Monkeypox!!!
What this video covers
Recorded in May 2022, in the first weeks of the multi-continent mpox (then called monkeypox) outbreak, this is a brief six-minute commentary in which Dr. Vinay Prasad reacts to something specific: a tweet from the New York City Health Department saying “masks can protect against” monkeypox — effectively advising community masking. His objection is methodological rather than epidemiological: blanket population recommendations, he argues, need evidence or at least an ongoing effort to generate it, and masking guidance should not be reflexively imported from COVID-era habits to a virus spreading through close contact. “Can we at least this time,” he asks, “do some evidence-based medicine?”
Prasad acknowledges the genuine uncertainty — nobody knew whether the outbreak would fizzle or explode — and invokes Nassim Taleb’s point about fat-tail risk in infectious disease as a reason for humility rather than dismissal. What he objects to is what he calls “COVID mania”: reaching for the same population-wide playbook because masking had become reflexive. He notes that sensible measures for this virus were different in kind — ring vaccination around exposed contacts, contact tracing, and clarifying how well the smallpox vaccine worked against it — and says he brushed up on all of them. His recurring proposal, repeated here: implement interventions in staggered, step-wedge or cluster-randomized fashion so the response itself generates evidence, rather than spending — as with COVID, in his telling — tens of trillions of dollars and learning nothing. The video is best understood as a real-time marker of Prasad’s role in 2022: a prominent physician-commentator applying his evidence-based-medicine framework to each new public-health episode as it unfolded, and pushing back against what he saw as reflexive maximalism.
Key points
- Recorded May 21, 2022, during the earliest phase of the global mpox outbreak, the video is a short real-time reaction rather than a deep evidence review.
- Prasad reacts to a New York City Health Department tweet advising that masks can protect against monkeypox, asking: “can we at least this time… do some evidence-based medicine?”
- He argues blanket population recommendations need evidence, and that COVID-era masking reflexes should not be imported to a virus spreading through close contact — a reflex he calls “COVID mania.”
- He says appropriate tools for this virus were different in kind: ring vaccination of exposed contacts, contact tracing, and clarifying smallpox-vaccine effectiveness.
- His recurring proposal: implement interventions in staggered, step-wedge or cluster-randomized fashion so the response itself generates evidence.