as slowing economic growth and a drop-off in demand weigh on sales.
Dow said it is also shutting down certain assets and broadly looking to align spending with the macroeconomic environment. The company said it expects to book a charge of $550 million to $725 million in the first quarter for costs tied to the cost-cutting moves.
Chief Executive
Jim Fitterling
said the company is optimizing its cost structure amid macroeconomic uncertainties and “challenging energy markets, particularly in Europe.”
Shares of Dow rose less than 1% to close at $58.12 on Thursday.
Dow’s layoffs come after manufacturing conglomerate
3M Co.
said earlier this week that it was cutting 2,500 jobs globally, or about 2.6% of the company, as it confronts weakening demand.
The companies join a wave of technology companies that are cutting thousands of jobs as they recalibrate after growing rapidly at the start of the Covid-19 pandemic. On Wednesday,
International Business Machines Corp.
said it would cut 3,900 jobs, while software company
SAP SE
on Thursday said it would shed 3,000 positions.
Dow on Thursday also posted weaker-than-expected results for the fourth quarter. Revenue fell more than 17% to $11.86 billion, missing analysts’ estimates, with the company citing slowing economic growth around the world and destocking of inventory by customers.
The company’s fourth-quarter profit tumbled to 85 cents a share, down from $2.32 a share a year earlier. Adjusted earnings for the quarter missed estimates by a penny.
“While we see initial positive signs from moderating inflation in the U.S., improving outlook for energy in Europe, and reopening in China, we continue to be prudent and proactive,” Mr. Fitterling said.
Dow said it is targeting $500 million in structural improvements and another $500 million in operating cost reductions. The company said it would look to cut costs tied to purchasing raw materials, logistics and utilities.
Wedbush Securities managing director Dan Ives warns that many Big Tech companies still need to ‘rip the Band-Aid off’ in terms of layoffs.
The latest annual survey from global communications firm Edelman found people’s hopes for their financial futures suffered a “massive collapse” worldwide over the past year, with most developed nations seeing economic optimism hit all-time lows.
The 2023 Edelman Trust Barometer released Sunday found that citizens in half the countries surveyed had year-over-year double-digit declines in the belief that their families would be better off in five years.
“The biggest story is the loss of economic optimism over the last year, even through the pandemic,” Edelman CEO Richard Edelman told FOX Business in an interview, calling the drop “significant.”
Members of the public sit on benches near a playground in Hong Kong, China, on Thursday, Dec. 29, 2022. (Photographer: Lam Yik/Bloomberg via Getty Images / Getty Images)
ALMOST HALF OF EUROPEAN UNION POPULATION REPORTS THEIR STANDARD OF LIVING HAS DECLINED, SURVEY FINDS
Edelman has conducted its Trust Barometer providing key insights for employers since 2000. In this year’s poll, economic optimism in 24 of the 28 countries surveyed fell to record lows, including the U.S. (36%), U.K. (23%), Germany (15%) and Japan (9%).
Flags of (from left) Germany, Canada, France, Italy, Japan, Great Britain, U.S. and the European Union are displayed for a G7 Foreign Ministers Meeting at the City Hall in northwest Germany on Nov. 3, 2022. (Photo by WOLFGANG RATTAY/POOL/AFP via Getty Images / Getty Images)
Not a single developed country has economic optimism above 35%.
IMF CHIEF EXPECTS TO KEEP 2023 GLOBAL GROWTH FORECAST STEADY
Economic anxieties were cited among respondents’ top fears, with 89% saying they were worried about job loss, and 74% citing inflation. Sixty-seven percent expressed concern about food shortages, and 66% said they were worried about energy shortages.
Edelman CEO Richard Edelman attends the Cannes Lions Festival 2017 on June 20, 2017 in Cannes, France. ((Photo by Francois G. Durand/Getty Images) / Getty Images)
Edelman called the situation “dire,” saying he believes new concerns have been added over the last 12 months on top of standard worries people have expressed in past years such as losing their jobs to machines or the impact of climate change.
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“But now we have a cost of living crisis,” he told FOX Business. “We have [the threat of] nuclear war. We have things moving from societal issues to personal issues, so people have really lost confidence.”
move to purge Twitter Inc. employees who don’t embrace his vision has led to a wave of departures among policy and safety-issue staffers around the globe, sparking questions from regulators in key jurisdictions about the site’s continued compliance efforts.
