Health and Human Services Secretary Xavier Becerra declared the monkeypox outbreak a public health emergency on Thursday in an effort to galvanize awareness and unlock additional flexibility and funding to fight the virus’s spread.
The health secretary is also considering a second declaration empowering federal officials to expedite medical countermeasures, such as potential treatments and vaccines, without going through full-fledged federal reviews. That would also allow for greater flexibility in how the current supply of vaccines is administered, Becerra said.
The administration’s announcement follows similar decisions by health officials in New York, California and Illinois and global health leaders. The World Health Organization on July 23 declared that monkeypox was a public health emergency of international concern, its highest-level warning, after confirmed outbreaks in about 70 countries where the virus has not historically spread.
Health officials Thursday also said they were taking steps to improve access to Jynneos, the only vaccine approved by the Food and Drug Administration to protect against the virus through a two-dose regimen. Federal officials have identified about 1.6 million people as highest risk for monkeypox, but the U.S. has only received enough Jynneos doses to fully cover about 550,000 people. Officials said that they had expedited an additional 150,000 doses of Jynneos to arrive in September, and FDA Commissioner Robert Califf told reporters that a “dose-sparing” plan was under serious consideration.
“We’re considering an approach … that would allow health care providers to use an existing one-dose vial of the vaccine to administer a total of up to five separate doses,” said Califf, adding that the plan was “looking good” and would be finalized in the coming days.
Federal leaders had spent weeks debating whether to declare monkeypox a public health emergency, and officials said that Thursday’s planned announcement is part of a broader push to contain the virus. The announcement follows the White House’s decision this week to name Robert J. Fenton Jr., a longtime official at the Federal Emergency Management Agency, as the coordinator of the national response to the virus.
“This public health emergency will allow us to explore additional strategies to get vaccines and treatments more quickly out in the affected communities. And it will allow us to get more data from jurisdictions so we can effectively track and attack this outbreak,” Fenton said Thursday.
Thursday’s announcements were cheered by President Biden’s allies on Capitol Hill, including House Oversight Chairwoman Carolyn B. Maloney (D-N.Y.), who had pressed the administration to declare an emergency.
“This critical step will allow the Biden administration to build on the progress it has already made to expand the availability of vaccines, testing, and treatment nationwide,” Maloney said in a statement.
But public health experts called Thursday’s announcement overdue, saying that the emergency declaration had been long-needed to fast-track more funding and flexibility.
“It’s about time,” David C. Harvey, executive director of the National Coalition of STD Directors, said in a statement. “With this declaration in place, the administration must act quickly to allocate funding to state and local health departments for … clinical services” to deal with monkeypox.
The top Republican on the Senate’s health committee said that the Biden administration had failed to move quickly to contain the virus.
“I have been baffled by the degree to which the administration seems to be disconnected from the realities on the ground for health care providers, public health personnel, and, most importantly, patients,” Sen. Richard Burr (R-N.C.) wrote in a letter to Becerra, calling the government’s response “a devastating public health failure.”
More than 7,100 cases of monkeypox have been confirmed in the United States since May 18 with the vast majority occurring among men who have sex with men — a total that has doubled about every eight days, but which experts say they believe is a significant undercount. Officials have also reported at least five cases of monkeypox in children, who are believed to have gotten infected through household transmission.
WHO officials last week advised men who have sex with men to temporarily reduce their number of sexual partners in an attempt to reduce transmission.
While health officials have stressed that monkeypox poses far fewer risks than coronavirus — with just a handful of deaths globally and none to date in the United States — the virus can lead to fever, swollen lymph nodes, rash and often painful lesions that can last for weeks and result in scarring. The virus also is linked to more severe complications in children, pregnant women and people with immune conditions.
The infectious-disease, which comes from the same family of viruses as smallpox, spreads primarily through close contact, and experts say they believe skin-to-skin exposure during sexual activity is a major source of transmission in the current outbreak. But they caution that the virus spreads through other forms of touch and can circulate outside the gay and bisexual communities, noting a handful of cases in women and children.
Some Biden officials had previously argued that declaring an emergency for monkeypox would call attention to the growing outbreak and strengthen the nation’s overall response. For instance, the emergency declaration can be used to compel hospitals to report more data about their monkeypox patients, and enable the Food and Drug Administration to expedite medical countermeasures that might otherwise take months or years to undergo traditional regulatory reviews. Many public health experts had also affirmed the WHO’s decision to declare a public health emergency, saying that a coordinated global response is “essential” to beating back the growing outbreak.
Federal officials on Thursday also circulated an “options memo” for how a public health emergency would improve the nation’s monkeypox response, according to two officials who were not authorized to comment. POLITICO first reported the existence of the memo.
Tom Inglesby, director of the Johns Hopkins Center for Health Security, said that declaring a public health emergency could help identify more potential monkeypox cases that are likely going undetected.
“We need to have everybody aware of what this disease looks like — and everybody aware that they need to be testing for it. Or we’re going to continue to have invisible chains of transmission,” said Inglesby, who also oversaw coronavirus testing efforts for the Biden administration before leaving the White House earlier this year.
But Becerra’s decision to declare monkeypox an emergency could raise political complications for the White House, which has faced calls from advocates to declare gun violence a public health emergency and climate change a national emergency. Democrats like Sen. Elizabeth Warren (D-Mass.) and reproductive health rights groups have also lobbied the administration to declare access to abortion a public health emergency in the wake of the Supreme Court’s recent ruling that overturned Roe v. Wade and led to new statewide abortion restrictions around the nation.
The Biden administration has also continued to renew public health emergency declarations, which expire every 90 days, for opioids and the coronavirus.