The Biden administration is considering a public health emergency

A Northwell Health staff member holds the monkeypox vaccine, at Cherry Grove on Fire Island, New York, where monkeypox vaccines were administered on July 14, 2022.

James Carbon | News day | Getty Images

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

Dr. Ashish Jha, the White House’s Covid response coordinator, said the administration is considering how a declaration of a public health emergency could bolster the US response to the outbreak.

“There is no final decision on this as far as I know,” Jha said. “It’s an ongoing, but very active conversation at HHS.”

Health and Human Services Secretary Xavier Becerra has the authority to declare a public health emergency under the Public Health Services Act. A statement can help mobilize federal financial assistance to respond to an outbreak.

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

The Biden administration’s response to the outbreak has come under scrutiny from Congress as infections rise. Fifty House Democrats, in a letter to President Joe Biden this week, called on the administration to declare a public health emergency in response to the outbreak.

Senate Health Committee Chair Patty Murray, in a letter to HHS Secretary Becerra, said she was concerned about the United States’ response to the outbreak. Murray said some patients and healthcare providers lack the information and resources they need to test for monkeypox and respond to the outbreak.

CDC Director Rochelle Walensky said last week that demand for vaccines exceeds available supply. Many people struggle to get vaccinated amid long queues outside clinics.

So far, the United States has shipped more than 300,000 doses of the monkeypox vaccine, called Jynneos, to city and state health departments, Jha told reporters on Friday. The Food and Drug Administration is in the process of clearing an additional 786,000 doses stored at manufacturer Bavarian Nordic’s facilities in Denmark for distribution in the United States.

Jha said some of these snaps have started shipping and will arrive in the United States this week and next week. Doses can be delivered to city and state health departments once FDA clearance is complete, Jha said. The United States has also ordered an additional 5 million doses that will be delivered through the middle of 2023, according to HHS.

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

The CDC confirmed the first two cases of monkeypox in children on Friday. One case is an infant in California and the other is an infant who is not a US resident. The cases are unlinked and the children likely caught the virus from transmission within their household, according to the CDC.

The children are both healthy and receiving the antiviral treatment tecovirimat, according to the CDC. Dr. Jennifer McQuiston, a CDC official, told reporters on Friday that the health agency was working to make it easier for clinicians to prescribe tecovirimat to patients.

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

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

“As this epidemic is spreading in a particular social network at this time, I think we have signaled from the beginning that there may be cases that occur outside of these networks and that we must be vigilant and ready to react and send a message about it,” McQuiston told reporters.

The United States has the capacity to perform 80,000 monkeypox tests per week after bringing in several commercial labs this month, according to the CDC. But the tests swab lesions caused by the virus, which can take weeks from initial exposure to develop. That means the United States likely doesn’t have an accurate picture of how many people are infected, because patients can only get tested once symptoms develop.

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