Scrutiny has been particularly close in Europe, where officials have in recent years assumed a greater role in regulating big tech companies.
Staff departures in recent days include dozens of people spread across units such as government policy, legal affairs and Twitter’s “trust and safety” division, which is responsible for functions like drafting content-moderation rules, according to current and former employees, postings on social media and emails sent to work addresses of people who had worked at Twitter that recently bounced back.They have left from hubs including Dublin, Singapore and San Francisco.
Many of the departures follow Mr. Musk’s ultimatum late last week that staffers pledge to work long hours and be “extremely hardcore” or take a buyout. Hundreds or more employees declined to commit to what Mr. Musk has called Twitter 2.0 and were locked out of company systems. That comes after layoffs in early November that cut roughly half of the company’s staff.
Twitter conducted another round of job cuts affecting engineers late Wednesday, before the Thanksgiving holiday in the U.S., people familiar with the matter said. The exact scope couldn’t be immediately learned, though some of the people estimated dozens of employees were let go.
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Twitter sent fired engineers an email saying their code wasn’t satisfactory and offering four weeks of severance, some of the people said. Some other engineers received an email warning them to improve their performance to keep their jobs, the people said.
Ireland’s Data Protection Commission said this week it was asking Twitter whether it still had sufficient staff to assure compliance with the European Union’s privacy law, the General Data Protection Regulation, or GDPR. The company last week told the Irish data regulator that it did, but is still reviewing the impact of the staff departures, a spokesman for the Irish regulator said.
He said Twitter has appointed an interim chief data protection officer, an obligation under the GDPR, after the departure of Damien Kieran, who had served in the role but left shortly after the first round of layoffs.
In France, meanwhile, the country’s communications regulator said it sent a letter last Friday asking that Twitter explain by this week whether it has sufficient personnel on staff to moderate hate speech deemed illegal under French law—under which Twitter could face legal orders and fines.
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The staff departures come as Twitter holds talks with the EU about the bloc’s new social-media law, dubbed the Digital Services Act, which will apply tougher rules on bigger platforms like Twitter by the middle of next year.
Didier Reynders,
the EU’s justice commissioner, is slated to attend a previously scheduled meeting with Twitter executives in Ireland on Thursday. He plans to ask about the company’s ability to comply with the law and to meet its commitments on data protection and tackling online hate speech, according to an EU official familiar with the trip.
Věra Jourová, a vice president of the EU’s executive arm, said she was concerned about reports of the firing of vast amounts of Twitter staff in Europe. “European laws continue to apply to Twitter, regardless of who is the owner,” she said.
Mr. Musk has said that he would follow the laws of the countries where Twitter operates and that it “cannot become a free-for-all hellscape.”
Twitter didn’t respond to a request for comment.
Late Wednesday, Mr. Musk tweeted that the number of views of tweets he described as “hate speech” had fallen below levels seen before a spike in such views in late October. “Congrats to the Twitter team!” Mr. Musk wrote.
Some of the people who either departed or declined to sign on to Twitter 2.0 appear to include Sinead McSweeney, the company’s Ireland-based vice president of global policy and philanthropy, who led government relations and compliance initiatives with regulations worldwide, as well as the two remaining staffers in Twitter’s Brussels office.
Ms. McSweeney and the two Brussels employees declined to comment, but emails to their work addresses started bouncing back undeliverable in recent days according to checks by The Wall Street Journal. Four other Brussels-based employees were earlier this month told they were being laid off, according to social-media posts and people familiar with the matter.
Twenty Air Street, London, the home of Twitter’s U.K. office.
Photo:
Dan Kitwood/Getty Images
Damien Viel, Twitter’s country manager for France, was also among a wave of staffers who posted publicly this week that they had left the company. He declined to comment when reached by the Journal.
At least some of the departures occurred in teams that reported to
Yoel Roth,
Twitter’s former head of trust and safety, who resigned earlier this month. In an op-ed for the New York Times, Mr. Roth said he resigned because Mr. Musk made it clear that he alone would make decisions on policy and the platform’s rules and that he had little use for those at the company who were advising him on those issues.
The team included Ilana Rosenzweig, who worked as Twitter’s senior director and head of international trust and safety. She has left the company, according to her LinkedIn profile. Based in Singapore, Ms. Rosenzweig led Twitter’s trust and safety teams across Europe, the Middle East and Africa, along with Japan and other Asia-Pacific countries, according to her profile.
