Falling monkeypox cases have health officials ‘cautiously optimistic’



After three months of surging monkeypox cases, the worldwide outbreak could have peaked, amid proof that homosexual males are curbing risky sexual behaviors and extra persons are getting vaccinated towards a virus that spreads by shut contact and has overwhelmingly affected men who have sex with men.

New U.S. cases of monkeypox have fallen by about 25 % up to now two weeks, from 444 cases a day on Aug. 10 to 337 on Aug. 24, in accordance with The Washington Post’s rolling seven-day common. Nearly 17,000 Americans have been identified with monkeypox for the reason that virus emerged in mid-May.

Globally, new cases fell by 21 % from final week, the World Health Organization reported Thursday.

Even as public health consultants cheered the slowdown in new infections, they cautioned that the virus continues to pose a danger — particularly in smaller communities exterior U.S. city facilities and in creating international locations amid vaccine shortages, restricted surveillance and inadequate testing — and will more and more spill past the homosexual and bisexual neighborhood. Epidemiologists and health officials additionally report ongoing challenges with the White House’s new vaccine strategy to stretch the variety of doses accessible.

Inside America’s monkeypox crisis — and the mistakes that made it worse

“There are signs that the outbreak is slowing in Europe, where a combination of effective public health measures, behavior change and vaccination are helping to prevent transmission,” WHO Director General Tedros Adhanom Ghebreyesus stated Thursday. But he warned that new cases are persevering with to extend in locations reminiscent of Latin America, the place there may be much less consciousness of the virus and restricted vaccine entry.

Anne Rimoin, an epidemiologist on the University of California at Los Angeles who has studied the monkeypox outbreak, stated a drop in cases is predicted after growing awareness and a push for vaccinations. “Whether or not that’s going to be sustained, we just don’t know,” she stated. “It’s premature to declare any kind of victory.”

Biden administration officials Friday hailed the “downward trend” of monkeypox cases in main U.S. cities as a optimistic signal however sidestepped questions on whether or not the nationwide outbreak had peaked.

“I want to be cautiously optimistic,” stated Rochelle Walensky, director of the Centers for Disease Control and Prevention, acknowledging that extra work is required to include the virus. “Week over week, our numbers are still increasing, [but] the rate of rise is lower … and things are not even across the country.”

For occasion, new virus cases in some areas are outpacing city facilities. Monkeypox cases in Georgia climbed 66 % between Aug. 10 and 24, a two-week interval when cases climbed simply 41 % in New York City, the epicenter of the U.S. outbreak, in accordance with state and native health division knowledge.

What you need to know about the monkeypox vaccine

New York City health commissioner Ashwin Vasan stated his group is hopeful that the virus is on the retreat, after almost 2,900 New Yorkers had been contaminated up to now three months. About 40 new cases per day had been identified in New York City final week, in contrast with greater than 70 cases per day earlier this month.

“In recent days, we have seen cases begin to fall and transmission slow,” Vasan testified in entrance of the New York City Council on Wednesday, crediting the rise in vaccinations and alter in sexual behaviors. “All of this is clearly taking hold and having a positive effect in slowing this outbreak.” Officials in cities like San Francisco and Chicago echoed comparable messages this week.

The CDC reported this week that homosexual males have modified dangerous sexual behaviors due to the outbreak, citing a web based survey that about half of males who have intercourse with males stated they have diminished one-time sexual encounters in addition to diminished intercourse with companions met on courting apps or at intercourse venues. Experts say the U.S. outbreak was in all probability accelerated by a flurry of dance events and informal intercourse throughout June’s Pride Month actions, and the CDC previously found that 94 % of cases had been related to sexual or intimate contact.

“Behavior change, along with vaccination, can help slow the spread and end the monkeypox outbreak,” CDC spokeswoman Kristen Nordlund stated in an announcement. She famous that U.S. knowledge incorporates info from many jurisdictions, “some of which continue to have accelerating case counts, and continued vigilance and action remains important.”

The World Health Organization declared monkeypox a world health emergency on July 23. Here’s what you must learn about the way it spreads. (Video: Joy Yi, Fenit Nirappil/The Washington Post, Photo: CDC/The Washington Post)

Walensky and different officials stated Friday that they plan to spice up vaccinations and messaging to LGTBQ communities at upcoming gatherings that would speed up new clusters of infections, reminiscent of New Orleans’ Southern Decadence pageant that’s expected to draw tens of 1000’s of individuals over Labor Day weekend. They additionally stated they’re warily watching as school college students return to campuses, one other potential driver of latest cases.

