Welcome to the Virus Briefing, your comprehensive guide to the latest news and expert analysis on the coronavirus pandemic and other outbreaks. |
 | | A nurse administering an intradermal monkeypox vaccine in Miami this month.Joe Raedle/Getty Images |
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Something perplexing is going on with the U.S. monkeypox outbreak. |
If you look at the national case numbers, it looks as if the outbreak in the country may have plateaued. The U.S. is averaging about 16,000 cases a day, but over the last two weeks, average case numbers have only increased by 3 percent — a positive development. |
However, when we drill down into the numbers, the story becomes murkier. Many of the cases have been in New York City and California, two places where cases seem to be on the decline, which could be blurring the overall picture. |
 | | Daily new monkeypox cases in New York City.New York City Health Department |
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 | | Daily confirmed and probable cases in California.California Department of Public Health |
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"It's not time to let up," Robert Fenton, the White House coordinator for the national monkeypox response, told me in one of his first interviews in the role. "We're still seeing growth in other states." |
Even so, the emerging picture from New York and California is a welcome development and can hopefully be replicated elsewhere. The only problem is, we don't yet know why this is happening. |
Public outreach may also be playing a role, and the vaccine, known as Jynneos, may be working well at preventing infection. Perhaps it's all of the above. |
Hopefully we'll have answers soon, as changes in behavior can be fleeting, especially if case levels drop to low levels again. However, if cases are stabilizing because the vaccine is having a real effect, it bodes well for our ability to contain the outbreak. But while we wait for data on how well the Jynneos vaccine is working, the rollout continues to experience hiccups. |
After a number of setbacks, the government settled on an intradermal delivery method, which allows the country to stretch its vaccine supplies. The approach delivers one fifth of the regular dose into the skin, instead of a full dose into the underlying fat. |
Fenton told me that the approach is meant to pull "up to five doses" from the vials, and the C.D.C. is providing assistance with the injections. "It's a strategy that is increasing our ability to reach those that are at risk and is being utilized very successfully to increase the number of doses we have on hand," he said. |
"We'll continue to monitor this approach from the standpoint of success," he added. "What we're doing is ensuring that the training, the tools are there to make this approach successful." |
Fenton also noted that the country would ramp up its vaccine supply in the coming months, having ordered roughly 5.5 million doses that should begin to arrive as early as September. |
"We know that there are issues with equity," Fenton said. To address disparities among Black and Latino Americans, he said his team was working through community-based organizations and clinics, as well as "leveraging Pride events" to "bring vaccines to where they're at." |
As for the next couple of weeks, Fenton wouldn't theorize about how the outbreak might play out but said that "we have to plan for any potential." |
"We're in the middle of this, and it's dynamic," he added. "And so what we need to do is be able to move with it." |
For now, Fenton said he was focused on reaching the population most at risk — men who have sex with men — but said the government would "continue to monitor who's being affected and whether we should expand that recommended pool of individuals that maybe should get vaccinated." |
"There's a lot left to be done," he added, "and we're not going to let up until we fully contain and control this." |
A new Covid booster rollout |
The Biden administration plans to offer the next generation of coronavirus booster shots to Americans 12 and older soon after Labor Day, and ahead of an expected surge this winter. |
The shots we currently have were formulated to disrupt the virus that was circulating in 2020. |
Even though these formulations have not been tested in humans, Marks said, the agency has "extremely good" data showing that the shots are safe and will be effective. "How confident am I?" he said. "I'm extremely confident." |
Some experts have argued that the review process is moving too quickly, especially since the vaccines we have now work well against severe outcomes and many Americans have immunity gained from previous infections. Other scientists said that the plan makes sense given how the virus has changed and the evidence that immunity wanes over time. |
Federal health officials are eager to offer the updated boosters as quickly as possible, pointing to a death toll that now averages about 450 Americans per day and could rise in the coming months as people spend more time indoors. |
What else we're following |
- An outbreak of tomato flu, a viral infection that was first detected in India, is spreading there, The Guardian reports.
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Your monkeypox experiences |
We recently asked our readers how the monkeypox outbreak had affected them. Thank you to everyone who shared their stories. |
"The monkeypox outbreak has been like Covid Part XVII for me. It's been just another thing to worry about right now, and it has curtailed my social and sexual activities. Events that I once used to go to I've put on hold. Casual sex has pretty much stopped altogether, and I feel like I'm in this holding pattern until we at least partially get through this via vaccinations. I feel like things are getting smaller around me, and once again I'm avoiding essential contact with friends." — Tim Averbeck, San Francisco |
"After taking Covid precautions while traveling this summer, I had one rendezvous that resulted in my contracting monkeypox in D.C. Benign symptoms began, which quickly escalated to extreme pain with 35-plus lesions. Prescription pain meds did nothing, and my only relief was hot showers and copious lidocaine applications. I was lucky enough to qualify for TPOXX, but it took four days for my monkeypox test results and delivery of TPOXX from the national strategic stockpile." — Patrick, Chicago |
"The monkeypox outbreak is affecting me in many ways. First, I am concerned to get intimate with any other person (I am not living in a relationship and I used to enjoy summer flings). Second, even though I got my first shot, I still have no idea about the level of protection of the vaccine. There is so little data." — Ben, Berlin |
"Other than being a gay man, I didn't meet the requirements for getting a vaccine — I didn't try to get one because others needed it more. That is, until my massage therapist texted saying he had tested positive for monkeypox. I'm two weeks past possible exposure, and most of my social events have canceled when I explained the situation. I'm regularly confronted with what I should tell people (if anything). I'm extra careful around people (there has been no skin-to-skin contact with anyone since I heard). My body seems to make pimples that I've never worried about. I worry about them now. So far, I'm one of the lucky ones. And yet, the emotional toll has been significant." — Terry, Seattle |
"I am heterosexual but have multiple close friends in the LGBTQ+ community, including my best friend. I know all my friends are responsible and take their own precautions. I do not feel the need to ask if they are vaccinated, nor do I feel the need to get one to be safe. Heterosexual men with LGBTQ+ friends are not at high risk. This is not the same as Covid-19." — Jeremy, Bay Area, Calif. |
| Thanks for reading. I'll be back Wednesday — Jonathan |
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