How bad is China’s covid outbreak?

China is in the middle of what may be the world’s largest covid-19 outbreak after authorities abruptly loosened almost three years of strict pandemic restrictions in December following nationwide protests against the measures.

The sudden dismantling of China’s “zero covid” regime — enforced through mass lockdowns, testing and contact tracing — has left the country’s health system unprepared and overwhelmed. It has alarmed international health experts concerned about Beijing’s transparency and caused diplomatic friction as countries enforce travel restrictions on arrivals from China.

How many people have been infected?

So far, there are no reliable national figures for the number of people among China’s 1.4 billion population who have been infected in the current outbreak. After admitting the difficulty of tracking infections, China’s National Health Commission stopped reporting daily tallies in December.

The data is still maintained by the Chinese Center for Disease Control and Prevention, based on counts from hospitals and local health commissions. But because mandatory mass testing has been dropped, the official figure is believed to massively underestimate the rate of infection. As of Jan. 8, there have been a little more than 500,000 confirmed covid cases since the pandemic began, according to the CDC.

Statements from local governments indicate that the true number of infections is exponentially higher. Officials in Henan province estimated this week that 89 percent of the province’s 99 million residents have been infected. In Zhejiang province, officials said the province was seeing over a million new infections a day in late December. As of Jan. 8, all 31 provinces, municipalities and regions had reported covid infections, according to the CDC.

How serious is the outbreak?

The number of deaths remains unknown, even as evidence is mounting that the true death count is much higher than what has been reported — a little more than 5,200 deaths since the pandemic began and fewer than 40 since zero-covid restrictions were lifted on Dec. 7.

As of Dec. 25, the takeup of intensive care beds in secondary and tertiary hospitals across the country was about 54 percent, but that figure has since increased to 80 percent, Jiao Yahui, director of the Department of Medical Affairs of the National Health Commission, said in an interview with state broadcaster CCTV on Sunday.

Officials reassured the public by noting that the fatality rate of the coronavirus’s omicron variant is 0.1 percent. The current outbreak has mostly consisted of the omicron subvariants BA.5.2 and BF.7, the State Council Information Office said in a news conference Monday.

The lack of testing combined with the narrow definition of what counts as a covid death — positive patients who die of respiratory failure — continue to skew the statistics. Officials have said they will investigate fatalities and release the results in the future.

What is the government saying?

Authorities say the worst of the outbreak is over for Chinese cities where infections spread quickly in December. Now, they are preparing for a new surge in rural areas around the upcoming Lunar New Year holiday that begins Jan. 21.

State media has reported that cases in most major cities have started to decline. Yin Yong, acting mayor of Beijing, told CCTV on Monday that the city had reached its peak and that authorities were turning their focus to monitoring potential new coronavirus variants or subvariants of omicron, and to mitigating the impact of covid on the elderly and other vulnerable groups.

Officials also said the peak had been reached in the province of Jiangsu in late December, while in Zhejiang, authorities said, “the first wave of infections has passed smoothly,” according to Health Times, a publication managed by People’s Daily. The state-run Farmers’ Daily said that visits to 51 villages across 31 provinces showed that most residents had been infected and had recovered.

Data released by Baidu, the main search engine in China, showed that the number of searches related to covid symptoms and medical supplies had dropped since peaking in mid-December.

Yet in Henan, officials said hospitals remain overcrowded because of a rise in critical cases in the past week. Researchers at the Institute of Public Health at Nankai University in Tianjin, using data from fever clinics, project that the nationwide peak will be between Dec. 20 and Jan. 15, with two smaller peaks in the first half of this year.

Officials have predicted a second wave over the Lunar New Year holiday, when the total number of passenger trips by residents is expected to reach 2.1 billion as pent-up demand for travel is unleashed. At this point, more contagion could spread to rural areas, where severe shortages of anti-fever drugs and medical staff have been reported.

How did zero covid affect the outbreak?

China’s pursuit of zero covid, eliminating the spread of the virus through lockdowns, mandatory quarantines, travel restrictions and mass testing, has proved to be a double-edged sword. While the approach kept infections and death rates low throughout most of the pandemic, it left the Chinese population with little natural immunity to the virus.

