Declining monkeypox cases make health officials ‘cautiously optimistic’


The global epidemic may have peaked after three months of spikes in monkeypox cases. There is evidence that gay men are curbing risky sexual practices and that more and more people are getting vaccinated against a virus that is spread through close contact and overwhelmingly affects men who have sex with men.

New cases of monkeypox in the United States have fallen by about 25% over the past two weeks, from 444 on Aug. 10 to 337 on Aug. 24, according to the Washington Post’s seven-day moving average. Nearly 17,000 Americans have been diagnosed with monkeypox since the virus emerged in mid-May.

Globally, the number of new cases decreased by 21% from last week. The World Health Organization reported Thursday.

Public health experts welcomed the slowdown in new infections but warned the virus continued to pose risks. Infections can spread, especially in small, non-urban communities in the United States and in developing countries where vaccines are scarce, surveillance is limited, and testing is inadequate. gay and bisexual communities. Epidemiologists and health officials also report ongoing challenges with the White House’s new vaccine strategy to expand the number of doses available.

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WHO Director-General Tedros Adhanom Ghebreyesus said Thursday that “there are signs that the outbreak is slowing in Europe, where a combination of effective public health measures, behavioral changes and vaccination has helped prevent transmission.” Stated. But he warned that new cases continue to rise in places such as Latin America, where awareness of the virus is low and access to vaccines is limited.

Anne Limoyne, an epidemiologist at the University of California, Los Angeles, who studies monkeypox outbreaks, said she expected a decline in cases after increased awareness and a push for vaccination. I don’t know if it will last,” she said. “It is too early to declare victory of any kind.”

Officials in the Biden administration on Friday hailed a “downtrend” in monkeypox cases in major US cities as a positive sign, but avoided questions about whether the nationwide outbreak had peaked.

“I want to be cautiously optimistic,” said Rochelle Wallenski, director of the Centers for Disease Control and Prevention, acknowledging that more work is needed to contain the virus. “Every week, our numbers continue to grow. [but] The rate of increase is low and not the same across the country. “

For example, new virus cases in some areas have outstripped urban areas. According to state and local health department data, the number of monkeypox cases in Georgia increased by 66% between August 10 and 24. During his two weeks, the number of cases in New York City, the epicenter of the epidemic in the United States, increased by just 41%.

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New York City Health Director Ashwin Vasan said his team hopes the virus is receding after it infected nearly 2,900 New Yorkers in the past three months. Last week in New York City he had about 40 new cases diagnosed per day, while earlier this month he had more than 70 cases per day.

“Recently, we’ve seen cases start to drop and transmission to slow down,” Vasan testified before the New York City Council on Wednesday, acknowledging increased vaccinations and changes in sexual behavior. is clearly taking hold and is having a positive effect on slowing this outbreak.” Officials in cities such as San Francisco and Chicago echoed similar messages this week.

CDC reported this week that gay men had modified their risky sexual behaviors because of the outbreak, citing an online survey showing that about half of the men who have sex with men only had one-off sexual encounters. He also said he had less sex with partners he met on dating apps, or at sex venues. Experts said the spread in the United States was likely fueled by a flood of dance parties and casual sex during Pride Month activities in June, with the CDC previously reporting 94% of cases were sexual. or have been found to be related to intimate contact.

“By changing behavior along with vaccination, we can slow the spread of monkeypox and end the epidemic,” said a CDC spokesperson. Kristen Nordland said in a statement. She noted that U.S. data included information from many jurisdictions, “some of which continue to see increasing numbers of cases, and continued vigilance and action remain critical.” Did.

Warenski and other officials said Friday that upcoming events that could fuel new clusters of infections, such as the Southern Decadence Festival in New Orleans, which is expected to draw tens of thousands of people over Labor Day weekend. At the gathering, they plan to strengthen vaccinations and messages to the LGTBQ community.

State and local health officials are urging the Biden administration to further assist in the response, saying additional funding is needed to raise public awareness. about the virus We will hire additional staff to conduct testing and conduct contact tracing, and make further investments to bolster the health sector, which has been battered by the two-year battle against the coronavirus.

Fight to protect gay, bisexual men from monkeypox exposes inequalities

“We appreciate the efforts of federal agencies to provide maximum flexibility to use COVID-19 grants to address this public health emergency,” state and territorial health officials said. The association’s chief executive, Michael Fraser, wrote to the White House in a letter shared. with the Washington Post. “But given the scope and scale of the outbreak … it is clear that this short-term solution is not viable in the long term.”

Fraser told The Post that another $500 million to $1 billion will be needed to combat monkeypox in states and localities over the next 12 months. He suggested that the Biden administration work with Congress to create an emergency funding package or make more funds available through the CDC’s Epidemic Rapid Response Preparedness Fund.

Experts also continue to voice concerns about the Biden administration’s vaccine strategy, which was quickly completed on Aug. 9 and has been hailed by some local authorities as an innovative way to meet surging demand. welcomed. However, many state and local officials face logistical problems to implement it.

“We’ve heard multiple reports from state and local colleagues that extracting five doses from one vaccine vial is very difficult,” writes Caitlin Rivers, an epidemiologist at Johns Hopkins University. I’m here. Posting on her Substack page last week, she criticized the sudden shift in strategy. “In total, state and local health officials now have up to a third of her. Few We have reduced the dosage for community use than before we transitioned to intradermal administration. “

The chairman of the Senate Health Committee also called on the Department of Health and Human Services to close a “worrisome” supply gap in vaccines for the monkeypox response and future outbreaks.

Sen. Patti Murray (D-Wash.) said in a letter to Dawn O on Tuesday: “HHS Assistant Secretary Connell overseeing the vaccine stockpile.

US monkeypox response reflects early coronavirus mistakes, experts say

The White House defended its vaccination strategy on Friday, saying about 75% of jurisdictions nationwide have already adopted the new approach and another 20% plan to do so.Split each vial into five doses. By doing so, the United States will be able to provide “more than 3 million doses of the vaccine, almost enough to reach the entire at-risk population,” O’Connell said Friday. CDC officials previously estimated that at least 3.2 million doses of the vaccine would be needed to cover gay and bisexual men, whom officials consider the most at risk.

However, Biden officials said they are open to adjusting their vaccination strategy as they gather more realistic data on the efficacy of split doses.

“We’re shifting the mindset from ‘how many vaccines can I get out of a vial’ to ‘how many arms can I vaccinate?’ Because we can get it,” says Demetre Daskalakis. Deputy White House Coordinator for Monkeypox Response.

Administration officials also say many local officials have yet to fully deplete vaccine supplies, despite weeks of complaints about limited vaccine availability. As of Wednesday, only 11 of 67 jurisdictions nationwide had at least one vaccine supply, according to a White House official who spoke on condition of anonymity to discuss ongoing policies and internal conversations. I’m proving that I’m using 85%.

After a spike in cases in June and July, the Biden administration reorganized its monkeypox strategy and coordinated the federal response on behalf of a new White House team. Biden officials later Efforts are being made to avert possible outbreaks, such as the recent incident in which an Illinois day care worker tested positive for monkeypox, potentially infecting about 60 people, including dozens of children. please give me. This worker also served as a home health care assistant for one elderly person.

The situation alarmed the White House, and Biden officials, fearing an outbreak among children, rushed dozens of vaccines to potentially exposed people. There were no additional infections associated with , Julie Pryde, administrator of the Champaign-Urbana Public Health District, told The Post.

Lena H. Sun contributed to this report.

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