The Biden administration is pushing to declare monkeypox a public health emergency


The Biden administration is considering whether to declare the country’s monkeypox outbreak a public health emergency and is also planning to appoint a White House coordinator to oversee the response as officials try to contain the virus from spreading across the United States.

After the World Health Organization declared monkeypox an international public health emergency on Saturday, the White House and health agency officials discussed their next steps to combat the virus over the weekend. Since May, nearly 17,000 cases have been confirmed outside Africa, including about 2,900 in the United States — and infections continue coming out in countries where the virus has not been found in history.

Although the new cases are concentrated in the gay and bisexual community, experts warn that the virus could spread to other groups. The first two cases of monkeypox in children were confirmed in the US on Friday, likely the result of sharing a household with an infected adult. But federal health officials say there is no evidence of persistent infection among broad populations.

Some health officials believe that a state of emergency is necessary to give the government more authority to cut red tape and collect data on the spread of the virus, others said the move was largely symbolic and would not address vaccines, treatment and other problems as shortages hampered the U.S. response, the three people, who spoke on condition of anonymity, said. was not authorized to comment.

Officials also raised questions about whether such a declaration would warrant a virus not linked to a single confirmed U.S. death. This is due to the strain of monkeypox involved in the outbreak In addition to complications in pregnant women, children and other vulnerable people, fever, sores and severe pain can last for weeks.

Officials hope to make a decision later this week on whether to declare a state of emergency, which is scheduled to be distributed after the 800,000 additional doses of the vaccine run out. Two people from the Food and Drug Administration said.

The decision was also complicated by domestic politics. Advocacy and health associations have urged the Biden administration to declare public health emergencies for abortion and gun violence, and the White House has said it is considering declaring a broader climate change emergency, sparking a debate over which issues to prioritize. The Biden administration also continued to renew public health emergency declarations for opioids and the coronavirus that expire every 90 days.

Officials at the Department of Health and Human Services have privately acknowledged that they are unsure whether to declare a state of emergency.

According to a memo sent to the president, the declaration “provides substantial justification for the use of (limited) tools that can be used to align with WHO and raise additional awareness, as well as help HHS respond.” Biden received a copy of it from The Washington Post on Sunday.

White House officials said the decision was made by HHS Secretary Xavier Becerra and they were concerned about the slow pace of the response. Patients say they still face days-long delays in getting test results, doctors have complained of bureaucratic hurdles in prescribing treatment, and officials like New York Mayor Eric Adams (D) have called for increased vaccine doses because their current supply is fast. tired.

“Our focus is on moving HHS as quickly as possible … it’s not just fighting another horse, it’s about strengthening and accelerating the response,” Biden said, adding that he is “pushing HHS to release a vaccine.” is opening the door and pushing the FDA to clear the vaccine in the next few days without cutting corners.

Becerra told CNN on Monday that his department is still reviewing the basis for the declaration. “We want to be ahead [monkeypox]. You don’t want it to become part of your life. But how many people have died compared to covid?” he said. “Zero … We declare public health emergencies based on data and science, not our concerns.”

Some outside experts say declaring a 90-day state of emergency could be an important tool to focus on a response.

“It allows all hands on deck to make the greatest possible effort,” said Jennifer Cates, director of global health policy at the Kaiser Family Foundation, a nonpartisan organization. think tank. “To prevent this from becoming endemic — and hopefully not too late.”

Cates added that emergency declarations should be reserved for “truly unique events” and “those criteria are being met for monkeypox. It’s crossing states, it’s spreading rapidly, it’s never been here before, and it has all the risks that come with it.” .

The White House has also approached the national monkeypox coordinator, concluding that the role is needed to manage the increasingly widespread response led by Ron Klein, the chief of staff who coordinated the U.S. Ebola response during the Obama administration. White House coronavirus coordinator Ashish Jha, infectious disease expert Anthony S. Fauci and dozens of other national security and public health officials. The two people, who were not authorized to discuss the plan, said the administration is looking at people with experience in pandemic response and government operations.

The White House declined to comment on discussions.

Some worry that it may be too late to stop the virus from gaining a foothold in the country, given the rapid increase in cases and difficulties in accessing tests.

“I think if we allow monkeypox to become endemic in the United States — and if we cross that threshold — it will be viewed as one of the greatest public health failures of recent times,” said Scott Gottlieb. During the Trump administration, he advised the FDA and the Biden administration on the coronavirus.

Biden officials counter that the virus may still be contained, pointing to the United States’ rapidly growing stockpile of treatments and vaccines, as well as testing.

“There is no other place in the world where they have 300,000 doses of vaccine … distributed to states like in America,” Becerra said Monday.

Some health officials argue that declaring a state of emergency would allow the administration to open up its authority to collect information about monkeypox and vaccinations that has not been shared with the federal government.

Although the Centers for Disease Control and Prevention estimates that more than 1.5 million men who have sex with men are eligible for the vaccine, “We don’t have any data at the CDC about who has been vaccinated,” CDC Director Rochelle Walensky told Washington Post Live. virtual event on Friday.

FDA officials also said they were waiting for an emergency decision before issuing a separate declaration that could expedite the use of medical countermeasures. A similar move during the coronavirus response allowed pharmacists to vaccinate young children and doctors to vaccinate out-of-state patients.

Meanwhile, front-runners say the response remains too bureaucratic, leading to a byzantine maze for patients who test positive and are severely ill for days. A New York man told The Post of an eight-day saga that began last week for treatment he was denied by several providers, including an urgent care clinic, who provided misleading or incorrect information.

Slow access to testing, treatment and vaccines was “a bit of a disaster” in the initial U.S. response to monkeypox, paralleling mistakes in the initial response to the coronavirus, said Megan Ranney, an emergency physician and academic dean at Brown University’s School of Public Health. Health.

“I can’t help but wonder if part of my delay is because our public health workers are so burned out,” Ranney added. “Everyone who can afford to work in epidemiology or contact tracing is doing it for covid.”

Lori McGinley and Lena H. A number contributed to this report.

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