Many elderly residents — already skeptical of vaccines, which have had a troubled past in China — did not get vaccinated, feeling that they would be protected by the zero-covid strategy. Only 40 percent of residents above the age of 80 have had booster shots.

Under China’s covid policy, the population was immunized with domestically made vaccines that are not as effective against the omicron variant as mRNA vaccines. China has yet to approve foreign mRNA vaccines, and a domestically made one is still under production.

What does this mean for the rest of the world?

Concerns about the possibility of a new variant emerging in China have prompted countries including the United States, Japan and South Korea, and many European countries, to require extra screening for arrivals from China.

Wu Zunyou, the chief epidemiologist at the CDC, told CCTV in a report published Sunday that no new variants have emerged and that new strains are being collected every day to monitor changes.

“All the strains we found so far have already been shared with international sharing platforms,” he said. “They are the ones either reported abroad, or have been introduced to China after spreading overseas. So far, no newly emerged mutated strains have been found in China.”

The World Health Organization has called on China to share more real-time data on the outbreak. Michael Ryan, the health emergencies director, said at a news conference in Geneva on Wednesday that the WHO “still believes that deaths are heavily underreported from China.” He added: “We still do not have adequate information to make a full comprehensive risk assessment.”

Beijing has criticized travel restrictions on people arriving from China imposed by other countries as “ridiculous” and politically motivated. It has threatened countermeasures and this week suspended short-term visas for Japanese and South Korean citizens.

XBB.1.5 variant becomes dominant COVID strain in US

https://mailchi.mp/ad2d38fe8ab3/the-weekly-gist-january-6-2023?e=d1e747d2d8

Surging from less than 5 percent of cases in the first week of December, XBB.1.5 now makes up over 40 percent of all COVID infections in the US. The new variant appears to demonstrate a high level of immune evasion, and is around 40 percent more contagious than the next most virulent strain, though illnesses caused by XBB.1.5 do not seem to be more severe. Weekly rates for new COVID-related hospital admissions are now higher than at any point since February 2022, despite case counts remaining lower than the peak of the summer wave in July 2022 (although it is likely that the vast majority of cases are now identified through home testing, and not reported, making the data unreliable). 

The Gist: While the new variant seems to be less likely to create a COVID spike of the magnitude we experienced last winter, hospitalizations rising faster than case counts bears watching. That’s especially true given the current staffing situation in most hospitals, which makes each COVID admission and each caregiver call-out for illness a cause for concern. 

Only 15 percent of eligible Americans have received the most recent bivalent booster, leaving the population more vulnerable to this and future variants. Plus, additional funding to support the fight against COVID does not seem to be forthcoming from the new Congress. Beset with surges of COVID, flu, and RSV admissions, hospitals must hope that the end of the holiday season brings some relief.

A tripledemic hurricane is making landfall. We need masks, not just tent hospitals

A viral hurricane is making landfall on health care systems battered by three pandemic years. With the official start of winter still weeks away, pediatric hospitals are facing crushing caseloads of children sick with RSV and other viral illnesses. Schools that promised a “return to normal” now report widespread absences and even closures from RSV and flu in many parts of the country, contributing to parents missing work in record numbers. With this year’s flu season beginning some six weeks early, the CDC has already declared a flu epidemic as hospitalizations for influenza soared to the highest point in more than a decade.

A storm of these proportions should demand not only crisis clinical measures, but also community prevention efforts. Yet instead of deploying public health strategies to weather the storm, the U.S. is abandoning them.

Even before the arrival of the so-called tripledemic, U.S. health systems were on the brink. But as the fall surge of illness threatens to capsize teetering hospitals, the will to deploy public health measures has also collapsed. Pediatricians are declaring “This is our March 2020” and issuing pleas for help while public health efforts to flatten the curve and reduce transmission rates of Covid-19 — or any infectious disease — have effectively evaporated. Unmanageable patient volumes are seen as inevitable, or billed as the predictable outcome of an “immunity debt,” despite considerable uncertainty surrounding the scientific underpinnings and practical utility of this concept.

