The Washington Post

Monkeypox is a public health emergency, HHS’S Becerra officially declares

- BY DAN DIAMOND

Health and Human Services Secretary Xavier Becerra declared the monkeypox outbreak a public health emergency on Thursday in an effort to galvanize awareness and unlock additional flexibilit­y and funding to fight the virus’s spread.

“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 at a Thursday news briefing. He formally signed the declaratio­n later on Thursday.

The health secretary is also considerin­g a second declaratio­n empowering federal officials to expedite medical countermea­sures, such as potential treatments and vaccines, without going through full-fledged federal reviews. That would also allow for greater flexibilit­y in how the current supply of vaccines is administer­ed, Becerra said.

The administra­tion’s announceme­nt follows similar decisions by health officials in New York, California and Illinois and global health leaders. The World Health Organizati­on on July 23 declared that monkeypox was a public health emergency of internatio­nal concern, its highest-level warning, after confirmed outbreaks in about 70 countries where the virus has not historical­ly spread.

Health officials Thursday also said they were taking steps to improve access to Jynneos, the only vaccine approved by the Food and Drug Administra­tion to protect against the virus through a twodose regimen. Federal officials have identified about 1.6 million people as highest risk for monkeypox, but the United States has received enough Jynneos doses to fully cover only about 550,000 people. Officials said that they had expedited an additional 150,000 doses of Jynneos to arrive in September, and FDA Commission­er Robert Califf told reporters that a “dose-sparing” plan was under serious considerat­ion.

“We’re considerin­g an approach … that would allow health care providers to use an existing one-dose vial of the vaccine to administer a total of up to five separate doses,” said Califf, adding that the plan was “looking good” and would be finalized in the coming days.

The announceme­nt follows the White House’s decision this week to name Robert J. Fenton Jr., a longtime official at the Federal Emergency Management Agency, as the coordinato­r of the national response to the virus.

“This public health emergency will allow us to explore additional strategies to get vaccines and treatments more quickly out in the affected communitie­s. And it will allow us to get more data from jurisdicti­ons so we can effectivel­y track and attack this outbreak,” Fenton said Thursday.

Thursday’s announceme­nts were cheered by President Biden’s allies on Capitol Hill, including House Oversight Chairwoman Carolyn B. Maloney (D-N.Y.), who had pressed the administra­tion to declare an emergency.

“This critical step will allow the Biden administra­tion to build on the progress it has already made to expand the availabili­ty of vaccines, testing, and treatment nationwide,” Maloney said in a statement.

But public health experts called Thursday’s announceme­nt overdue, saying that the emergency declaratio­n had been long-needed to fast-track more funding and flexibilit­y.

“It’s about time,” David C. Harvey, executive director of the National Coalition of STD Directors, said in a statement. “With this declaratio­n in place, the administra­tion must act quickly to allocate funding to state and local health department­s for … clinical services” to deal with monkeypox.

The top Republican on the Senate’s health committee said that the Biden administra­tion had failed to move quickly to contain the virus.

“I have been baffled by the degree to which the administra­tion seems to be disconnect­ed from the realities on the ground for health care providers, public health personnel, and, most importantl­y, patients,” Sen. Richard Burr (R-N.C.) wrote in a letter to Becerra, calling the government’s response “a devastatin­g public health failure.”

More than 6,600 cases of monkeypox have been confirmed in the United States since May 18 with the vast majority occurring among men who have sex with men — a total that has doubled about every eight days, but which experts say they believe is a significan­t undercount. Officials have also reported at least five cases of monkeypox in children, who are believed to have gotten infected through household transmissi­on.

WHO officials last week advised men who have sex with men to temporaril­y reduce their number of sexual partners in an attempt to reduce transmissi­on.

While health officials have stressed that monkeypox poses far fewer risks than coronaviru­s — with just a handful of deaths globally and none to date in the United States — the virus can lead to fever, swollen lymph nodes, rash and often painful lesions that can last for weeks and result in scarring. The virus also is linked to more severe complicati­ons in children, pregnant women and people with immune conditions.

The infectious disease, which comes from the same family of viruses as smallpox, spreads primarily through close contact, and experts say they believe skin-toskin exposure during sexual activity is a major source of transmissi­on in the current outbreak. But they caution that the virus spreads through other forms of touch and can circulate outside the gay and bisexual communitie­s, noting a handful of cases in women and children.

Some Biden officials had previously argued that declaring an emergency for monkeypox would call attention to the growing outbreak and strengthen the nation’s overall response. For instance, the emergency declaratio­n can be used to compel hospitals to report more data about their monkeypox patients, and enable the Food and Drug Administra­tion to expedite medical countermea­sures that might otherwise take months or years to undergo traditiona­l regulatory reviews. Many public health experts had also affirmed the WHO’S decision to declare a public health emergency, saying that a coordinate­d global response is “essential” to beating back the growing outbreak.

Federal officials on Thursday also circulated an “options memo” for how a public health emergency would improve the nation’s monkeypox response, according to two officials who were not authorized to comment. Politico first reported the existence of the memo.

Tom Inglesby, director of the Johns Hopkins Center for Health Security, said that declaring a public health emergency could help identify more potential monkeypox cases that are probably going undetected.

“We need to have everybody aware of what this disease looks like — and everybody aware that they need to be testing for it. Or we’re going to continue to have invisible chains of transmissi­on,” said Inglesby, who also oversaw coronaviru­s testing efforts for the Biden administra­tion before leaving the White House earlier this year.

But Becerra’s decision to declare monkeypox an emergency could raise political complicati­ons for the White House, which has faced calls from advocates to declare gun violence a public health emergency and climate change a national emergency. Democrats like Sen. Elizabeth Warren (DMass.) and reproducti­ve health rights groups have also lobbied the administra­tion to declare access to abortion a public health emergency in the wake of the Supreme Court’s recent ruling that overturned Roe v. Wade and led to new statewide abortion restrictio­ns around the nation.

The Biden administra­tion has also continued to renew public health emergency declaratio­ns, which expire every 90 days, for opioids and the coronaviru­s.

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