“I decided not to agree to Twitter 2.0,” Keith Yet, a Twitter trust and safety worker based in Singapore, wrote on LinkedIn on Monday. Mr. Yet worked on child sexual exploitation issues and handling legal escalations from Japan and other countries, according to his LinkedIn profile. Attempts to reach Ms. Rosenzweig and Mr. Yet were unsuccessful.
The departures come amid a wave of new tech regulation, particularly in Europe. The Digital Services Act, which will by the middle of next year require tech companies like Twitter with more than 45 million users in the EU to maintain robust systems for removing content that European national governments deem to be illegal.
The layoff announcements just keep coming. As interest rates continue to climb and earnings slump, WSJ’s Dion Rabouin explains why we can expect to see a bigger wave of layoffs in the near future. Illustration: Elizabeth Smelov
The act also requires these companies to reduce risks associated with content that regulators consider harmful or hateful. It mandates regular outside audits of the companies’ processes and threatens noncompliance fines of up to 6% of a company’s annual revenue.
Political leaders had warned that Mr. Musk’s Twitter would have to comply with EU rules. “In Europe, the bird will fly by our rules,” tweeted the EU’s commissioner for the internal market,
Thierry Breton,
hours after Mr. Musk completed his Twitter deal in late October tweeting, “the bird is free.”
A spokesman for the European Commission, the EU’s executive arm, said this week that it had active contacts with the company regarding the regulation and tackling disinformation and illegal hate speech, but declined to comment on the substance of Twitter’s compliance plans.
Activists and researchers are also concerned that the departures could undermine Twitter’s ability to block state-backed information operations aimed at spreading propaganda and harassing adversaries. The wave of departures “raises questions about how Twitter will moderate tweets and comments in a professional and neutral manner,” said Patrick Poon, an activist turned scholar at Japan’s Meiji University, who analyzes free speech.
—Liza Lin, Alexa Corse and Sarah E. Needleman contributed to this article.
Write to Sam Schechner at Sam.Schechner@wsj.com, Kim Mackrael at kim.mackrael@wsj.com and Newley Purnell at newley.purnell@wsj.com
Measles, the preventable but highly infectious disease, could be on the verge of a comeback after a lull in the immediate months following the emergence of the coronavirus, the World Health Organization and the U.S. Centers for Disease Control and Prevention said Wednesday.
Calling measles an “imminent threat in every region of the world,” the two public health bodies said in a report that almost 40 million children missed their vaccine doses last year. They said 25 million children did not receive their first dose, while an additional 14.7 million children missed their second shot, marking a record high in missed vaccinations.
The number of measles infections has declined over the past two decades, though it remains a mortal threat, particularly for unvaccinated young children in the developing world. But there were an estimated 9 million cases and 128,000 deaths globally last year, up from 7.5 million cases and 60,700 in 2020. That increase came amid poorer disease surveillance and vaccine campaigns that were delayed by the pandemic, the WHO and CDC said.
Vaccination can also confer benefits to one’s community, a concept known as herd immunity. About 95 percent of a population needs to be vaccinated with two doses for herd immunity to occur, but only around 81 percent of children globally have received their first dose, and 71 percent their second, the two bodies said.
So far, this flu season is more severe than it has been in 13 years
Measles, which starts with cold-like symptoms, undermines the immune system, making those infected more susceptible to other diseases. Seizures and blindness are possible in some instances, according to Britain’s National Health Service.
The WHO has previously warned that the dip in measles infections early in the pandemic was the “calm before the storm.”
“Routine immunization must be protected and strengthened” despite the coronavirus, said Kate O’Brien, WHO’s director of immunization, vaccines and biologicals, last year. Otherwise, “we risk trading one deadly disease for another.”
Hur Jian, an infectious-disease expert at South Korea’s Yeungnam University Medical Center, said the recent rebound in global travel portends a probable return of measles even in wealthy countries with higher vaccine coverage. Younger generations who have had less exposure to the disease may have weaker defenses, she added.
The United States declared that it had eradicated measles — defined as no transmission for a year and a well-performing surveillance system — in 2000, but occasional outbreaks still occur. This year 50-plus cases have been detected in the United States, according to the CDC.
President Biden offered pardons Thursday to thousands of people convicted of simple marijuana possession under federal law, as U.S. states and other governments around the world reconsider their approach toward the drug, with some moving to decriminalize or legalize it.
