WASHINGTON After weeks of administrative and logistical hiccups in delivering testing, treatments, and vaccines, the Biden administration is now changing course in its response to the monkeypox outbreak.
People close to the administration noted that the number of illnesses has increased from hundreds to thousands in a short period of time, and that Biden officials concede they are now playing catch-up as case counts surge faster than previously anticipated.
The administration has named a monkeypox coordinator to oversee the response from the White House across agencies and with state and local governments as part of its new strategy. The coordinator will also strive to enhance access to an experimental therapy for those who have been infected.
Twelve practicing physicians and former public health officials who talked with NBC News said that the administration still faces a confusing array of challenges.
I believe we still have the chance to maintain control over this, but having the resources is really the key, according to Julie Morita, who oversaw the Chicago Department of Public Health for nearly two decades and counseled President Joe Biden on Covid during the transition.
Ample resources must be allocated to public health, vaccine supplies must be expanded, and communication efforts must be significantly stepped up. However, all of those possibilities are possible and may result in the outbreak being contained. It’s not too late, said Morita.
This week, a large number of states declared public health emergencies, including New York and California, while the Centers for Disease Control and Prevention recorded infections in all but two states. The seven-day average of newly reported cases surged from 45 on July 11 to 214 just two weeks later, according to an NBC News analysis of CDC data.
Since the start of May, the U.S. has documented over 6,000 cases in total. The total number surpasses 20,000 globally.
The administration’s strategy focus has mostly been on immunizing the most high-risk individuals, such as men who have had many male partners in a two-week period or those with known exposure, as the virus is now circulating virtually exclusively among men who have sex with men.
The outbreak has since been brought under control, but administration officials have recently asked other males who have sex with men to cut back on high-risk behavior, such as having many partners. Through dating apps, events, and interactions with community leaders, they are aiming to spread that message to the homosexual, transexual, and bisexual groups.
That is a change in tactics from earlier in the summer, when officials concentrated on immunizing those those who had been exposed to the disease and their close contacts. However, when illnesses increased dramatically over the past month, state and local health officials were unable to keep up, according to a person familiar with the operations.
Robert Fenton and Demetre Daskalakis were named as the national monkeypox response coordinator and deputy coordinator, respectively, by the White House on Tuesday. On Thursday, the two will give their first press conference regarding the response efforts.
According to a government official, “The President is continually searching for ways we can do more to stem the spread of Monkeypox.” “And by having Bob Fenton and Dr. Daskalakis at the helm as White House coordinators, we will ramp up our urgent, whole of government response even more.
In addition to the 300,000 doses previously granted, the federal government has stated that it intends to distribute more than 700,000 doses to the states, but no specific plans for any further doses have been made public.
We boosted up our complete response and quickly accelerated timeframes to make over one million doses of vaccinations available after the data revealed that this outbreak was distinct from previous ones and transmitting quickly, the administration official said.
Doctors and public health officials claim that vaccine doses have been slow to arrive, and they are worried that there won’t be enough to fulfill demand, which is currently being pushed in part by groups with lower infection risks, such healthcare professionals and monogamous men.
According to Tyler Temeer, CEO of the San Francisco AIDS Foundation, municipal officials in San Francisco requested 35,000 doses for the city but have only received about 12,000 doses so far. According to him, his clinic has a waiting list of 10,000 people and has received little more than 1,000 doses.
A person needs to get two doses of the vaccination for it to work best.
On July 3 in New York, Gerald Febles displays monkepox lesions on his hands.
Ryan, Benjamin / NBC News
The gap between supply and demand is equally enormous in New York City. But Black men who have intercourse with other guys are one important category where infections have been particularly prevalent, according to Celine Gounder, an infectious disease doctor in New York. She stated that greater effort must be put forward in order to reach those who are most at risk, many of whom lack health insurance, don’t have a primary care physician, or are ostracized for having sex with other men.
We are noticing that between 30 and 40 percent of instances are in males of color or trans women of color, but the bulk of people waiting in line for vaccinations are white guys, whether we are in New York City, where I am, or Atlanta, where my colleagues are, said Gounder. And that is worrying because you aren’t interacting with that high-risk group.
According to Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials, some states may also experience a delay in receiving their vaccine doses because the federal government has stated that it won’t ship a state’s entire allotment of vaccines until that state starts sharing data on infection rates and demographics. Some states contend they can’t do this because of privacy laws.
Doctors claim that patients who contract monkeypox must endure hours of paperwork before they can access Tpoxx, a smallpox medication that is thought to be effective for treating monkeypox patients. According to Gounder and other medical professionals, this procedure has deterred some clinicians from treating patients with monkeypox.
The federal government has made an effort to streamline the procedure, but since Tpoxx is not approved by the Food and Drug Administration to treat monkeypox, officials want to make sure they are getting information on who is receiving it to determine its safety and efficacy, according to a person familiar with the procedure.
Public servants and medical professionals said they are urging the White House to declare a public health emergency, which would allow Covid funding to be used for monkeypox treatment, remove some administrative restrictions on Tpoxx access, and enhance data sharing between the federal government and the states.
Although funding must come after the declaration of a federal public health emergency, some of our existing issues will be alleviated, according to David Harvey, executive director of the National Coalition of STD Directors.
According to many close to the administration, dissatisfaction with the administration’s response have resulted in some internal finger-pointing between the White House and Department of Health and Human Services.
The decision to declare a public health emergency would be left up to Health and Human Services Secretary Xavier Becerra, according to the White House.
Many of the problems that medical professionals and public health officials have been dealing with in relation to the response to monkeypox are reminiscent of those encountered during the Covid epidemic, such as a lack of testing, unclear messaging, and insufficient vaccine supply. Although the monkeypox virus is very different from the Covid virus and is thought to travel primarily through skin-to-skin contact rather than through the air, it has brought to light the shortcomings in the government’s ability to deal with fresh outbreaks.
According to Andy Slavitt, who oversaw the White House response to Covid during Biden’s first year in office, we are not fundamentally prepared for crisis response in the field of public health. In addition, our public health system is in terrible shape. These are issues that Congress and people in the administration need to address. There are several requests for such task, and reforms are required.