LOS ANGELES – Monkeypox has become a worldwide public health crisis, with more than 23,200 confirmed or presumptive positive cases reported as of Tuesday across more than 70 countries where it is not considered endemic.
In the United States the governors of New York, California and Illinois declared states of emergency as President Joe Biden named FEMA’s Robert Fenton as the White House National Monkeypox Response Coordinator and Dr. Demetre Daskalakis as the White House National Monkeypox Response Deputy Coordinator to lead federal efforts to combat the pernicious viral outbreak, that is rampant in the LGBTQ+ community among men who have sex with men.
This monkeypox outbreak healthcare officials from the World Heath Organization, (WHO) the National Health Services, (NHS) agency in Britain, and the U.S. Centers for Disease Control and Prevention, (CDC) have repeatedly stressed is not a sexually transmitted disease but rather a contact type of virial transmission that means anyone is at risk of infection.
Pediatric cases have been reported by the CDC and on Tuesday one case by the Long Beach Department of Health & Human Services. Cis-gender cases have also been confirmed by the WHO and CDC.
The disease is not fatal except in rare cases and there are vaccines available to combat its transmission, primarily the JYNNEOS vaccine, which is approved by the U.S. Food and Drug Administration which healthcare experts noted helps protect against monkeypox when given before or shortly after an exposure.
Driving the emergency though is the explosion of cases. Mitigation and risk reduction are key experts like Jim Mangia, the president and CEO of St. John’s Community Health, a network of public health clinics serving South, Central, and East Los Angeles tells the Blade.
Mangia and his peers acknowledge that supply chain issues in distribution at a federal and then state levels have also contributed to the tripling of confirmed cases since June. But Mangia says that focused efforts need to be made to stem the outbreak by educating the community on risk reduction and management.
“MPV is a serious health concern that indeed deserves swift action from elected officials. But truly drawing from lessons learned during the HIV/AIDs crisis means not relying on vaccines alone – especially while waiting for the federal government and supply chain to catch up to our demand for them. We need community-wide education, prevention, and treatment strategies around MPV – and we need them now,” Mangia told the Blade.
On the issue of supply chain and availability, which has been a source of contention, the declaration of states of emergency will help but more relief efforts are needed advocacy groups say.
In Los Angeles, the LA County Board of Supervisors voted to declare an emergency the day after California Governor Gavin Newsom proclaimed a State of Emergency to combat the outbreak.
The move from the Los Angeles County Board came via unanimous vote of the five-member board on a motion led by Supervisor Holly Mitchell (D- Second District).
The proclamation now allows government and public health officials to mobilize additional resources and request recovery assistance under the California Disaster Assistance Act in order to increase and deploy funding and emergency planning to combat the outbreak more effectively.
“We thank the Board of Supervisors for more formally recognizing monkeypox as a public health emergency with its proclamation today but must ask: now, what’s the plan?” said Aids Health Care President Michael Weinstein in a statement. “Vaccine doses are—and will remain—in critically short supply. However, there has not really been clear direction from County on where or how to even access vaccines, and we know that an additional 42,000 doses will soon arrive from the feds. The Supervisors should also immediately allocate an additional $10 million for both monkeypox and STDs, which have reached epidemic proportion nationwide throughout the COVID-19 pandemic.”
Mangia in an op-ed written this week for the Blade pointed out: “There are other tools we should be advocating for in addition to vaccines. One is Tpoxx, an antiviral medication that hasn’t been approved by the FDA but is being widely and successfully used in Europe. Another is faster MPV tests – currently, the results can take several days. Only a few lab companies are approved to test MPV specimens sent by clinics and hospitals, and we need faster results to prevent further spread in real time.”
The focus should be getting shots in arms both Weinstein and Mangia say. But early efforts including pop-up clinics have been plagued by shortages and criteria set by health departments that doesn’t address the reality of the outbreak’s sourcing.
Andrew Beaver, a former ACT-UP activist and Angeleno told the Blade, after witnessing long lines at pop-up vax clinics outside the local bathhouses and saunas this past weekend, that the criteria needs to be more realistic. In an email Beaver wrote;
“Of all the organizations distributing vaccines in LA JWCH (John Wesley Community Hospital) has been the most effective. Rather than create criteria vax seekers had to prove they chose locations that were in and of themselves a kind of criteria.
100’s of men were willing line up for hours outside the bathhouses and saunas. All the locations were in SPA 4 where over 50% of cases live.
If a gay man is willing to stand in line outside a bathhouse in a “not so nice” neighborhood…but a location that isn’t miles from where they live…then it’s fair to say they believe they should get vaccinated as soon as possible. JWCH allowed the men to self-select v the County or orgs to decide for them.”
In a news release Tuesday, the Los Angeles County Department of Public Health announced with the arrival of additional JYNNEOS vaccination doses it had expanded the criteria to include additional residents at high risk of exposure to monkeypox.
The Monkeypox vaccine is now also available to gay or bisexual men and transgender persons 18 years of age and older who:
- Had multiple or anonymous sex partners in the last 14 days including engaging in survival and/or transactional sex (e.g., sex in exchange for shelter, food and other goods and needs).
Residents who are immunocompromised, including those with advanced or uncontrolled HIV, may be at high risk for severe disease and will be prioritized for vaccination, LADPH said.
But says Mangia, attention must be given to addressing the spread and risk, especially by the gay party circuit and dating apps.
“We also need to emphasize that MPV is not an STI. While it is spread through close physical contact, that contact can be nonsexual. Day care workers, nannies, massage therapists, tattoo artists, and others whose livelihoods involve skin-to-skin contact are also at high risk right now, and we need to be educating and advocating for those folks as well.
Direct contact with the rash or body fluids and sexual contact are the most risky activities; kissing, cuddling, and being in crowds of non fully clothed people are moderately risky; and sharing dishes, beds, towels, toiletry items or being in crowds with fully clothed people are possible ways of contracting MPV. Limiting those activities for now and communicating with each other about exposure are essential ways to prevent spread,” he said.
For now the shortfall in the supply lends much greater impetus to addressing risk management and prevention an official with the CDC told the Blade. “Realistically we are looking at supplies in less quantities than will be required- but if we can educate people on preventative measures that may greatly reduce the caseloads,” the official said.
A source at the CDC told the Blade health officials worry that the outbreak could become the country’s second major public health disaster in as many years if there is not an effort to work faster to contain it.
From CBS News: