WHO chief declares monkeypox outbreak a global health emergency

monkeypoxNIAID-300x259The worldwide struggle to contain a fast-spreading outbreak of monkeypox took on new urgency, with the World Health Organization declaring a global emergency and U.S. experts discussing whether the  viral infection is becoming yet another significant sexually transmitted disease that this country is ill-prepared to quell.

The WHO declaration, by WHO Director-General Tedros Adhanom Ghebreyesus, divided experts, some of whom were critical about the already pokey response to monkeypox or by others who said it was misguided.

Dr. Tedros conceded that the committee that advises him on global health emergencies had met twice, declining once to issue its alarm about the current monkeypox spread and then deadlocking on the issue. The WHO director used his authority to issue the emergency declaration, citing data showing that more than 16,500 cases have been reported in 75 countries.

This is what the New York Times reported of the spread in the United States and other industrialized nations of the infection caused by a virus (as shown above, in photo from the National Institute of Allergy and Infectious Diseases):

“As of [July 23], the United States had recorded nearly 3,000 cases, including two children, but the real toll is thought to be much higher, as testing is only now being scaled up. Britain and Spain each have about as many cases, and the rest are distributed through about 70 countries. Many of the infected in these countries report no known source of infection, indicating undetected community spread.”

Public health officials have wrestled with the challenges of creating alarm in the general public and avoiding stigmatizing the chief population group most affected for now by monkeypox’s spread: men who have sex with other men, notably at large gatherings and with partners with whom they have little or no familiarity.

As the New York Times reported of the information that WHO considered:

“There are more than 16,000 cases of monkeypox outside Africa, roughly five times the number when the advisers met in June. Nearly all the infections have occurred among men who have sex with men.”

Here is how the Associated Press reported the disease is spread:

“[H]ealth officials have stressed that anyone can catch the virus. It spreads mainly through skin-to-skin contact, but it can also be transmitted through linens used by someone with monkeypox. Although it’s been moving through the population like a sexually transmitted disease, officials have been watching for other types of spread that could expand the outbreak. There have been several cases like that: Officials on [July 22] said they were aware of two children with monkeypox in the U.S., and at least eight women. Symptoms include fever, body aches, chills, fatigue, and the bumps on parts of the body. The illness has been relatively mild in many men, and no one has died in the U.S. But people can be contagious for weeks, and the lesions can be extremely painful.”

The infection, unlike the coronavirus, has been around for a long time. Nations already stricken by the disease for a while now — including in Africa — are understandably upset that it is only when the illness spread into the West that it has raised concern, the New York Times reported:

“Monkeypox has periodically flared in some African countries for decades. Experts have sounded the alarm about its potential as a global threat for years now, but their warnings went mostly unheeded. Vaccines and drugs are available in large part because of fears of a bioterrorism attack with smallpox, a close relative of the monkeypox virus. But access to a drug called tecovirimat has been snarled by time-consuming bureaucracy and government control of the supply, delaying treatment by days or even weeks for some patients. Doses of Jynneos, the newer and safer of two available vaccines, have been severely constrained — even in the United States, which helped develop the vaccine.”

Politics and the U.S. response to monkeypox

The Biden Administration has distributed thousands of doses of pox vaccine, which public health officials have prioritized initially for those exposed to individuals diagnosed with infections. The administration says hundreds of thousands of doses will be available soon, though critics say it will take weeks before the vaccines will be sufficient to meet demand.

The vaccine delays, long lines for those who are seeking shots, and the ramp up of concern about monkeypox has prompted yet more criticism about this country’s readiness to respond to risky disease outbreaks. Some experts say that the slow action against monkeypox may allow the infection to spread into the general population and to dig in as another major sexually transmitted disease (STD).