The Covid-19 pandemic should have left us better prepared for this moment. It helped the public to understand that respiratory viruses primarily spread through shared indoor air. Public health practices to stop the spread of Covid-19 — such as masking, moving activities outdoors, and limiting large gatherings during surges — were incorporated into the daily routines of many Americans. RSV and flu are also much less transmissible than Covid-19, making them easier to control with common-sense public health practices.

Instead of dialing up those first-line practices as pediatric ICUs overflow and classrooms close, though, the U.S. is relying on its precious and fragile last lines of defense to combat the tripledemic: health care professionals and medical facilities.

Warnings and advisories recently issued by U.S. public health leadersclinical leaderspoliticians, and the media have consistently neglected to mention masking as a powerful short-term public health strategy that can blunt the surge of viral illness. Instead, recent guidance has exclusively promoted handwashing and cough etiquette. These recommendations run counter to recent calls to build on improved understanding of the transmission of respiratory viruses.

In the U.S.’s efforts to “move on” from thinking about Covid, it has created a “new normal” that is deeply abnormal — one in which we normalize resorting to crisis measures, such as treating patients in tents, instead of using common-sense public health strategies. Treating Covid like the flu — or the flu like Covid — has effectively meant that we treat neither illness as if it were a serious threat to health systems and to public health. Mobilizing Department of Defense troops and Federal Emergency Management Agency personnel to cover health system shortfalls is apparently more palatable than asking people to wear masks.

The tripledemic has already claimed its first child deaths in the U.S., adding to a large ongoing death toll from Covid. Allowing health systems to reach the brink of collapse will lead to many more preventable deaths among pediatric and other vulnerable patients who can’t access the care they need.

By any accounting, these losses are shocking and tragic. But they should strike us as particularly abhorrent and shameful because the tripledemic is a crisis that leaders, health agencies, and institutions have, in a sense, chosen. Over the past year, the Biden administration and its allies have repeatedly encouraged the public to stand down on public health measures, with the President even stating in September that “the pandemic is over.” By moving real risks out of view and failing to push for more robust measures to mitigate Covid, these messages have put the country on a path to its present circumstances, in which pediatric RSV patients are transferred to hospitals hundreds of miles away because there is no capacity to treat them in their own communities.

Living with viruses should mean embracing simple public health measures rather than learning to live with staggering levels of illness and death. Leaders in public health and medicine should issue timely and appropriate guidance that reflects the latest science instead of second-guessing the prevailing winds in public opinion. Instead of self-censoring their recommendations out of fear of political consequences, they should continue to promote the full range of public health strategies, including masking in crowded indoor public places during surges.

The tripledemic should bring renewed urgency to policies that will reduce the toll of seasonal illness on health, education, and the economy. Improvements in indoor air quality in public spaces, including schools, child care centers, and workplaces, can limit the spread of diseases and have many demonstrated health and economic benefits, yet the U.S. continues to lack standards to guide infrastructure or workplace safety standards. Paid leave enabling workers to stay home when they are ill can reduce the transmission of disease as well as loss of income, yet the U.S. is one of the only high-income countries without universal paid sick leave or family medical leave.

Greater effort must also be made to increase vaccination coverage for flu and Covid and bring an RSV vaccine online as quickly as possible. Only about half of high-risk adults under 65 received a flu shot last year, a gap that can be closed with more energetic vaccination campaigns. Reducing annual flu deaths using a broader range of strategies enabled by the pandemic — rather than pegging Covid deaths to them — should be the goal.

Amid the many sobering stories of the tripledemic, there is some good news. As the experience of Covid-19 has shown, it is possible to limit the toll of respiratory viruses like flu and RSV. However, this work requires resources, appropriate policies, and political will. Americans don’t need to accept winter disease surges and overrun health systems as an inevitable new normal. Instead, the country should see the tripledemic as a call to reinvigorate public health strategies in response to these threats to the health of our communities.

Covid-19 is surging in Europe. Is America next?

https://www.advisory.com/daily-briefing/2022/10/10/covid-resurgence

While infections, hospitalizations, and deaths from Covid-19 have been steadily declining in the United States in recent months, experts warn that rising cases in Europe may be “a harbinger for what’s about to happen in the United States,” Rob Stein writes for NPR’s “Shots.”