“No one should be in jail just for using or possessing marijuana,” Biden said. He called on senior administration officials to review how the drug is regulated under federal law and whether it should continue to be treated as a Schedule I substance along with drugs such as heroin, LSD and ecstasy.
On Oct. 6, President Biden pardoned thousands of people convicted of a federal crime for simply possessing marijuana and urged governors to do the same. (Video: Julie Yoon/The Washington Post)
Here’s what you need to know about how U.S. marijuana policies and laws compare to those of other countries.
What does Biden’s offer of mass pardons for people convicted of simple marijuana possession mean?
More than 600,000 people were arrested for marijuana possession in the United States in 2018, according to the latest available data from the American Civil Liberties Union. (Not all arrests lead to charges and convictions.) But Biden’s announcement applies only to federal prosecutions, a fraction of people affected by possession laws. His pardon power does not extend to those convicted under state law.
“Many if not most people serving time are in state systems,” said Griffen Thorne, an attorney at Harris Bricken, a law firm that works with cannabis companies. (Biden also called on state governors Thursday to offer similar pardons.)
No one is serving time in a federal prison solely for the crime of marijuana possession, White House officials said Thursday, though more than 6,500 people may have such convictions on their records.
How do the United States’ policies stack up against the rest of the world?
Possessing or consuming marijuana for any reason is illegal under federal law, but as of February, 37 states and the District of Columbia had authorized it for medical use, according to the National Conference of State Legislatures. In addition, at least 19 states and D.C. had legalized recreational marijuana for adults as of May.
Technically, “every state-level marijuana program is a complete violation of federal law,” Thorne said, but the federal government has “looked the other way.”
A handful of countries have legalized recreational use of marijuana, though there are many gray areas and caveats. Places where it is legal to recreationally use cannabis include Uruguay, Canada and Malta. In some cases, there are restrictions on age, quantities and transport of the drug.
South Africa decriminalized adult use of cannabis in private, although purchasing or selling it remains illegal. Thailand this year legalized growing and trading marijuana. However, government officials have warned that “nonproductive” use of the drug — such as smoking it outside — could lead to penalties such as short prison terms.
Marijuana is now legal in Thailand. What does that mean for tourists?
Germany’s coalition government pledged before taking office last year to legalize the recreational use of cannabis. Australia allows medical marijuana, but recreational use at home is only legal in the Australian Capital Territory, encompassing Canberra and surrounding townships. Personal use of limited quantities of cannabis is tolerated in the Netherlands, though it’s technically illegal.
“Certainly, there are other countries that have liberal policies and are more consistent about it,” said Robert Mikos, a professor at Vanderbilt University who specializes in drug law. “But because we have so many states that have legalized adult recreational or medical use, I would count the U.S. as one of the more progressive countries.”
Is the world moving toward legalizing marijuana for personal use?
Momentum toward legalizing marijuana is ramping up in Latin America and Africa, Thorne said.
A 2018 Constitutional Court decision paved the way for South Africa to decriminalize personal use, and President Cyril Ramaphosa said this year that his government would work on bolstering its domestic cannabis sector, Reuters reported. Peru legalized medical use in 2017, and Zimbabwe did so in 2018.
Marijuana is one of the world’s most widely consumed drugs, with roughly 147 million people — about 2 percent of the global population — using it annually, according to the World Health Organization. U.S. adults between the ages of 19 and 30 also used marijuana at record levels last year, the National Institutes of Health reported.
But there are pockets of opposition in parts of the world, particularly Asia. In a 2020 referendum, New Zealand voters narrowly rejected legalizing cannabis for nonmedicinal use. It is available there with a prescription. Singapore — whose tough drug laws extend to cannabis — also recently signaled that it would not move to permit medicinal marijuana in the near future.
Does the mass pardon for marijuana possession have global significance?
Maybe. U.S. drug policy has long influenced how the world treats marijuana. Since the 1960s, the United States has championed international conventions and treaties that required participating countries to ban recreational cannabis, said Mikos, the law professor.
But now that dozens of U.S. states have legalized cannabis for recreational or medicinal use, several countries “have taken that as a green light to go ahead and start experimenting,” he said.