State and native health officials are urgent for the Biden administration to offer extra assist for the response, saying they want further funding to lift public consciousness in regards to the virus, rent further employees to conduct testing and carry out contact tracing, and make additional investments to strengthen health departments that have been worn down by two years preventing the coronavirus.

Struggle to protect gay, bisexual men from monkeypox exposes inequities

“We appreciate federal agencies’ efforts to provide maximum flexibility to use COVID-19 supplemental funding to address this public health emergency,” Michael Fraser, chief government of the Association of State and Territorial Health Officials, wrote to the White House in a letter shared with The Washington Post. “However, given the scope and scale of the outbreak … it is clear that this short-term solution is not viable for the long term.”

Fraser instructed The Post that a further $500 million to $1 billion can be wanted to fund the state and native monkeypox response for the subsequent 12 months. He steered that the Biden administration craft an emergency funding bundle with Congress or make extra funding accessible by means of CDC’s Infectious Disease Rapid Response Reserve Fund.

Experts additionally proceed to voice considerations in regards to the Biden administration’s vaccine technique to extend limited supply by splitting every single-use vial into 5 doses by means of a unique injection technique. The plan, quickly finalized on Aug. 9, has been cheered by some native officials as an revolutionary approach to meet surging demand. But many state and native officials are encountering logistical problems implementing it.

“I have now heard multiple reports from my state and local colleagues that it is very difficult to extract five doses from a single vaccine vial,” Caitlin Rivers, a Johns Hopkins epidemiologist, wrote in a post on her Substack page last week, criticizing the abrupt technique shift. “Taken together, state and local health authorities now have up to one-third fewer doses for use in their communities than they were before the move to intradermal administration.”

The chair of the Senate’s health panel additionally urged the Department of Health and Human Services to shut “alarming” provide gaps in vaccines, for the monkeypox response in addition to future outbreaks.

“The Administration must do more to address existing, unacceptable shortages in vaccine supply, institute comprehensive distribution and communication strategies, and develop long-term procurement plans,” Sen. Patty Murray (D-Wash.) wrote in a letter Tuesday to Dawn O’Connell, the assistant HHS secretary who oversees the vaccine stockpile.

U.S. monkeypox response mirrors early coronavirus missteps, experts say

The White House on Friday defended its vaccination technique, saying that about 75 % of jurisdictions across the nation have already adopted the brand new strategy, and one other 20 % are planning to take action. Splitting every vial into 5 doses will enable the United States to “provide more than 3 million doses of vaccines … nearly enough vaccines to reach the entire at-risk population,” O’Connell stated Friday. CDC officials have beforehand estimated that not less than 3.2 million doses of vaccine can be wanted to cowl the homosexual and bisexual males whom officials contemplate at highest danger.

But Biden officials stated they had been open to adjusting their vaccination technique as they accumulate extra real-world knowledge in regards to the effectiveness of splitting doses.

“We’re really trying to shift the thinking away from ‘how many vaccines can you pull out of the vial’ to ‘how many arms can you vaccinate,’ because that’s going to give us a lot more information,” stated Demetre Daskalakis, the White House’s deputy coordinator for the monkeypox response.

President Biden on May 23 stated he believed the United States had sufficient smallpox vaccines stockpiled to cope with “the likelihood of the problem.” (Video: C-SPAN/MSNBC/ABC)

Administration officials additionally have stated that regardless of weeks of complaints of restricted vaccine availability, many native officials have but to totally use their vaccine provide. As of Wednesday, solely 11 of the 67 jurisdictions across the nation have attested to utilizing not less than 85 % of their vaccine provide, in accordance with a White House official who spoke on the situation of anonymity to debate ongoing coverage and inside conversations.

After cases surged in June and July, the Biden administration reorganized its monkeypox technique and deputized a new White House team to coordinate the federal response. In interviews, Biden officials highlighted their subsequent work to avert potential outbreaks, reminiscent of a latest incident by which a day-care worker in Illinois tested positive for monkeypox, probably exposing about 60 individuals, together with a number of dozen kids. The employee additionally served as a house health aide for one aged individual.

The state of affairs alarmed the White House, and Biden officials, fearing an outbreak amongst kids, rushed dozens of vaccines to the individuals who had been probably uncovered. Three weeks later, there have been no further infections linked to the day-care employee, Julie Pryde, administrator of the Champaign-Urbana Public Health District, instructed The Post.

Lena H. Sun contributed to this report.

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