Will the US see a ‘winter resurgence’ of Covid-19?

Currently, several models project that U.S. Covid-19 infections will continue to decline at least until the end of 2022. However, researchers caution that there are multiple variables that could change current projections, including whether more infectious strains start circulating around the nation.

According to Stein, “[t]he first hint of what could be in store is what’s happening in Europe.” Recently, many European countries, including the U.K., France, and Italy, have seen an increase in Covid-19 infections.

“In the past, what’s happened in Europe often has been a harbinger for what’s about to happen in the United States,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “So I think the bottom line message for us in this country is: We have to be prepared for what they are beginning to see in Europe.”

“We look around the world and see countries such as Germany and France are seeing increases as we speak,” said Lauren Ancel Meyers, director of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. “That gives me pause. It adds uncertainty about what we can expect in the coming weeks and the coming months.”

However, Justin Lessler, an epidemiologist at the University of North Carolina who helps run the COVID-19 Scenario Modeling Hub, noted that the United States may not have the same experience as Europe, largely because it is unclear whether Europe’s increase is related to individuals’ vulnerability to new strains.

“If it is mostly just behavioral changes and climate, we might be able to avoid similar upticks if there is broad uptake of the bivalent vaccine,” Lessler added. “If it is immune escape across several variants with convergent evolution, the outlook for the U.S. may be more concerning.”

Some researchers believe the United States is already experiencing early signs of this. “For example, the levels of virus being detected in wastewater is up in some parts of the country, such in Pennsylvania, Connecticut, Vermont and other parts of Northeast,” Stein writes. “That could an early-warning sign of what’s coming, though overall the virus is declining nationally.”

It’s really too early to say something big is happening, but it’s something that we’re keeping an eye on,” said Amy Kirby, national wastewater surveillance program lead at CDC.

According to David Rubin, the director of the PolicyLab at Children’s Hospital of Philadelphia, which tracks the pandemic, Covid-19 infections and hospitalizations are already rising in some parts of New England, and other northern regions, including the Pacific Northwest.

“We’re seeing the northern rim of the country beginning to show some evidence of increasing transmission,” Rubin said. “The winter resurgence is beginning.”

How likely is a severe Covid-19 surge?

Unless a “dramatically different new variant emerges,” it is “highly unlikely this year’s surge would get as severe as the last two years in terms of severe disease and deaths,” Stein writes.

“We have a lot more immunity in the population than we did last winter,” said Jennifer Nuzzo, who leads the Pandemic Center at the Brown University School of Public Health.

“Not only have people gotten vaccinated, but a lot of people have now gotten this virus. In fact, some people have gotten it multiple times. And that does build up [immunity] in the population and reduce overall over risk of severe illness,” Nuzzo said.

Another factor that could affect the severity of the impact of rising infections is the number of people who receive updated Covid-19 vaccines, which help boost waning immunity from previous infections or shots.

However, the United States’ booster uptake has been slow. “Nearly 50% of people who are eligible for a booster have not gotten one,” said William Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health. “It’s wild. It’s really crazy.”

Since updated boosters became available in September, less than 8 million of the over 200 million people who are eligible have received one.

According to Nuzzo, it is critical for people to stay up to date on their vaccines, especially with the high likelihood of another Covid-19 surge. “The most important thing that we could do is to take off the table that this virus can cause severe illness and death,” Nuzzo said.

“There are a lot of people who could really benefit from getting boosted but have not done so,” she added.

Chengdu locks down 21.2 million people as Chinese cities battle Covid-19

https://www.cnbc.com/2022/09/01/chengdu-locks-down-21point2-million-people-as-chinese-cities-battle-covid-19.html

KEY POINTS

  • One of China’s biggest cities, Chengdu, announced a lockdown of its 21.2 million residents as it launched four days of citywide Covid-19 testing, as some of country’s most populous and economically important urban centers battle outbreaks.
  • All residents in Chengdu, the capital of Sichuan province, were ordered to stay largely at home from 6 p.m. on Thursday, with households allowed to send one person per day to shop for necessities, the city government said in a statement.

