Editor’s note: This story, initially published Aug. 1 after Gov. J.B. Pritzker declared monkeypox a public health emergency in Illinois, was updated Aug. 4 when the federal government declared the outbreak a nationwide emergency.
The national monkeypox outbreak was declared a federal public health emergency by U.S Health and Human Services Secretary Xavier Becerra during a Thursday news conference.
The formal declaration will relax paperwork requirements and red tape for providers and provide more resources for tests and vaccines.
Additionally, the department is looking at a second declaration designed to distribute potential treatments and vaccines to high-risk populations without the typically required federal review, Becerra said Thursday, Aug. 4.
As of Wednesday, Aug. 3, the U.S. has reported more than 6,000 cases, of which Illinois has seen over 500.
Becerra and other public health officials have identified a population of about 1.6 million individuals at the highest risk for contracting the virus, but the U.S. only has the supply of doses to fully vaccinate 550,000 people. The country is expecting another 150,000 doses in September, but for now, officials are considering a plan to split one dose into multiple smaller doses to provide some level of protection to more people, they told reporters Thursday.
“We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus,” Becerra said.
HHS has not yet released a written emergency declaration, but an announcement on its website is expected.
The news of a national emergency also comes on the heels of Illinois Gov. J.B. Pritzker declaring the state’s own monkeypox outbreak a public health emergency Monday, with 520 cases officially reported across the state, according to a news release from Pritzker’s office. Before the nationwide declaration, New York, California and Illinois had issued their own emergency announcements, with New York leading the U.S. with over 1,600 cases reported so far.
The illness typically starts with flu-like symptoms, including fever, aches and fatigue. Infected people then develop pox lesions around their body, most commonly on their face and around their genitals. The lesions can be particularly painful and sometimes cause difficulty eating, drinking or using the bathroom, according to infectious disease experts.
So far, the vast majority of cases have occurred among gay, bisexual and other men who have sex with men, although anyone can contract the illness through close contact with someone who has the virus. While monkeypox is not a sexually transmitted infection, the virus spreads most easily through prolonged skin-to-skin contact, which can happen during sex.
The emergency declaration from Pritzker will enable local and state public health agencies to roll out vaccines and testing operations more quickly, with money and help from the Illinois Emergency Management Agency.
“I am declaring a state of emergency to ensure smooth coordination between state agencies and all levels of government, thereby increasing our ability to prevent and treat the disease quickly,” Pritzker said in a statement. “We have seen this virus disproportionately impact the LGBTQ+ community in its initial spread. Here in Illinois, we will ensure our LGBTQ+ community has the resources they need to stay safe while ensuring members are not stigmatized as they access critical health care.”
Through interviews with local doctors in Evanston and around the Chicago region who have treated monkeypox patients, the RoundTable has compiled the following list of recommendations for the public to stay safe and healthy:
- Evaluate your personal level of risk. If you are a man who has sex with other men and have had multiple or anonymous sex partners recently, you are at an elevated risk for becoming infected.
- Get vaccinated. You can find a list of locations administering vaccine doses on the Chicago Department of Public Health website.
- Limit your number of sexual partners for the time being, have open conversations about sexual activity with your partners and use condoms or barrier devices.
- If you develop symptoms, contact a health care provider right away and ask about your eligibility for the investigational antiviral drug Tecovirimat, sold under the brand name Tpoxx, which patients have said helps relieve symptoms and shortens the course of illness.
People can take care of themselves and others by reporting symptoms quickly, isolating themselves and notifying any of their recent close contacts, according to Dr. Anu Hazra, an infectious diseases and sexual health physician with Howard Brown Health in Chicago.
“Revisit your stigmas around this illness itself and understand that if you are at risk and you develop symptoms, you should tell someone,” Hazra said. “You should be able to come to a health-care setting and receive treatment, if needed, and any other interventions that are needed. You shouldn’t feel ashamed, you should not feel embarrassed about getting monkeypox. We’re living through an outbreak, and if you’re in an at-risk group, you’re obviously highly susceptible to potentially getting this illness.”
Pritzker’s public health emergency proclamation is currently scheduled to last 30 days, although it could be extended. Still, Hazra and other doctors said the public health system in the United States does not have the resources to keep up with the outbreak as it currently stands.
For example, as Hazra pointed out, many health-care providers across the country hoped that the COVID-19 pandemic would force the nation to reinvest in public health infrastructure, but instead, people are burned out and leaving the field. In Chicago, for every dollar that goes toward the city’s police department, just 8 cents goes toward public health.
“Unlike COVID – where we didn’t know the pathogen, we had to create a vaccine and then it took a couple years to create the drug – we’ve got the vaccine, we’ve got the drug and you know the pathogen,” said Dr. Vishnu Chundi of Metro Infectious Disease Consultants. “But we’re not able to execute all these things, even within eight weeks, on a rapid basis to stop the spread, so it tells you the system is not correct for what the requirements are.”