One possible frame from which to examine the question is "Since we have no functioning public system that competently fights infectious diseases, is this a reason to short the stock market and stockpile food and so on?"
This frame is just looking mostly at a biological entity as a biological entitiy. If "sweeping through our population unresisted" is biologically what it would naturally do (since it probably will be unresisted) then... it might do that?
But if not, not. It depends on the biology the epidemiology and also maybe the responses from institutions to try to predict that. I'm pretty blackpilled on institutions at this point, but maybe we'll get lucky and the disease itself will not have the oomph within itself to actually hurt the herd?
So given its positively known biological capacities, and currently not have strong evidence that this is decisively what's going to happen.
Thus, I'm not gonna short the stock markets yet (and so on). Not for now anyway? I'm not yet allocating many resources to it myself, so my own answer practical here so far is like: "No, don't start prepping... (yet)?"
Another possible frame is: "Imagining that one is setting policy for a hypothetical competent public health system that generically prevents all reasonably possible very bad infectious diseases (aiming to eradicate many of them, of course), by always taking preventive actions that would stop every disease (based on each one's worst possible disease properties that have not been ruled out), so that by following the policy it would be the case that no actual disease ever got through, but also the system didn't waste a lot of money achieving this outcome... in that case, have observables been in fact observed that should trigger some of these generic policies?"
Applying this filter, over my personal state of knowledge, right now, for this second question, the result I get is:
YES, if a competent public health system existed with my current beliefs (which include huge error bars, and highly limited data right now) then a hypothetically competent public health system would already be acting very fast right now.
Note that I'm not in charge of US Public Medicine (yet?) and if I was then it would be responsible to learn a lot more, very fast, and then use that knowledge to make a detailed and positive case for why action or worry is not justified. I would be pulling all-nighters based on this if I had that responsibility, but I don't, so I'm not.
Instead I'm just going to drop a few bits of evidence that seem relevant to me.
Question #1: Is the disease horrifically shitty?
Answer #1: Yes. It has some body horror (with pustules and scars and stuff) and a mortality of probably ~1%. Higher mortality in children. This mostly from priors about monkeypox, which we know about from decades of study. (It could be a mortality rate of 0.1% all in by the end, but it also could be 2%. If you get it, and you're still alive 5 weeks after symptom onset, I think... maybe you lived? This means it could take 5 weeks to get a good idea of the mortality rate for really real.)
Question #2: How does it transmit?
Answer #2: Assume aerosol. Versions of monkeypox can transmit by aerosol, and so everyone working with it (running quarantines, doing medical care, etc) should make that assumption and wear anti-aerosol PPE like they were dealing with measles or covid. This might change with more data.
Question #3: Versions of it? What about THIS version?
Answer #3: I was going to say that maybe no one has sequenced this thing yet... but then my google-fu kicked in, and more searching turned up a preliminary sequencing report for a draft genome that has 92% coverage, and enough data to align against known strains.
This one falls clearly among "the versions with mortality more like 1%" and is not similar to "the example with a 10% mortality" so that's nice.
That said, it has more SNPs of edit distance away from the normal ones than might be expected? So maybe it has some tricks up its sleeve that are worthy of study? Looking at the phylogentic tree built using the draft sequence (see paper linked above for details and full image, this is a zoom in), OUTBREAK_2022 clearly clusters with other light blues (that is: the west africa strain with lower mortality) BUT is farthest to the right because it has the most mutations.
Question #4: Is the R0 greater than 1?
Answer #4: Probably yes. Looking at the situation in Spain suggests GROWTH inside of localized communities. This article seems to be gleaning numbers from relatively direct reports that include: a sense of time, with few early patients, and then, later in time, more patients.
Quotes that give this suggestion include Portugal:
Portugal has confirmed the presence of the virus in five patients and has another 20 under study
The Community of Madrid, for its part, has put the number of patients whose symptoms suggest that they have contracted the disease at 22 , in addition to the seven already confirmed by PCR.
Then a geographic distribution that suggests that travel is occurring, with bigger (earlier seeded?) places away from the capital having more than smaller (later seeded?) places:
Four hospital sources consulted by EL PAÍS raise the number of patients treated in the last two days in hospitals in the region to "between 40 and 50". There are 16 patients from the Clinical Hospital pending confirmation of results, a dozen from the Twelve of October and several cases in the Gregorio Marañón, Ramón y Cajal and Fundación Jiménez Díaz hospitals.
