WASHINGTON – The monkeypox outbreak that has infected more than 6,600 people in the United States is a public health emergency, the Biden administration declared Thursday, a move that could make it easier to tap funding and wield the federal bureaucracy to combat the once-rare disease.
The declaration came more than a week after the head of the World Health Organization, on July 23, said the “extraordinary” situation qualifies as a global emergency.
The administration has been criticized for not moving more quickly — repeating some of the same mistakes that plagued the U.S. response to COVID-19 — and Thursday’s move is intended to help get ahead of the virus spread.
While the disease is being transmitted primarily among men who have sex with men, former U.S. Surgeon General Jerome Adams told USA TODAY July 21 it’s only a matter of time before the outbreak spreads in the population more broadly.
The declaration allows the federal government to move faster to combat the outbreak and stigma against the community of men who have sex with men, said Dr. Demetre Daskalakis, the deputy coordinator of the newly created White House National Monkeypox Response team.
“This is a very clear statement of the value of the lives of people who are in the LGBTQ community,” he said. “It also represents an important commitment by the administration to the community.”
Another example of how the Biden administration hopes to take more aggressive action is seeking to extend the reach of available vaccinations. Although supplies of the Jynneos vaccine have fallen short of demand, administration officials said they expect more to be available soon.
In addition to doses on order from manufacturer Bavarian Nordic, Dr. Robert Califf, the head of the Food and Drug Administration, said Thursday that his agency is considering changing the way the vaccine is administered.
By injecting the vaccine just below the skin, the same amount of vaccine could yield as many as five times as many doses, Califf said in the Thursday news conference. Thursday’s emergency declaration means the agency can dispense with some requirements to expedite the new approach.
The latest
- The disease, a milder cousin of smallpox, was first found in the U.S. in mid-May. It’s spread to 87 countries, 80 of which have not historically seen the disease.
- Monkeypox is transmitted person-to-person, usually through close contact with infected skin lesions or recently contaminated objects, such as sheets and clothing.
- Nearly all cases reported in the U.S. have come through male to male sexual contact, according to the Centers for Disease Control and Prevention.
- Vaccines can be used to prevent monkeypox both before and after exposure but there haven’t been enough available.
- As of Thursday, the Biden administration had shipped more than 600,000 doses of the Jynneos monkeypox vaccine across the country.
Top takeaways
Unlike COVID-19, monkeypox is not a new disease and it’s not as transmissible. But officials are running into some of the same issues in combating monkeypox that they faced at the start of the pandemic.
For example, testing for monkeypox was initially difficult in the U.S. as laboratories were not equipped for it. Today, only about 10% of the U.S. testing capacity is being used, according to CDC Director Dr. Rochelle Walensky.
Identifying cases of monkeypox through testing and then contact-tracing remains key to stopping community spread, according to WHO Director-General Tedros Adhanom Ghebreyesus. Vaccines also are an important strategy, he said when declaring the global emergency.
Why declare an emergency?
Declaring the virus a public health emergency raises awareness, frees up funding, removes some bureaucratic barriers and enables the federal government to collect more data from states on the ongoing outbreak, officials said Thursday.
It also allows the FDA to quickly change the way the vaccine is administered, vastly increasing the number of available shots.
Who’s eligible for vaccination?
The people at highest risk for infection are being prioritized for vaccination, including people living with HIV, men who have sex with men and people who are already eligible for preventive HIV therapy, Walensky said.
This includes about 1.7 million Americans, she said.
About 600,000 doses have been made available with nearly the same number due to arrive shortly, administration officials said.
“If you have the opportunity to get the Jynneos vaccine, please consider getting it immediately,” Califf said.
Delivering the vaccine to a shallower layer of the skin would allow five people to be vaccinated from the same vial now used for each person. Califf said the new route of administration is just as easy to deliver as well as safe and effective. “We’re very confident about the administration of the dose.”
The FDA will make a final decision about whether to change the shots within the next few days, he said.
What about treatments?
An antiviral called TPOXX is available to patients with monkeypox, though it has sometimes been hard to access during the outbreak.
TPOXX was initially approved to treat smallpox, which kills 30% to 50% of its victims, and has only been studied in healthy people, not those who are infected with monkeypox.
Califf said it is “critical” to collect data on how the antiviral is performing during the outbreak, and the FDA is planning a clinical trial now.
Monkeypox symptoms
Symptoms can begin to appear seven to 14 days after exposure and include fever, muscle aches, exhaustion and a rash or lesions, which can be extremely painful, with some patients requiring hospitalization. The lesions can be extremely painful, with some patients requiring hospitalization.
While it can be fatal in areas with poor medical care, five deaths have been reported worldwide, none in the U.S. outbreak.
What they’re saying
- “We don’t have the capacity we need,” Adams told USA TODAY July 21, “but we’re seeing it gradually start to build up, and experts such as myself are calling on the CDC and the federal government to do more, to increase testing, to increase vaccines and to increase communication about monkeypox.”
- “While this outbreak is spreading in a particular social network right now, I think we’ve messaged from the start that there could be cases that occur outside those networks and that we need to be vigilant for it and ready to respond,” said Jennifer McQuiston, the deputy director of the Division of High Consequence Pathogens and Pathology at the CDC.
- “We continue to marshal forward the tools we need to make sure we can take on monkeypox and keep it from spreading to the point of becoming endemic,” said Xavier Becerra, secretary, Department of Health and Human Services.
Want to know more? Here’s what you missed
Early opportunities missed to stop the outbreak: After repeating early COVID mistakes, US now has the world’s biggest monkeypox outbreak.
Avoiding stigma: Monkeypox is spreading through sex, but it’s not an STI. Why calling it one is a problem.
Monkeypox now a ‘global emergency’:US needs to step up, says former surgeon general.
Monkeypox is not a gay disease:But LGBTQ leaders say they need more help for gay men and everyone else
Here’s what to know:As monkeypox outbreak spreads, CDC pledges more vaccines.
More:Public health clinics running out of monkeypox vaccine as lines form and systems crash
Contributing: Rebecca Morin, Elizabeth Weise.
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