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Monkeypox officially a public health emergency, HHS chief Becerra says

The emergency declaration makes available more tools to combat the virus, which is spreading across the country and the world

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Illustration by Alex Cochran, Deseret News

Monkeypox is officially a public health emergency in the United States.

Xavier Becerra, secretary of the U.S. Department of Health and Human Services, made the declaration Thursday afternoon during a media briefing, alongside White House monkeypox response coordinator Robert Fenton and other officials.

“We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus,” Becerra said.

Fenton noted the outbreak has been spreading faster than previous occurrences and pledged commitment “to pulling every lever to combat this virus.”

The declaration enables a more robust and efficient deployment of resources, including vaccines, testing, treatment and education. It allows financial resources to be used for both treatment and vaccine development and evaluation, frees up emergency funds and makes it easier to hire more workers to address the emergency.

Fenton said the declaration will also make it easier to get different jurisdictions to share data about the outbreak.

The World Health Organization declared the monkeypox virus a public health emergency of international concern on July 23; just two other viruses, COVID-19 and polio, currently have this designation. The international health agency reports cases of monkeypox in at least 78 countries, not including western and central Africa, where the disease is endemic.

Here at home, several states and local jurisdictions have already made their own emergency declarations, including New York, Illinois and California, as well as cities including San Francisco. Those areas have all seen a significant increase in cases.

The declaration comes as case numbers are climbing rapidly. The Centers for Disease Control and Prevention monkeypox case map shows 6,617 cases, with only Wyoming and Montana not reporting any, as of 2 p.m. Aug. 3. Becerra said that last week in the U.S. there were fewer than 5,000 cases.

The declaration had been expected and some critics said the Biden administration has been moving too slow on many aspects of managing the outbreak, including calling it an emergency. Politico reported Thursday that the Department of Health and Human Services had been circulating a “decision memo” through U.S. health agencies and had received “broad support from agency heads.”

About the virus

Monkeypox is a viral infection that has seldom been seen in a large number of cases outside of Africa.

While some monkeypox outbreaks have been linked to close contact with animals that are infected, this outbreak is different. The majority of cases in this outbreak are among men who have sex with men. But public health officials warn that the virus poses risk to anyone because it’s easily spread through close contact with infected skin or materials and surfaces and through respiratory and mucous secretions.

Cases have already been confirmed in several pregnant women and at least two children, indicating broader community spread.

Centers for Disease Control and Prevention director Dr. Rochelle Walensky said between 1.6 and 1.7 million people are at highest risk of monkeypox infection right now. 

The early symptoms include fever, headache, muscle aches, swollen lymph nodes, chills and exhaustion. Typically, symptoms are mild. In the next stage, a rash develops — often on the face — that can spread to the chest and hands. The pus-filled lesions eventually scab over and fall off. Sometimes, there are serious, even deadly complications.

Smallpox vaccines, antivirals and vaccine immune globulin can all be used to combat monkeypox.

U.S. efforts to contain this outbreak have focused on vaccination, testing, treatment and education, officials said during the conference call.

Mustering tools

Although large shipments of vaccine have been made available to state and local health departments, with more than 602,000 doses delivered already throughout the country and more on the way, critics have said that’s not nearly enough and the U.S. could lose its chance to defeat the virus.

Dr. Robert Califf, U.S. Food and Drug Administration commissioner, said the goal has always been to vaccinate as many people as possible and his agency is considering and will decide within a few days whether to change the way the Jynneos smallpox/monkeypox vaccine is delivered to allow more people to receive it.

Right now, the vaccine is given as a subcutaneous shot. But FDA experts believe that a bottle of vaccine could instead deliver five doses by intradermal injection, which essentially amounts to creating a little pocket of vaccine just below the skin surface. That would not sacrifice efficacy or safety, he said. That would effectively quintuple the vaccine dose supply.

If that decision is made, the intradermal injections would be allowed under an emergency use authorization, he added.

Califf encouraged those who have the opportunity to be vaccinated to do so immediately.

Officials also said Thursday that testing capacity is far greater than the demand at this time, with the capacity to administer 80,000 tests a week “and growing,” Becerra said. Right now, about 8,000 tests are done each week.

And he said that some 14,000 tecovirimat (usually called TPOXX) treatments have been distributed, but the Strategic National Stockpile has 1.7 million doses if needed.

What happens if they can’t contain the outbreak?

Becerra sounded a hopeful note, promising to “marshal forward the tools that we need to make sure that we can take on monkeypox and keep it from spreading to the point of becoming endemic.”

He said the U.S. has a growing number of vaccines and will continue to receive even more. There’s more than enough treatment to handle the need. And with the expanded access to testing, “we have all the infrastructure in place to do this right,” he said, noting growing partnerships not only in public health, but in the LGBTQ community that’s been most affected so far by the outbreak.