“To our knowledge, this study represents the largest effort to date to determine the global burden of cancer attributable to risk factors, and it contributes to a growing body of evidence aimed at estimating the risk-attributable burden for specific cancers nationally, internationally, and globally,” Dr. Chris Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, and his colleagues wrote in the study.
The paper, funded by the Bill & Melinda Gates Foundation, analyzed the relationship between risk factors and cancer, the second leading cause of death worldwide, using data from the Institute for Health Metrics and Evaluation’s Global Burden of Disease project.
The project collects and analyzes global data on deaths and disability. Murray and his colleagues zeroed in on cancer deaths and disability from 2010 to 2019 across 204 countries, examining 23 cancer types and 34 risk factors.
The leading cancers in terms of risk-attributable deaths globally in 2019 was tracheal, bronchus and lung cancer for both men and women, the researchers found.
The data also showed that risk-attributable cancer deaths are on the rise, increasing worldwide by 20.4% from 2010 to 2019. Globally, in 2019, the leading five regions in terms of risk-attributable death rates were central Europe, east Asia, North America, southern Latin America and western Europe.
“These findings highlight that a substantial proportion of cancer burden globally has potential for prevention through interventions aimed at reducing exposure to known cancer risk factors but also that a large proportion of cancer burden might not be avoidable through control of the risk factors currently estimated,” the researchers wrote. “Thus, cancer risk reduction efforts must be coupled with comprehensive cancer control strategies that include efforts to support early diagnosis and effective treatment.”
The new study “clearly delineates” the importance of primary cancer prevention and “the increasing cancer numbers related to obesity clearly demands our attention,” Dr. William Dahut, chief scientific officer for the American Cancer Society, who was not involved in the new study, wrote in an email to CNN.
“Modifying behavior could lead to millions more lives saved greatly overshadowing the impact of any drug ever approved,” he wrote, adding, “The continued impact of tobacco despite approximately 65 years of a linkage to cancer remains very problematic.”
Although tobacco use in the United States is less than in other countries, tobacco-related cancer deaths continue to be a major problem and disproportionately impact certain states, Dahut wrote.
A separate study, published earlier this month in the International Journal of Cancer, found that the estimated proportion of cancer deaths in 2019 attributable to cigarette smoking in adults ages 25 to 79 ranged from 16.5% in Utah to 37.8% in Kentucky. The estimated total lost earnings due to cigarette smoking-attributable cancer deaths ranged from $32.2 million in Wyoming to $1.6 billion in California.
“In addition, it is no secret that alcohol use as well as the dramatic increase in the median BMI will lead to significant numbers of preventable cancer deaths,” Dahut added. “Finally, cancer screening is particularly important in those at increased risk as we move to a world where screening is precision based and adaptable.”
In an editorial that was published alongside the new study in The Lancet, Dr. Diana Safarti and Jason Gurney of Te Aho o Te Kahu Cancer Control Agency in New Zealand wrote that preventable risk factors associated with cancer tend to be patterned according to poverty.
“Poverty influences the environments in which people live, and those environments shape the lifestyle decisions that people are able to make. Action to prevent cancer requires concerted effort within and outside the health sector. This action includes specific policies focused on reducing exposure to cancer-causing risk factors, such as tobacco and alcohol use, and access to vaccinations that prevent cancer-causing infections, including hepatitis B and HPV,” Safarti and Gurney wrote.
“The primary prevention of cancer through eradication or mitigation of modifiable risk factors is our best hope of reducing the future burden of cancer,” they wrote. “Reducing this burden will improve health and wellbeing, and alleviate the compounding effects on humans and the fiscal resourcing pressure within cancer services and the wider health sector.”
Residents in New York and Virginia shared their level of concern over monkeypox after the World Health Organization declared the virus a global health emergency.
“Sometimes I feel like there’s a lot of fearmongering going on,” Charity, from Virginia, told Fox News. “They’re trying to make us scared.”
But another Virginian, Letitia, said monkeypox is “definitely something to be concerned about.”
“If you touch someone whose got monkeypox and they have like a rash or a scab, it can be transmitted that way, or you touch maybe something that they touched it can be transmitted that way,” Letitia said. “That’s scary.”
MONKEYPOX ISN’T ‘SAME KIND OF VIRUS’ AS COVID, DOCTOR SAYS
Letitia, from Virginia, says there is definitely cause to be concerned about the monkeypox virus. (Jon Michael Raasch/Fox News Digital)
Cases in the U.S. have grown to over 3,500 – with the majority in New York – since the first case was confirmed in May, according to the Centers for Disease Control and Prevention. Monkeypox, similar to smallpox, causes a puss-filled rash, fever and aches. Children and people with immune deficiencies tend to face more severe cases.