The southwestern Chinese metropolis of Chengdu announced a lockdown of its 21.2 million residents as it launched four days of citywide Covid-19 testing, as some of the country’s most populous and economically important cities battle outbreaks.

Residents of Chengdu, the capital of Sichuan province, were ordered to stay home from 6 p.m. on Thursday, with households allowed to send one person per day to shop for necessities, the city government said in a statement.

Chengdu, which reported 157 domestically transmitted infections on Wednesday, is the largest Chinese city to be locked down since Shanghai in April and May. It remained unclear whether the lockdown would be lifted after the mass testing ends on Sunday.

Other major cities including Shenzhen in the south and Dalian in the northeast have also stepped up Covid restrictions this week, ranging from work-from-home requirements to the closure of entertainment businesses in some districts.

The moves curtail the activities of tens of millions of people, intensifying the challenges for China to minimize the economic impact of a “dynamic-zero” Covid policy that has kept China’s borders mostly shut to international visitors and make it an outlier as other countries try to live with the coronavirus.

Most of the curbs are intended to last a few days for now, although two provincial cities in northern China have extended curbs slightly beyond initial promises.

Chengdu’s lockdown sparked panic buying of essentials among residents.

“I am waiting in a very long queue to get in the grocery near my home,” 28-year-old engineer Kya Zhang said, adding that she was worried about access to fresh food if the lockdown is extended.

Hwabao Trust economist Nie Wen said that because Chengdu acted quickly to lock down, it was unlikely to see a repeat of Shanghai’s two-month ordeal.

Non-essential employees in Chengdu were asked to work from home and residents were urged not to leave the city unless needed. Residents who must leave their residential compounds for hospital visits or other special needs must obtain approval from neighborhood staffers.

Industrial firms engaged in important manufacturing and able to manage on closed campuses were exempted from work-from-home requirements.

Sweden’s Volvo Cars said it would temporarily close its Chengdu plant.

Flights to and from Chengdu were dramatically curtailed, according to Flight Master data. At 10 a.m. local time (0200 GMT) on Thursday, it showed 398 flights had been canceled at Shuangliu Airport in Chengdu, with a cancellation rate of 62%. At Chengdu’s Tianfu Airport, 79%, or 725 flights, were canceled.

Shenzhen curbs

In Shenzhen, which has the third-highest economic output among Chinese cities, the most populous district Baoan and tech hub Nanshan suspended large events and indoor entertainment for a few days and ordered stricter checks of digital health credentials for people entering residential compounds.

Nanshan is home to internet giant Tencent and the world’s biggest dronemaker, DJI, among other major Chinese companies.

More than half of Shenzhen’s ten districts, home to over 15 million people, have ordered blanket closure of entertainment venues and halted or reduced restaurant dining for a few days, with curbs in two districts initially planned to be lifted by the end of Thursday.

Shenzhen authorities have largely avoided shutting down offices and factories as they did during a week-long lockdown in March.

Data on Thursday showed that Chinese factory activity contracted for the first time in three months in August amid weakening demand, while power shortages and fresh Covid-19 flare-ups disrupted production.

In Shanghai, schools reopened on Thursday after being closed for months.

Mainland China has reported no Covid death since May, leaving the death toll at 5,226.

How does monkeypox spread? An epidemiologist explains why it isn’t an STI and what counts as close contact

Monkeypox is caused by a virus that, despite periodic outbreaks, is not thought to spread easily from person to person and historically has not spurred long chains of transmission within communities. Now, many researchers are left scratching their heads as to why monkeypox seems to be propagating so readily and unconventionally in the current global outbreak.

The monkeypox virus typically spreads through direct contact with respiratory secretions, such as mucus or saliva, or skin lesions. Skin lesions traditionally appear soon after infection as a rash – small pimples or round papules on the face, hands or genitalia. These lesions may also appear inside the mouth, eyes and other parts of the body that produce mucus. They can last for several weeks and be a source of virus before they are fully healed. Other symptoms usually include fever, swollen lymph nodes, fatigue and headache.

