Tom Williams | CQ-Roll Call, Inc via Getty Images California Gov. Gavin Newsom declared a state of emergency due to the rapidly spreading monkeypox outbreak on Monday, the third US state to do so in as many days. Newsom said the emergency declaration will help support the state’s vaccination efforts. Demand for vaccines has outstripped supply as infections rise. Staff at sexual health clinics and other sites are struggling to keep up with the influx of people seeking the shots. California is mobilizing staff from its emergency medical services to help administer the vaccines. Newsom said the state is working at all levels of government to slow the spread through testing, contract tracing and community outreach. California’s declaration comes after Illinois declared a public health emergency earlier Monday. New York declared a disaster emergency in response to the outbreak late Friday. The US has reported nearly 6,000 cases of monkeypox in 48 states, Washington DC and Puerto Rico, according to the Centers for Disease Control and Prevention. The outbreak has spread rapidly since health authorities in Boston confirmed the first US case in May. California, Illinois and New York – home to the nation’s three largest cities – have reported 47% of all confirmed monkeypox infections in the U.S. New York is the epicenter of the U.S. outbreak, with nearly 1,400 confirmed cases from Monday. Monkeypox is rarely fatal and so far no deaths have been reported in the US. But some patients suffer excruciating pain from the rash caused by the virus. Scientists and public health officials worry that monkeypox could circulate permanently in the US if the outbreak is not contained. The WHO declared monkeypox a global health emergency last month. More than 19,000 cases of monkeypox have been reported in at least 78 countries, according to WHO data. The outbreak is unusual because the virus is spreading widely in North America and Europe. In the past, monkeypox spread at low levels in West and Central Africa where rodents and other animals carry the virus. Monkey pox is mainly spread through skin-to-skin contact during sex. Gay and bisexual men are at the highest risk of infection right now, public health officials say. About 98 percent of patients who provided demographic information at clinics identified as men who have sex with men, according to the CDC. However, health officials have repeatedly stressed that anyone catches monkeypox through physical contact with someone who has the rash characteristic of the virus or contaminated materials such as towels and sheets. The CDC last month confirmed the first two cases of children infected with the virus in the US, likely through transmission within their families. Monkey pox can also spread through respiratory droplets when an infected person has lesions in their mouth, but that requires prolonged face-to-face interaction, according to the CDC. Physical contact is the primary mode of transmission, health officials say.
The US is weighing a public health emergency
The Biden administration is considering whether to declare a public health emergency in the US, according to senior federal health officials. That would help mobilize resources for state health officials battling the outbreak. The last time the US declared a public health emergency was in response to Covid-19 in January 2020. Lawmakers in Congress and local communities criticized the pace of the federal government’s response, but Health Secretary Xavier Becerra said last week that the Biden administration was doing everything it could to increase resources to fight the outbreak. Becerra said states must do more to prevent transmission and Congress must approve funding to support the response to the outbreak. The Department of Health and Human Services has delivered more than 330,000 doses of the monkeypox vaccine to state health departments since May. HHS made another 786,000 doses available to states and other jurisdictions on Friday. However, sexual health clinics say they don’t yet have enough vaccine to meet demand right now. The Food and Drug Administration approved the two-dose Jynneos vaccine in 2019 for people at high risk of exposure to smallpox or smallpox. Jynneos, made by Danish biotech company Bavarian Nordic, is the only FDA-approved monkeypox vaccine in the US. The US now has the capacity to conduct 80,000 tests a week after bringing in several commercial laboratories last month, according to the CDC. However, the number of confirmed infections in the US is likely an undercount because people cannot be tested until they develop a rash, which can last several weeks in some cases. Clinicians swab the rash to obtain the sample for testing. The US also has 1.7 million courses of tecovirimat antiviral therapy in the strategic national stockpile. Doctors can use tecovirimat to treat monkeypox, but that requires an extra layer of paperwork because the drug is only approved for smallpox. The CDC cut red tape last month to make it easier for doctors to prescribe tecovirimat. Monkeypox belongs to the same family of viruses as smallpox, but causes a much milder disease.