How are covid-19 symptoms changing?With new variants and a changing landscape of vaccination and immunity, what do the symptoms of covid-19-and our understanding of them-now look like? Mun-Keat Looi reports Mun-Keat Looi international features editorHow have covid symptoms changed since the start of the pandemic?In the short space of a few years we've seen surprising changes in the way covid-19 presents. At the start of the pandemic the first commonly reported symptoms were loss of smell and taste, followed by shortness of breath and a cough, followed by vascular injuries, says David Strain, senior clinical lecturer at the University of Exeter Medical School. "That became the standard that we expected," he says.

Japan has declared its second state of emergency regarding covid-19, as the number of daily infections surged to seven times that of the first and Tokyo hospitals reported nearly 80% occupancy.

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The SAGE adviser and Wellcome Trust director tells Mun-Keat Looi how the UK government acted too slowly against the pandemic, about the perils of vaccine nationalism, and why he is bullish about controlling covid variants

Which authorities have declared monkeypox a public health emergency?The World Health Organization declared monkeypox a public health emergency of international concern (PHEIC) on 24 July. 1 Since then only the United States, which accounts for more cases than anywhere else in the world, has done similarly. The Biden administration made the call on 4 August, just days after the cities of New York and San Francisco announced their own, in a bid to free up access to funding and expand the workforce and vaccines, as well as raise public awareness of the dangers.At the time of writing, more than 35 000 monkeypox cases have been reported in 92 countries worldwide, with 12 deaths. "Almost 7500 cases were reported last week-a 20% increase over the previous week, which was also 20% more than the week before," said WHO's director general, Tedros Adhanom Ghebreyesus, at a press briefing on 18 August. Almost all cases were from Europe and the Americas.

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