These are enough OBSERVATIONS to allow me to infer a mechanistic process (of a really icky disease) that was able to generate viable human-to-human transmission via exponential growth.
Does the R0=1.1 here, or does R0=3?
I have no idea.
In the absence of knowing, it it correct policy (facing a possible exponentially growing monster that is currently small and weak but which might become large and strong in naively surprising ways to people who don't know what an exponential function is) to assume the number is higher until competently and swiftly determined to be lower and less worrisome.
But even R0=1.1 is worrisome.
The correct policy is to CAUSE the number be LOWER (if active causation is needed to achieve this), like R0=0.8 or even less than that, and then persist in that policy until the number of cases is zero... otherwise you're just dragging out the big sadness (all the individual, ad hoc, confused coping of many individuals, damaging the economy, while trapped in the fog of a hypothetically avoidable battle against mere biology) over a longer period of time.
The costs of ad hoc individual avoidance is where the huge costs pile up on the members of the public who Public Medicine officials have a duty to serve (in Lawful Good countries, anyway).
The US I think is maybe currently Chaotic Neutral? The US seems to mostly not believe in policies or causation anymore? Or to generally give a fuck, because the bureaucrats are immune from voter backlash and hold the voters in contempt and basically seem to lie to us by default while being incapable of reasoning about object level mechanisms, risks, costs, benefits, etc... For now?
I kind of hope that the 2022 and 2024 election cycles deliver new leaders who win on infectious disease policy and then clean things up... but that doesn't necessarily help us until 2023 or 2025.
Question #5: Can we effectively test for it?
Answer #5: I don't know. Everything I've heard so far is PCR testing of obviously symptomatic people, which has all kinds of slowness built into it.
I'm not sure what body compartments contain the virus and how far into the incubation period one has to get before various tests work on it.
If there are no tests, and no knowledge of test/incubation interactions then the only way TO BE SURE to prevent it from getting into a country and spreading in the community would be to shut down air travel from infected countries to my country.
Absent more detailed information, and going just from "a horrific infectious disease with R0>1 has started showing up among international travelers" I would be shutting down flights from infected countries, and putting the burden of proof on individual travelers to show positively that they are not infected during the "early confusion" period.
A fully adequate thing is probably to have people test before the flight, get diverted to a 40 quarantine after the flight, and then test out of quarantine (with positive tests diverting to isolated medical care).
I have LOOKED and almost every virus has a shorter maximum incubation period than 40 days, so that would probably be adequate, unless dealing with a bioweapon or something that was someone designed to stretch out the incubation for the sake of making it harder to detect or stop or be sure.
If you don't want to put up with 40 days in quarantine... maybe you shouldn't be flying anywhere you can't drive at the possible beginning of a possibly terrible pandemic?
Covid was handled poorly in MANY ways. One of the ways it was handled poorly is that quarantines were 14 days long despite early evidence of 27 day incubation in some cases.
This won't necessarily destroy the planet or even hurt that many people. Maybe 1000 total infections ever in the world and then somehow just... done? One can hope.
Don't personally worry about it IRL yet, probably?
But also another biological disaster is not RULED OUT by the things I know, and therefore I would personally be freaking the fuck out out if I worked at the CDC and it was my responsibility to respond to deal every similar potential problem with systematically adequate levels of caution to generate systematically acceptable outcomes over all similar categories of initially observable risk.
Obviously sane things to do (at a high policy level) include:
It probably costs little to start vaccinating critical people right now with "best bet" vaccines, including people in the transporation and medical industries.
Starting challenge trials with all the known plausible vaccines against this specific disease, plus quite a few control patients (assuming informed consent and high pay) with exposure and no vaccine, with daily testing and so on, to figure out which vaccines might be perfect, and how soon people test positive if they are going to test positive.
This is PROBABLY an OVERREACTION. However the whole point of having the capacity for abstract mechanistic reasoning in service of "getting good outcomes in the world using science and policies and stuff" is that you do cheap efficient "correct" overreactions every time, and it only costs millions to overreact on the little stuff, but it saves trillions of dollars to avoid the really bad pandemics, and therefore DOING IT RIGHT EVERY TIME probably comes out "worth it on average".