Public health news this week was good on both the COVID-19 and monkeypox fronts, with continuing declines in new COVID-19 cases, and a new slowing in monkeypox (which may soon be renamed Mpox…or something else.)
COVID-19
The COVID-19 news this week continues to be good, said Dr. Muntu Davis, LA County Public Health Officer, in this week’s LA County Public Health update. Davis reported an “ongoing decline” in new COVID-19 cases, with an average of 3,100 new cases per day over the last seven days (though there was a slight uptick in hospitalizations).
The week’s numbers, including also-still-falling case and hospitalization rates, Davis said, keep us safely within the “medium” community tier, as defined by the CDC.
But Davis was also quick to explain that the CDC tiers describe the current level of stress on the community and our health care system, but do NOT mean that transmission rates of COVID-19 are at a “medium” level. In fact, Davis said, transmission rates remain very high, especially because the BA.5 subvariant of the Omicron strain of COVID-19, which now accounts for 90.2% of all local cases, is extremely infectious, and also commonly causes re-infections in people who have recently had the virus. And that means, he said, that it’s still important to layer in as many protections as possible, including getting fully vaccinated and boosted, wearing masks indoors and at large gatherings, testing frequently, isolating when sick, and seeking treatment when appropriate.
The good news, though, is that – at least locally – there are no new variants of concern, and the cases caused by all variants other than BA.5 seem to be waning at the moment.
In COVID-19 vaccine news this week, Davis announced that the Novavax vaccine, which uses more traditional vaccine mechanisms than the Moderna and Pfizer MNRA vaccines, has now been authorized for use in children ages 12-17. Like the MNRA vaccines, this one is also a two-dose series, and vaccination sites can be found by searching by zip code at VaccinateLACounty.com.
Monkeypox (or Mpox?)
Meanwhile, in the second half of this week’s public health briefing, Dr. Rita Singhal, Chief Medical Officer for LA County, reported some cautiously good news on the monkeypox front as well – while the number of new cases continues to rise globally, nationally, and locally, the rate of increase slowed a bit this week, with new cases now doubling in 16 days instead of the 10 we were seeing just a couple weeks ago.
This week there were 1,264 new monkeypox cases in LA County, with 47 hospitalizations so far, and no deaths. There have been six cases reported in congregate housing settings.
The demographics of local monkeypox infections continue to follow previous trends: 98% of cases have been in men, and 82% in people who identify as LGBTQ+. And the most affected ethnic groups are Latino/Hispanic (38%) and white (32%). Also, about 46% of LA County cases are in the Los Angeles metro area, with the next most-affected area the San Fernando Valley.
On the vaccine front, Singhal reported that LA County has now received 72,190 doses of monkeypox vaccine, all of which have been distributed, and 48,692 of which have been administered. Another 41,300 doses have just arrived, and more will come when those have been distributed.
Singhal also reported that monkeypox vaccine eligibility was extended this week to two new groups: those who have had skin-to-skin or intimate contact (including kissing and hugging) with people at large venues or events in the last 14 days…and those of any gender or sexual orientation who have engaged in commercial and/or transactional sex in the last 14 days.
To receive a first dose of the two-dose monkeypox vaccine, Singhal said, those who are eligible should try their personal health care provider first, or – if that provider does not have the vaccine – register for a vaccination through LA County. Those who did receive a first dose from their own health care provider should try to schedule a second dose with that provider 28 days after the first dose. Those who received first doses through LA County will receive a text mesage about setting up an appointment for their second dose.
Singhal said LA County and many other health care providers can also provide the TPOXX antiviral medication for those who have a severe case of monkeypox (causing extreme pain or interfering with activities of daily living), or those who are at risk of severe cases.
Finally in monkeypox news this week, the LA Times reports this morning that the disease may be getting a new name – possibly MPX or Mpox (as LA County Public Health Director Barbara Ferrer has been calling it for the last few weeks) – to avoid unfairly labeling or discriminating against people from certain places or demographic groups.
The situation is similar to that with the AIDS virus, which was originally called “gay-related immune deficiency” (or GRID), because it first spread widely among the gay population. But after it was discovered that the virus was transmitted through bodily fluids in a number of ways, not just gay sex, it was re-named Acquired Immune Deficiency Syndrom (AIDS).
As the Times (and others) are pointing out now, “monkeypox” is a similar misnomer or potentially harmful term for several reasons. First, the disease is more common in rats than monkeys…and, second, the term “monkey” has historically been used to disparage both dark-skinned people and the sexual activity of homosexuals. So “monkeypox” may further stigmatize and wrongly assign blame for the disease to those groups without reason.
According to the Times story:
“Terms such as “swine flu” and “Middle East Respiratory Syndrome” have had “unintended negative impacts by stigmatizing certain communities or economic sectors,” Dr. Keiji Fukuda, a former assistant director-general for health security at the WHO, said in 2015.
“We’ve seen certain disease names provoke a backlash against members of particular religious or ethnic communities, create unjustified barriers to travel, commerce and trade, and trigger needless slaughtering of food animals,” he said. “This can have serious consequences for peoples’ lives and livelihoods.””
The final decision on re-naming the disease will be up to the World Health Organization, and will likely take several months.
For more information on monkeypox, vaccines and treatments in LA County, please contact LA County Public Health at ph.lacounty.gov/Monkeypox or (822) 540-0473.