I am an epidemiologist who studies emerging infectious diseases that cause outbreaks, epidemics and pandemics. Understanding what’s currently known about how monkeypox is transmitted and ways to protect yourself and others from infection can help reduce the spread of the virus.

How is this outbreak different from prior ones?

The current monkeypox epidemic is a bit unusual in a few ways.

First, the sheer scope of the current epidemic, with over 25,000 cases worldwide as of early August and in countries where the virus has never appeared, sets it apart from previous outbreaks. Monkeypox is endemic to specific areas in central and western Africa, where cases occur sporadically and outbreaks are usually contained and quickly burn out. In the current outbreak, global spread has been rapid. Young men, mostly ages 18 to 44, account for the majority of cases, and over 97% identify as men who have sex with men (MSM). Some superspreading events associated with air travel, international gatherings and multiple-partner sexual encounters contributed to early transmission of the virus.

Second, the way symptoms are appearing may facilitate spread among people who don’t yet know they are infected. Most patients reported mild symptoms without fever or swollen lymph nodes, symptoms that typically appear before a skin rash is visible. While most people do develop skin lesions, many reported having only a single papule that was often obscured inside a mucosal area, such as inside the mouth, throat or rectum, making it easier to miss.

A number of people reported no symptoms at all. Asymptomatic infections are more likely to go undiagnosed and unreported than those with symptoms. But it is not yet known how asymptomatic individuals may be contributing to spread or how many asymptomatic cases may be undetected so far.

Who is at risk of getting monkeypox?

For most people, the risk of getting monkeypox is currently low. Anyone who has prolonged, close contact with an infected person is at risk, including partners, parents, children or siblings, among others. The most common settings for transmission are within households or health care settings.

Because of sustained transmission within the community of men who have sex with men, they are considered an at-risk group, and targeted recommendations can help allocate resources and limit transmission. While monkeypox is spreading primarily among MSM, this does not mean that the virus will remain confined to this group or that it won’t jump to other social networks. The virus itself has no regard for age, gender, ethnicity or sexual orientation.

Anyone who comes into direct contact with the monkeypox virus is at risk of being infected. New cases are recorded daily, with additional countries and regions reporting their first cases and already affected countries observing a continued rise in infections.

As with most infections, other factors, such as the amount of viral exposure, type of contact and individual immune response, play a role in whether an infection takes hold.

Is monkeypox an STI?

While sexual encounters are currently the predominant mode of transmission among reported cases, monkeypox is not a sexually transmitted infection. STIs are spread primarily through sexual contact, while monkeypox can spread through any form of prolonged, close contact.

Close contact that transmits the monkeypox virus involves encounters that are typically more intimate or involved than having a casual conversation or standing next to someone in an elevator. Transmission requires exchange of mucosal fluids or direct contact with the virus in sufficient quantity to seed an infection. This could occur through physical contact during kissing or cuddling.

Because sexual encounters involve direct skin-to-skin physical contact where bodily fluids may be exchanged, these close encounters can transmit viruses more easily. Recently, monkeypox DNA has been detected in feces and various body fluids, including saliva, blood, semen and urine. But the presence of viral DNA does not necessarily mean that the virus can infect someone else. Transmission from these sources is still under investigation.

As the virus moves through populations, public health officials focus on getting the message out to the most at-risk and hardest hit communities about how to stay safe. Currently, breaking the transmission chain among sexual contacts is a priority, including but not limited to MSM communities. Targeted messaging is meant to protect the health of a specific group, not to stigmatize the intended audience.

Other modes of transmission may play a greater role outside the MSM community. Household transmission, where individuals may come into close contact with infected people or contaminated items, is one of the most common types of exposure. Research is ongoing into the potential airborne and respiratory droplet spread of monkeypox in the current situation.

Outbreaks are dynamic situations that evolve over time, which is why public health messages may change as the epidemic progresses. Not every outbreak looks or behaves the same way – even pathogens seen in previous outbreaks can be different the next time around. As researchers learn more about how the disease is transmitted and identify changes in patterns of spread, public health officials will provide updates about specific forms of contact, behaviors or other factors that could increase infection risk. While changing guidelines can be frustrating or confusing, keeping up to date with the latest recommendations can help you protect yourself and stay safe.