“The fact that [the WHO] did declare that level of critical mass is very scary,” Greg, from Virginia, said. “I’m waiting for how we need to better prepare for this and if it’s time for masks again.”
US MONKEYPOX CASES JUMP AS TESTING INCREASES
Test tubes labeled “Monkeypox virus positive and negative” are seen in this illustration taken May 23, 2022. (Reuters/Dado Ruvic/Illustration/File Photo)
Charity, from Virginia told Fox News: “I got COVID-19, and I was like I’m really probably gonna die because of how they made it seem.”
“When I had COVID-19, it wasn’t really that bad, so it’s probably the same situation,” she continued.
WHITE HOUSE COVID ADVISER ADDRESSES CURRENT MONKEYPOX THREAT LEVEL
The ongoing COVID-19 pandemic has killed more than one million people in the U.S. since January 2020, according to the WHO.
Charity, from Virginia, says there was a lot of fearmongering around COVID-19. (Jon Michael Raasch/Fox News Digital)
Layla – born with comorbidities – said she is only moderately concerned about contracting monkeypox, but people should respect those in fear.
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“I do want to take it seriously,” Layla said. “But seeing how I first heard about it two months ago and it didn’t ramp up in the same way that COVID-19 did, I’m not going to say that I’m going to avoid going everywhere and just stay shut in my house because of it.”
A New Yorker said she doesn’t “have a lot of energy left to be worried” after enduring more than two years of the COVID-19 pandemic.
“I mean I wouldn’t want to get it, but I’m not doing anything to not get it,” she said.
Megan Myers reported from New York City and Jon Michael Raasch reported from Alexandria, Virginia.
The U.S. has reported more than 3,400 confirmed or suspected monkeypox cases, federal data showed, becoming the country with the most known infections since the onset of the global health emergency.
The rise in cases comes as the U.S. expands testing capacity, broadening the ability to spot new infections, but also as the global outbreak continues to grow. Some public-health experts said rising transmission heightens the chances a broader population will face the risk of infections as the opportunity to slow and potentially stop the outbreak is fading.
The outbreak has largely been recorded among men who have sex with men, as the virus exploits social networks among people in close contact. This is already a concern, but spreading more broadly means the potential added challenge of trying to educate and protect a broader population, health experts said.
“We are at a very critical juncture in the outbreak,” said Jay Varma, a physician and epidemiologist who directs Weill Cornell Medicine’s Center for Pandemic Prevention and Response in New York City.
The continuing spread of monkeypox has prompted the World Health Organization to declare a global health emergency. WSJ’s Denise Roland explains what you need to know about the outbreak. Photo: Kena Betancur/AFP/Getty Images
The U.S. surpassed the reported case count in Spain after recently surpassing other European countries, including Germany and the U.K. There are now at least 17,852 cases in nearly 70 countries where the viral disease doesn’t typically occur, including at least 3,487 in the U.S., which has a significantly larger population than European countries that also have outbreaks, according to the Centers for Disease Control and Prevention.
The true case count is likely significantly higher than the known count, in part due to more limited testing early on in the outbreak, and completely beating back the virus is already unlikely, Dr. Varma said. But there is still a chance through vaccinations, education and treatment to hem the virus in, slowing transmission enough to make it a very rare disease, he said.
The World Health Organization on Saturday said monkeypox is a public-health emergency of international concern, marking the first such declaration since the start of the Covid-19 pandemic in January 2020.
Another risk from a growing outbreak is that the virus will reach a U.S. animal population, creating a reservoir where it could be passed back to people, said Aileen Marty, a distinguished professor of infectious disease and outbreak response at Florida International University.
“The last thing we need is for our animals to get infected,” Dr. Marty said.
Classic monkeypox starts with flulike symptoms including fever and aches, with the later appearance of a rash usually starting on the face. In the current outbreak, doctors have described some cases in which the rash appears before a fever and other cases in which the rash remains concentrated in the genital area, for example.
Health authorities have been focusing vaccination and outreach efforts among gay and bisexual men, since the outbreak thus far has been heavily concentrated in that population. But there are also two known pediatric infections in the U.S., one in a California toddler and the other in an infant in Washington, D.C., according to the CDC.