That, of course, would be a direct consequence of politicians — particularly of the Republican variety — to support and properly fund public health efforts in this country, including clinics that treat STDs, the nonpartisan, independent Kaiser Health News service has reported:

“Clinics that treat sexually transmitted diseases — already struggling to contain an explosive increase in infections such as syphilis and gonorrhea — now find themselves on the front lines in the nation’s fight to control the rapidly growing monkeypox outbreak. After decades of underfunding and 2½ years into a pandemic that severely disrupted care, clinic staffers and public health officials say the clinics are ill-equipped for yet another epidemic. ‘America does not have what it needs to adequately and totally fight monkeypox,’ said David Harvey, executive director of the National Coalition of STD Directors. ‘We are already stretched to capacity.’ Monkeypox — a cousin of smallpox — is not technically considered a sexually transmitted infection. But it spreads through close contact and is now being transmitted largely through networks of men who have sex with men. Because the current monkeypox outbreak causes blisters or pimples on the genitals, many patients are seeking care for what appears to be herpes, syphilis, or another sexually transmitted infection. Patients often prefer to seek care anonymously at public clinics, rather than visit their primary care doctors, because of the stigma of sexually transmitted infections.”

Extremists, anti-science and light on facts, have targeted public health programs, arguing that the coronavirus pandemic led experts to overreach and attack individuals’ rights. They have campaigned for an array of new laws that will hamper efforts to respond to disease outbreaks, critics say.

At the national level, Republicans in Congress have returned to their theological view that sees little or no role for the federal government in health care. This has meant, among other things, that GOP members have refused the administration’s requests for more money to battle the coronavirus, including to keep testing and vaccinating people, including developing new vaccines targeting the highly contagious Omicron variants.

The coronavirus pandemic persists, too

The coronavirus keeps mutating, enough so that even the most protected and arguably powerful individual in the country — President Biden — has gotten and is recovering from a mild Covid case. The disease has killed more than 1 million Americans and infected more than 90 million of us — numbers that likely are under-reported. As the New York Times also has noted of the pandemic:

“Cases, hospitalizations and deaths are all higher than they have been at nearly any point this summer as the BA.5 variant continues to spread across the United States. The number of new cases announced each day has hovered near 130,000 for several days, and all but a few states have seen steady increases over the past two weeks. The official case numbers are seen as a significant undercount because many people have chosen to use home tests or are forgoing tests altogether … Hospitalizations are also steadily increasing nationally. More than 41,000 people are currently hospitalized with the coronavirus across the country, an increase of 19% over the past two weeks. Death data remains volatile following a series of reporting delays related to summer holidays, but deaths are increasing. After two months when daily death numbers rarely rose above 400, the average has recently grown to more than 420 people dying of Covid in this country each day.”

We are not done with the pandemic — and the infection doesn’t care how casual we wish to be about the death and debilitation it can cause. Those with heightened vulnerability to the illness — those who are older, immunocompromised, overweight, and with underlying conditions, or individuals from hard-hit communities of color — still should stay careful, including by keeping on their masks.

And, yes, so-called one-way masking has protective benefits. The savvy will want to build up not discard their supply of masks, nabbing test kits, too (free from the federal government, including a second round of them, and delivered to your door). Just in case.

Those who are sexually active and at risk from monkeypox should heed their own doctors’ advice and counsel from responsible, experts in their community about safer sex practices. As vaccines become more plentiful, they should discuss with their doctors if and when they should get these shots.

The vaccines remain life changers and life savers. If you have not gotten your coronavirus shots, please do so, boosters and all, pronto. Those who had hang-ups about the existing, novel shots, notably with their innovative underlying technology, soon may have access to a late-arriving vaccine made in more traditional ways.

If you haven’t chatted with your doctor for a bit, you should — especially about whether your individual health would benefit from an additional dose of vaccine and when might be the time to get it. Parents should discuss with their pediatricians potential shots for and boosters for the little kids’ older siblings. (Get the young folks caught up on their shots now if you can, too.) If you have been exposed or think you have gotten infected, please get tested — and quarantine or isolate to protect yourself and others.

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