What do I do if I’ve been exposed to monkeypox?

Anyone who has been infected can help contain spread by isolating from others, including pets. Covering skin lesions, wearing a mask in shared spaces and decontaminating shared surfaces or items, such as bed linens, dishes, clothes or towels, can also reduce spread.

You can also help interrupt the transmission chain by participating in contact tracing, notifying public health officials of others who may have been exposed through you, which is a basic tenet and common practice of disease control.

The Centers for Disease Control and Prevention has further guidance on how to control monkeypox spread in both household settings and shared living facilities.

Lastly, getting vaccinated as soon as possible can still protect you from severe illness even if you’ve already been infected.

U.S. declares public health emergency over monkeypox

The Biden administration has declared the monkeypox outbreak a public health emergency — a move that gives officials more flexibility to tackle the virus’ spread.

Why it matters: New YorkCalifornia and Illinois all declared public health emergencies related to monkeypox in the last two weeks. The World Health Organization has already declared monkeypox a global emergency.

Details: Department of Health and Human Services secretary Xavier Becerra made the announcement Thursday in a briefing on monkeypox.

  • Federal health officials can now expedite preventative measures to treat monkeypox without going through a full federal review, the Washington Post reports.

What they’re saying: “We’re prepared to take our response to the next level in addressing this virus,” Becerra said Thursday. “We urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus.”

  • Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said the declaration will help “exploit the outbreak” and potentially increase access to care for those at risk.
  • Dr. Demetre Daskalakis, the White House national monkeypox response deputy coordinator, said “today’s actions will allow us to meet the needs of communities impacted by the virus … and aggressively work to stop this outbreak.”

State of play: Dr. Robert Califf, the commissioner of the Food and Drug Administration, said the U.S. is “at a critical inflection point” in the monkeypox outbreak, requiring “additional solutions to address the rise in infection rates.”

  • There are 6,600 cases of monkeypox in the U.S. as of Thursday, Becerra said.
  • There were less than 5,000 cases of monkeypox last week, he added.

The big picture: Biden’s decision to declare monkeypox a public emergency allows him to raise awareness of the virus and unlock more flexibility for spending on ways to treat and tackle the virus.

  • About 20% of Americans are worried they’ll contract monkeypox, Axios previously reported. But there are still some gaps in Americans’ knowledge of the virus and how it impacts our population.

What’s next: U.S. health officials said that 800,000 monkeypox vaccine doses will be made available for distribution. But in hotspot states for the monkeypox outbreak, there’s a drastic disconnect between the number of doses that local health officials say they need versus what they have been allotted.

  • The U.S. will receive another 150,000 monkeypox vaccine doses in the strategic national stockpile in September, Dawn O’Connell, administrator at HHS’ Administration for Strategic Preparedness & Response, told reporters Thursday. These were previously scheduled to arrive in October.

1 in 5 Americans fear they’ll get monkeypox

https://www.axios.com/2022/07/29/monkeypox-cases-virus-vaccine-us

About 20% of Americans are afraid they’ll soon contract monkeypox, but there are still some significant holes in the public’s understanding of the virus, according to a new survey from the Annenberg Public Policy Center.

The big picture: These early stages of monkeypox outbreaks aren’t nearly as dangerous as early COVID outbreaks were, but some of the challenges for public health officials — like educating people about a virus they’re not familiar with, and mobilizing vaccination efforts — are similar.

By the numbers: One in five Americans are worried about getting monkeypox in the next three months, the Annenberg survey found.

  • Nearly half are unsure whether monkeypox is less contagious than COVID, although 69% correctly identified the way it usually spreads (through close contact with an infected person).
  • Two-thirds said they either don’t think there’s a vaccine for monkeypox, or aren’t sure. (There is a vaccine. The Biden administration said Thursday that it’s allocating another 786,000 doses, on top of the more than 340,000 it distributed this month.)
  • Women were more worried about contracting monkeypox than men, even though the overwhelming majority of cases in the U.S. have been among men.