The two cases are likely the result of household transmission and aren’t related, a CDC spokeswoman said Monday. The cases are under investigation, and both children, though symptomatic, were in good health and receiving treatment medication, she said. In the case of children, monkeypox could spread through activities like holding, cuddling, feeding and shared items like towels and bedding, the CDC said.
The virus requires close contact to spread. Health authorities haven’t reported deaths beyond Africa in the current outbreak, but there have been several deaths in two African countries since the start of the year, WHO data show.
Although there are available vaccines to combat the monkeypox outbreak they have been in short supply.
Photo:
EDUARDO MUNOZ/REUTERS
Because some countries such as the U.S. have invested in adding defenses against smallpox, which is related to monkeypox, there are already available vaccines to combat the current outbreak. Still, the vaccines have been in short supply as gay and bisexual men clamor for shots.
U.S. health authorities, criticized by some activists for not moving faster to bolster the vaccine stockpile, have said the numbers are growing. The Department of Health and Human Services says it has shipped more than 300,000 doses of the two-dose Jynneos vaccine, made by
Bavarian Nordic
A/S, to jurisdictions around the U.S. The government said it accelerated inspection for another 800,000 doses coming this summer and that there are millions of shots that are set for delivery by mid-2023, HHS said.
Supply constraints have improved, but demand still seems to be outpacing available shots, said Amanda Babine, executive director with the advocacy group Equality New York.
New York City, which recently counted more than 1,000 confirmed and presumed cases, said there are likely many more cases that haven’t been diagnosed.
Meanwhile, testing capacity, another bottleneck, has improved. With private laboratories now online, U.S. capacity recently reached 80,000 tests a week, up from 6,000 a week at the start of the outbreak, HHS said.
World Health Organization reports 92 confirmed monkeypox cases and 28 suspected ones in 12 nations as the mysterious spread continues.
The World Health Organization (WHO) says it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.
As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox were reported from 12 member states that are not endemic for the virus, the UN agency said, adding it will provide further guidance and recommendations in the coming days for countries on how to mitigate the spread of monkeypox.
“Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic,” the agency said.
‘Genital form’
Monkeypox is an infectious disease that is usually mild and is endemic in parts of West and Central Africa. Although it belongs to the same virus family as smallpox, its symptoms are milder.
People usually recover within two to four weeks without needing to be hospitalised, but the disease is occasionally deadly.
It is spread by close contact so it can be relatively easily contained through such measures as self-isolation and hygiene.
“What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world,” said WHO official David Heymann, an infectious disease specialist.
Heymann said an international committee of experts met via video conference to look at what needed to be studied about the outbreak and communicated to the public, including whether there is any asymptomatic spread, the people who are at most risk, and the various routes of transmission.
He said the meeting was convened “because of the urgency of the situation”. The committee is not the group that would suggest declaring a public health emergency of international concern, WHO’s highest form of alert, which applies to the COVID-19 pandemic.
He said close contact was the key transmission route, as lesions typical of the disease are very infectious. For example, parents caring for sick children are at risk, as are health workers, which is why some countries have started inoculating teams treating monkeypox patients using vaccines for smallpox, a related virus.
Many of the current cases have been identified at sexual health clinics.
‘You can protect yourself’
US President Joe Biden said on Sunday the recent cases of monkeypox identified in Europe and the United States were something “to be concerned about”.
In his first public comments on the disease, Biden added: “It is a concern in that if it were to spread it would be consequential. They haven’t told me the level of exposure yet but it is something that everybody should be concerned about. We’re working on it hard to figure out what we do.”
He added that work is under way to determine what vaccine might be effective.
Early genomic sequencing of a handful of the cases in Europe has suggested a similarity with the strain that spread in a limited fashion in Britain, Israel and Singapore in 2018.
Heymann said it was “biologically plausible” that the virus had been circulating outside of the countries where it is endemic, but had not led to major outbreaks as a result of COVID-19 lockdowns, social distancing, and travel restrictions.
He stressed the monkeypox outbreak did not resemble the early days of the COVID-19 pandemic because it does not transmit as easily. Those who suspect they may have been exposed or who show symptoms – including bumpy rash and fever – should avoid close contact with others.
“There are vaccines available but the most important message is you can protect yourself,” said Heymann.
