The odd thing about Monkeypox right now is it's increasing concentration in America
At the current rate, the United States will very soon constitute 50% of total recorded monkeypox cases in the world, despite being <5% of the world’s population. This is a surprising and interesting fact that needs to be discussed. Though I’m sure some people in media and science are discussing this, I haven’t seen that much talk around it, and a few Google searches didn’t reveal anything directly on topic.
To get an intuitive sense of this, here’s logarithmic Monkeypox cases in the US:
By contrast here it is in the UK:
But looking through it seems this is a pattern repeated in many (though not all) places. Monkeypox has largely plateaued in many countries, but is logarithmically increasing in the US.
Of course there are important exceptions. There is no plateau yet in Brazil, for example.
The rapid expansion of the proportion of global cases in the US raises the question why?
The two most obvious conjectures:
The US response is uniquely bad
The US is, due to some aspect of its demography or sociology, uniquely vulnerable to the disease.
Of course there are other possibilities- e.g. a more contagious strain is spreading in the US.
I feign no hypotheses. Just pointing out a trend that I haven’t seen much discussed.
Edit: Someone’s going to argue that it might be that the United States is just better at picking up cases However- assuming plausible parameters- that hypothesis can’t explain the plateauing pattern in numerous first-world countries amply equipped to detect it.
Edit x2: Let me add another hypothesis. A commenter suggested that we shouldn’t get worried about this until the US cumulative cases per million exceeds that of other countries. This is a good point, and suggests to me another hypothesis: The US is like other first-world countries, but a bit delayed. It’s about to hit the plateau stage.
You left out the possibility that the way the U.S. tests or records cases as a whole is significantly different. I don't pretend to know why this would be, but it's not inconceivable, right?
By the way, I haven't had the chance to dip into this blog too often, but whenever I do I'm truly impressed by the level of analysis and insight, and your candor. Not to mention, your generosity in sharing your writing for free. It's a terrific Substack and I always mention it to friends when I'm in the business of making recommendations. Thanks for all the effort you put in!
Brazil also had a huge anti-vax movement, did it not, just like the US? It seems plausible that both just have much lower compliance with public health measures than Euro countries, for reasons of national character.
Also, both have highly emancipated gays with big party scenes. Other countries that have low compliance with public health measures might tend to repress their gays a lot more.
Seems to me it's the intersection of highly liberated gays and low general compliance with public health measures that most plausibly explains the disease spreading in both the US and Brazil, but not Europe or the far East.