U.S. Declares Monkeypox a Public Health EmergencyAugust 5, 2022
The Biden administration declared a public health emergency (PHE) for monkeypox, signaling new urgency as cases rise in the U.S.
Since the first case was identified in the U.S. in May, the total number of cases has risen to 6,617, according to the latest data from the CDC. It’s a sharp increase from less than 5,000 last week.
“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,” HHS Secretary Xavier Becerra said in a press briefing Thursday afternoon.
Officials said they would expand the number of testing sites across the country, and accelerate the distribution of vaccines and treatments.
HHS Assistant Secretary for Preparedness and Response Dawn O’Connell, JD, said the U.S. will receive another 150,000 doses of Jynneos, the smallpox vaccine used to prevent monkeypox, for the Strategic National Stockpile in September. This is up from a total of 1.1 million doses allocated to states and jurisdictions after a substantial increase announced last week.
FDA Commissioner Robert Califf, MD, said that HHS is considering a new approach to distributing the Jynneos vaccine that would allow healthcare providers to administer up to five doses from a single vial. The vaccine would be administered via intradermal, rather than subcutaneous, injections.
The World Health Organization already declared monkeypox a public health emergency of international concern (PHEIC) last month, and several states — including New York, California, and Illinois — declared their own emergencies to better respond to the outbreak. New York has 1,666 cases, California has 826, and Illinois has 547 cases. Texas, Florida, and Georgia follow close behind.
Some cities — including New York City, San Francisco, and San Diego — have also declared similar emergencies. All but two states have confirmed cases.
The PHE designation will allow the HHS Secretary to make certain funding available to respond to the emergency, modify certain Medicare, Medicaid, and other health program rules to make items and services more readily available, appoint temporary personnel to deal directly with the emergency, and change certain rules around telemedicine.
In addition to potentially increasing access to care for those infected, CDC Director Rochelle Walensky, MD, MPH, said, the PHE “declaration will also help us continue to expand public health ability to expedite data sharing.”
Public health experts and LGBTQ advocates have criticized the U.S. response to monkeypox, which they say has made testing unnecessarily complicated, and vaccines and treatments difficult to access, leaving the infected to deal with what can be excruciating pain for days, in some cases.
One of the criticisms has been that the U.S. response to the monkeypox outbreak was too slow, with HHS waiting more than 3 weeks after the first confirmed case to order vaccines in bulk. Clinics and public health entities across the U.S. have since noted the limited supplies of vaccines, or run out all together. In New York, eligibility for vaccines is still limited to those who have already had a high-risk contact with others.
But Biden administration officials said they are communicating directly with public health officials, community health centers, and other community organizations serving the LGBTQ+ community — ramping up efforts to encourage broader use of testing, provide training for sexual health providers on contact tracing, and disseminate information to affected communities on limiting their risk for monkeypox.
“I think from the LGBTQ perspective, this is a very clear statement of the value of the lives of people who are in the LGBTQ community,” said Demetre Daskalakis, MD, the White House National Monkeypox Response Deputy Coordinator. “It’s an opportunity for us to really be clear and to leverage the emergency [declaration] to move faster and also work, as we have been, to make sure our messaging is tight, and is intentionally designed not only to be stigma free, but to counter stigma.”
On Tuesday, President Biden appointed FEMA regional administrator Robert Fenton as the National Monkeypox Response Coordinator in an effort to increase access to tests, vaccines, and treatments.
At the briefing, Fenton noted that testing capacity has increased from 6,000 tests per week to 80,000 tests per week since the start of the outbreak.
“We’re taking critical steps to make treatments more available to more people, but this virus is moving fast,” he said. “This is a unique outbreak that is spreading faster than previous outbreaks.”
The U.S. so far has delivered more than 602,000 doses of the smallpox vaccine, Jynneos, around the country. Clinicians and pharmacists must request the antiviral tecovirimat (Tpoxx) from the Strategic National Stockpile via the CDC, making access complicated. According to CNN, only about 223 people had been treated with the antiviral as of July 22.