Between the lines: Memories of false assurances and mixed messaging about the coronavirus in the early days of the pandemic are factoring into public sentiment on monkeypox, said Kathleen Hall Jamieson, director of the Annenberg center.

  • “There is some suspicion scientists don’t know what they know, so that translates to higher worry,” Jamieson told Axios.

Misinformation and conspiracy theories are also a problem.

  • 12% of respondents in the Annenberg survey said they believe the monkeypox virus was probably or definitely created in a lab; 21% said they were not sure whether it was caused by exposure to a 5G signal.
  • The fact that the virus has so far spread primarily among men who have sex with men has also fueled widespread perceptions that it’s a sexually transmitted infection, which it is not.

What we’re watching: Perceptions of risk remain fluid and could shift if monkeypox finds new modes of transmission, or if it continues to affect children.

  • “If kids get it and there’s been no contact with individuals at risk, then you have a completely different situation than you have now,” Jamieson said.

Antibiotic-resistant infections rose in hospitals during pandemic, CDC data shows

https://www.healthcaredive.com/news/covid-pandemic-rise-hospital-infections-antibiotic-resistant-cdc/627109/

Exterior of the Center for Disease Control headquarters is seen on October 13, 2014, in Atlanta, Georgia.

Dive Brief:

  • Hospital-acquired, antibiotic-resistant infections grew 15% from 2019 to 2020, according to data out Tuesday from the Centers for Disease Control and Prevention.
  • Nearly 30,000 people died from infections associated with healthcare settings in the first year of the pandemic and about 40% were infected during a hospital stay, according to the CDC.
  • Personal protective equipment and staffing shortages; longer patient stays and use of devices like catheters and ventilators; and significant surges in antibiotic use contributed to the rise in infections, the CDC said.

Dive Insight:

The new data erases years of progress — from 2012 to 2017, hospital-acquired, antimicrobial-resistant infections fell 27%, according to data from the CDC.

Hospitals struggled to follow infection prevention and control guidance during the first year of the pandemic as they faced resource strains and treated sicker patients who needed longer stays. At the same time, hospitals boosted their use of antibiotics, reducing their effectiveness.

In many cases, patients who exhibited pneumonia-like symptoms at hospitals were given antibiotics as a first option even though they were infected with COVID-19. Antibiotics are not effective in treating COVID-19.

Nearly 80% of patients hospitalized with COVID-19 from March to October of 2020 received an antibiotic, according to the CDC.

Antimicrobrial resistance testing was also down in 2020. The CDC’s AR lab network reported receiving 23% fewer testing specimens during 2020 compared to 2019. Due to the pandemic, some CDC progams that focused on antimicrobrial resistance were also repurposed to offer surge capacity COVID-19 testing, the report said.

Without infrastructure and preparedness, it warned, critical data could be “delayed again when the next threat emerges.”

“This setback can and must be temporary,” Michael Craig, director of the CDC’s antibiotic resistance coordination and strategy unit, said in a report analyzing the data.

“The best way to avert a pandemic caused by an antimicrobial-resistant pathogen is to identify gaps and invest in prevention to keep our nation safe,” he said.

“Superbug” infections and deaths rose in 2020

https://mailchi.mp/30feb0b31ba0/the-weekly-gist-july-15-2022?e=d1e747d2d8

While the world’s attention was focused on fighting COVID-19, antibiotic-resistant infections were spreading. A Centers for Disease Control and Prevention (CDC) report finds that hospital-acquired infections and deaths from antimicrobial-resistant pathogens increased 15 percent in 2020, compared to 2019. COVID overwhelmed healthcare settings, shifting the focus of infection control resources, resulting in sicker patients with longer catheter and ventilator use, which increased infection risks. Plus, clinicians initially unsure of how to treat the new disease prescribed COVID patients antibiotics at unusually high rates, setting the stage for growing drug resistance.

The Gist: This uptick reverses years of progress made on reducing the number of superbug infections in hospitals. Prior to the pandemic, hospitals were becoming markedly safer places, with fewer hospital-acquired infections, adverse drug reactions, and poor procedural outcomes. 

As health systems exit COVID crisis mode, hospitals must renew their focus on these longstanding goals of the infection control agenda.