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But the recent death of a Los Angeles County resident — the first attributed to monkeypox in the United States — is a tragic reminder that the outbreak is ongoing and still poses a risk.
“There is some hope that these cases are leveling off. It shouldn’t be anyone’s comfort that this outbreak is over,” David Harvey, executive director of the National Coalition of STD Directors, said at a briefing Tuesday.
“We still need to increase our efforts to respond to this outbreak. And there are many, many data questions, clinical care questions, research questions that remain to be answered about this very unusual outbreak of a known virus over the decades that presents itself very differently in the United States.”
Deaths from monkeypox are extremely rare and often affect babies, pregnant women and people with weakened immune systems, such as HIV. This year, the World Health Organization has reported 22 deaths among about 58,000 cases. About 22,000 of these cases have been reported in the United States.
“Back in July, the CDC estimated that it took eight days for cases to double nationwide. By mid-August, the doubling rate was 25 days, showing encouraging signs of progress,” Dr. Demetre Daskalakis, the White House’s assistant monkeypox response coordinator, said last week.
But Harvey and other public health leaders warned Tuesday that people on the front lines of the response — including local health departments, epidemiologists and clinics dealing with sexually transmitted infections — don’t have enough resources to ensure continued improvement.
And there is a “very important immunocompromised population in the United States” that will be at high risk if the outbreak continues, Dr. Cesar Arias, board member of the Infectious Disease Society of America and chief of infectious diseases at Houston Methodist Hospital, said at the briefing.
Other key areas of concern cited by U.S. public health leaders at Tuesday’s briefing include inappropriate vaccination, access to testing and incomplete surveillance data.
They urged Congress to immediately provide significant funding to address the outbreak, defending the Biden administration’s request that about $4 billion in funding be allocated to the monkeypox response in the next government funding bill as one of “four critical needs” together with support. for Ukraine, Covid-19 response and natural disaster recovery.
The push for funding comes a day before federal leaders — including the director of the U.S. Centers for Disease Control and Prevention, Dr. Rochelle Walensky and director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci – is scheduled to speak to the Senate Health, Education, Labor and Pensions Committee about the federal response to the monkeypox outbreak.
Need for fair protection
Public health leaders attribute the slowing rate of new cases to vaccination and behavioral changes among those most at risk. Men who have sex with men have been disproportionately affected in the outbreak, with about half reporting that they have taken steps to protect themselves and their partners, according to the CDC.
But for the hopeful trend to continue, continued work and investment are needed — especially to reach underrepresented groups, health leaders say.
“In many ways, the initial, easy work has been done. Now local health departments need to be more creative, to reach deeper into their hardest-to-reach communities with messaging, education, vaccine, testing and treatment,” said Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials.
Data from the CDC shows that people of color make up a disproportionate share of cases but are underrepresented among those vaccinated.
More than half of new monkeypox cases over the past two months have been among black and Hispanic people, but only about a third of the first vaccine doses have gone to individuals in those groups, according to a CNN analysis of CDC data.
The White House Monkeypox Response Team addressed these disparities last month, highlighting efforts to offer vaccinations at major events and festivals as a strategy to stem them.
“With increasing supply of vaccines, I think we have a new opportunity in the strategy which is bringing vaccine to people instead of trying to get people to find vaccines.” Daskalakis said.
Last week, Daskalakis noted that case rates were slowing in parts of the country that have been hardest hit, including New York, Texas, California and Illinois.
But local public health leaders stressed the need for a broader perspective.
“We cannot take our foot off the gas simply because larger cities have the means to mount a robust response, leaving smaller rural communities to fend for themselves,” Harvey said.
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