The world has become a bitch to deal with. Every single day, we put most of our energy into survival. We're not just trying to survive collapse, a slow motion doom that includes the rampant spread of disabling diseases. We're trying to survive other humans and their ignorance.

A decade ago, life partners used to get together over the kitchen table and talk about the nitty gritty details of the future. They talked about things like life insurance, college savings, and retirement plans. In 2024, my partner and I talk about what to do if the power goes out during a tornado in the middle of a heat wave in the middle of a pandemic. We talk about what to do if flooding disrupts the drinking water supply. These aren't hypotheticals fretted over by fearmongers. Over the last few years, it has all happened.

They happened to us.

I know several writers who are struggling with Long Covid. Not one. Not two. Not three. I know at least half a dozen.

1918 pandemic influenza virus and Streptococcus pneumoniae coinfection results in activation of coagulation and widespread pulmonary thrombosis in mice and humans

A large post-covid global surge in common communicable diseases including influenza, measles, tuberculosis, and whooping cough has been identified in a new analysis of data from 60 organisations and public health agencies.

Since the beginning of 2022, 44 countries have experienced a 10-fold increase in the incidence of at least one of 13 infectious diseases compared with a pre-pandemic baseline, according to the analysis1 by the UK based disease forecasting firm Airfinity and the US news website Bloomberg.

Experts said that with no historical precedent, they can’t fully explain the resurgence in infectious diseases.

Jeremy Farrar, World Health Organization chief scientist, told The BMJ, “We’ve not had an acute, fast moving, and devastating pandemic in the modern scientific era. The last major devastating pandemic was in 1918 when there was no vaccination, no diagnostics or treatments. We’re in new territory here.”

Airfinity scientists said, however, that declining vaccine rates during the pandemic, notably for children—because of disrupted supply chains and limited immunisation during lockdowns—is likely to be a major factor for measles, polio, tuberculosis, and whooping cough, all classified as vaccine preventable diseases.

Data from Unicef show that 25 million children missed at least one dose of the three shot diphtheria, tetanus, and whooping cough vaccine in 2021, with just 81% getting all three doses, the lowest level in 13 years.

Whooping cough cases in China in the first four months of 2024 were 45 times that for the whole of 2023. Spain has already seen a 134% post-pandemic increase in cases of whooping cough, with France, Norway, and the UK also expected to surpass pre-pandemic levels in the next few months, according to the report. “Current outbreaks could be driven by pressure on the virus to gain adaptations that may impact the effectiveness of current vaccines,” said Piroeva.

Measles is another disease on the rise. More than 1.8 million children in 20 countries in Europe missed their measles jab between 2020 and 2022, with vaccination rates falling below 90%. European countries saw a 30-fold spike in measles cases in 2023, the study reported.

Measles was declared eliminated in the US in 2000 but the study reports it’s now making a comeback in more than 20 American states.2 Incidence is also rising in the UK.3 In Austria measles incidence in the first five months of 2024 is 190% higher than the pre-pandemic peak, according to the study.

Speaking at the report’s launch, Farrar said rebuilding society’s trust in vaccines is essential. “While the world is out of the acute public health emergency phase, the pandemic has had second order effects including a growing anti-vaccine movement,” he said. “We can’t just say some people are anti-science or anti-vaccine and forget them. We’ve got to make the case for science and for vaccines and explain their importance.”

Influenza is one of several diseases not categorised as vaccine preventable where incidence is also increasing. The number of cases in the last flu season was 75% higher in Europe and 28% higher in the US compared with 2019. Cases of respiratory syncytial virus have nearly doubled in parts of Australia compared with a year ago. This may be because of immunity debt following the protection from routine pathogens during the pandemic lockdowns, leaving people more vulnerable as life got back to normal.

Due to limited surveillance and testing in the DRC (only about 20% of suspected cases are ever confirmed), we only have a limited understanding of the severity or transmissibility of this new threat.  The WHO reported last weekend:

• Mpox case fatality ratio in the Democratic Republic of the Congo in 2024 is 0.5% among confirmed cases (25 deaths out of 5160 cases) and 3.3% among suspected cases (717 deaths among 21 835 cases).

While the risks of sustained community spread of Mpox Clade Ib outside of Central Africa is currently believed to be low (see ECDC Assessment), we are dealing with limited data, and the reality that this virus continues to evolve.