WHO warns ‘high’ risk of monkeypox in Europe as it declares health emergency

The World Health Organisation on Saturday declared the monkeypox outbreak, which has affected nearly 16,000 people in 72 countries, to be a global health emergency -- the highest alarm it can sound.

Director-General of the World Health Organisation (WHO) Tedros Adhanom Ghebreyesus
Director-General of the World Health Organisation (WHO) Tedros Adhanom Ghebreyesus said he assessed the risk of monkeypox in the European region as high. Ludovic MARIN / POOL / AFP

“I have decided that the global monkeypox outbreak represents a public health emergency of international concern,” WHO chief Tedros Adhanom Ghebreyesus said at a press conference.

He said a committee of experts who met on Thursday was unable to reach a consensus, so it fell on him to decide whether to trigger the highest alert possible.

“WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region where we assess the risk as high,” he added.

Monkeypox has affected over 15,800 people in 72 countries, according to a tally by the US Centers for Disease Control and Prevention (CDC) published on
July 20.

A surge in monkeypox infections has been reported since early May outside the West and Central African countries where the disease has long been endemic.

On June 23, the WHO convened an emergency committee (EC) of experts to decide if monkeypox constitutes a so-called Public Health Emergency of International Concern (PHEIC) — the UN health agency’s highest alert level.

But a majority advised Tedros that the situation, at that point, had not met the threshold.

The second meeting was called on Thursday with case numbers rising further, where Tedros said he was worried.

“I need your advice in assessing the immediate and mid-term public health implications,” Tedros told the meeting, which lasted more than six hours.

A US health expert sounded a grim warning late on Friday.

“Since the last #monkeypox EC just weeks ago, we’ve seen an exponential rise in cases. It’s inevitable that cases will dramatically rise in the coming weeks & months. That’s why @DrTedros must sound the global alarm,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.

“A failure to act will have grave consequences for global health.”

And, on Saturday, he called for “a global action plan with ample funding”, saying there was “no time to lose”.

Warning against discrimination
A viral infection resembling smallpox and first detected in humans in 1970, monkeypox is less dangerous and contagious than smallpox, which was eradicated in 1980.

Ninety-five percent of cases have been transmitted through sexual activity, according to a study of 528 people in 16 countries published in the New England Journal of Medicine — the largest research to date.

Overall, 98 percent of infected people were gay or bisexual men, and around a third were known to have visited sex-on-site venues, such as sex parties or saunas within the previous month.

“This transmission pattern represents both an opportunity to implement targeted public health interventions, and a challenge because in some countries, the communities affected face life-threatening discrimination,”
Tedros said earlier, citing concern that stigma and scapegoating could make the outbreak harder to track.

The European Union’s drug watchdog on Friday recommended for approval the use of Imvanex, a smallpox vaccine, to treat monkeypox.

Imvanex, developed by Danish drugmaker Bavarian Nordic, has been approved in the EU since 2013 for the prevention of smallpox.

It was also considered a potential vaccine for monkeypox because of the similarity between the monkeypox virus and the smallpox virus. 

The first symptoms of monkeypox are fever, headaches, muscle pain and back pain during the course of five days.

Rashes subsequently appear on the face, the palms of hands and soles of feet, followed by lesions, spots and finally scabs.

READ ALSO: WHO says European festivals should go ahead despite monkeypox risk

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EXPLAINED: What is a Wahlartzt in Austria?

Going to a Wahlarzt, or an 'elective doctor', comes with a higher price but can also provide benefits. What are the differences between a public and elective doctor and how can you get costs refunded if you choose a Wahlarzt in Austria?

EXPLAINED: What is a Wahlartzt in Austria?

In Austria, there are many different healthcare options available, as doctors can choose to have a contract with public health insurance or not. An “elective” doctor, also known as Wahlarzt, is not connected to public insurers such as ÖGK and SVS, but a “contract doctor” is. But why does this matter, and what does it change in health services?

Physicians linked to the Wahlarzt system typically practice in private settings, in private clinics, hospitals or in their own practices.They are independent and have the possibility to create their own schedules, fees, and treatment plans. If you choose to visit a Wahlarzt, you need to be prepared for out-of-pocket expenses, as many services are not covered by mandatory health insurance.

A contract doctor, on the other hand, gets paid directly by the public insurance but then has their fees set by them as well (as a patient, you only present your e-card and won’t have to pay anything upfront). They need to follow some strict regulations set by the insurance companies and states, including how many hours a week their offices are open (usually around 20 hours a week, but they must offer appointment times in the mornings, afternoons and evenings).

READ MORE: How the Austrian healthcare system works

Pros and cons

Since a Wahlarzt sets their own fees (and they tend to be higher than the insurance doctors), you typically experience shorter waiting times and have more time with the doctors. Facilities are often more modern, and they can provide more personalised treatment plans. 

Services from a Wahlarzt physician also come with a higher cost, and even if a portion is reimbursed by a patient’s public health fund, the amount can vary. Additionally, patients are required to pay the full price at the time of the appointment, making the service less accessible to everyone.

READ ALSO: Everything foreigners need to know about the Austrian healthcare system

How can I get a refund for a Wahlarzt appointment?

In general, when receiving medical services from a Wahlarzt, you are likely to be reimbursed by your insurance fund after the treatment.

The amount of money you can get back if you go to a Wahlarzt in Austria varies depending on several factors, including your health insurance coverage and the specific services provided by the Wahlarzt.

For example, with the most common public insurance, ÖGK, around 80 percent of the amount that ÖGK would have spent if the doctor were linked to the public system is reimbursed.

READ ALSO: What you need to know about Austria’s new healthcare reform

It is important to note that this does not correspond to 80 percent of your medical bill but 80 percent of what ÖGK would have paid for your treatment at a public doctor, which is significantly lower than the amount listed on your bill.

Getting the reimbursement is relatively easy – you can do it online by submitting the doctor’s invoice and a paid fee note (proof of payment) to your health insurance provider. ÖGK’s page is HERE. Some people choose private insurance in addition to the mandatory public one to cover the costs of their Wahlarzt visits. In those cases, usually, you first pay the doctor the full fee. Then, you submit an invoice to the public health insurance and wait until you receive the refund from the public insurance.

Finally, you submit the documents from the doctor and from the public insurance to the private insurance to receive the remaining amount refunded to your bank account.