Biden administration considering public health emergency

A Northwell Health employee holds the monkeypox vaccine at Cherry Grove in Fire Island, New York, where the monkeypox vaccine was given on July 14, 2022.

James Carbone | Newsday | Getty Images

A senior White House health official said Friday that the Biden administration is considering declaring a public health emergency in response to the growing outbreak of monkeypox.

Dr. Ashish Jha, the White House’s Covid response coordinator, said the administration is looking at how a public health emergency declaration might bolster the United States’ response to the outbreak.

“There is no final decision on this and I am aware of it,” Jha said. “It’s an ongoing conversation, but it’s very active at HHS.”

Secretary of Health and Human Services Xavier Becerra has the authority to declare a public health emergency under the Public Health Services Act. The announcement could help mobilize federal financial assistance for the outbreak response.

The United States has reported more than 2,500 cases of monkeypox so far in 44 states, Washington, D.C., and Puerto Rico, according to the Centers for Disease Control and Prevention. The largest outbreaks were in New York, California, Illinois, Florida, the capital and Georgia.

The Biden administration’s response to the outbreak has come under congressional scrutiny as infections mount. Fifty Democratic lawmakers, in a letter to President Joe Biden this week, called on the administration to declare a public health emergency in response to the outbreak.

In a letter to HHS Secretary Becerra, Patti Murray, chair of the Senate Health Committee, said she was concerned about the US response to the outbreak. Some patients and health care providers do not have the information and resources they need to test for monkeypox and respond to an outbreak, Murray said.

CDC Director Rochelle Walinsky said last week that demand for vaccines is outstripping supply. Many people struggle to get vaccinated amid long lines outside clinics.

Jha told reporters Friday that the United States has shipped more than 300,000 doses of the monkeypox vaccine called Genus to city and state health departments so far. The Food and Drug Administration is in the process of approving an additional 786,000 doses stored at the Bavaria Nordic plant in Denmark for distribution in the United States.

Jha said some of those shots have begun shipping and will arrive in the US this week and next week. Jha said the doses can be delivered to city and state health departments once FDA authorization is completed. The US has also ordered another 5 million doses that will be delivered through mid-2023, according to HHS.

Monkeypox is spread primarily through skin-to-skin contact during sex. Currently, men who have sex with men are more susceptible to infection, but anyone can catch the virus through close physical contact. People generally recover within two to four weeks, but the virus causes lesions that can be very painful. No deaths have been reported in the United States

On Friday, the CDC confirmed the first two cases of monkeypox in children. One case is for a toddler in California, and the other is for a non-resident infant in the United States. The cases are unrelated, and children likely contracted the virus because it was transmitted indoors, according to the Centers for Disease Control and Prevention.

Children are healthy and receiving antiviral treatment, according to the CDC. Dr. Jennifer McCuston, a CDC official, told reporters Friday that the health agency is working to make it easier for doctors to prescribe tecovirimat to patients.

Prescribing tekovirimat for monkeypox comes with an extra layer of bureaucracy at the moment because it is FDA-approved only for smallpox. Monkeypox belongs to the same family of viruses as smallpox, but it causes milder disease.

More than 97% of monkeypox patients who provide demographic information are gay, bisexual or other men who have sex with men, McKeston said.

“While this outbreak is spreading to a particular social network at the moment, I think we’ve been sending messages from the start that there may be cases happening outside of those networks and that we need to be vigilant about them and be prepared to respond to them and send messages about them,” McCuston told reporters.

The United States has the capacity to run 80,000 monkeypox tests a week after bringing in several commercial labs this month, according to the CDC. But the tests scan for lesions caused by the virus, which can take weeks from initial exposure to develop. This means that the United States likely does not have an accurate picture of how many people are infected because patients can only be tested after symptoms appear.

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