Monkeypox likely infecting new groups, experts say- POLITICO

With Daniel Lippman

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EXPANDING TRANSMISSION? — Monkeypox may already be spreading more significantly beyond men who have sex with men — the population with the most reported cases so far.

Experts, emphasizing the unknowns surrounding the outbreak, said other populations are likely already infected with the virus, even if US testing data hasn’t caught up to those cases.

In a recent memo about the vaccine, the FDA said nearly 100 children have likely been exposed to the virus, based on requests from providers to the agency.

“I am sure that it is spreading in some other contexts, and we just don’t know yet,” Julie Swann, who has advised the CDC and is a systems engineer at NC State University, told Pulse. “I believe we need to avoid thinking of this as only a problem in the MSM community.”

The FDA recently approved a new vaccination method to stretch existing doses, anticipating the need to vaccinate more people in less time through the end of the year.

And the administration has been pushing to expand testing capacity to get a better understanding of the spread. On Thursday, the White House released ongoing research priorities, which include more wastewater surveillance and improved modeling.

But current testing still isn’t accounting for all the cases and transmission happening today.

“I’m sure we have way more cases that have been diagnosed,” Swann said. “And so we may not even understand the extent to which it’s gone beyond the MSM community to other populations.”

It’s a reality Doctors are already considering as they work to ramp up vaccinations through the new dose-sparing strategy.

“Once [there’s] community spread in one part of the population, it’s inevitable that it’s going to spread to other parts of the community,” said George Diaz, a doctor specializing in infectious diseases at Providence Regional Medical Center Everett in Washington state.

Diaz has been working with state and local authorities to vaccinate people for monkeypox as doses become available — right now reserved for those at high infection risk.

But does he think the general public will eventually be offered vaccines?

“If we can get enough vaccine, I would say the answer’s ‘yes,'” he told Pulse, noting that the dose shortage is a limiting factor from that sort of policy. “Right now, we’re limiting those vaccinations to the people at very highest risk.”

BITTERSWEET WIN FOR DEMS — Democrats in Congress are poised to pass their Inflation Reduction Act, a bill that will fulfill decades of talk about allowing Medicare to negotiate drug prices, POLITICO’s Alice Miranda Ollstein reports.

But the moment could be bittersweet, with many provisions in the original blueprint of the legislation now gone and the next opportunity to push sweeping health legislation unknown.

“There’s a lot of heartache in legislation,” Rep. Peter Welch (D-Vt.), one of the lead House negotiators of the bill, told POLITICO on Thursday. “You start out with the aspiration for perfection and hopefully you get to settle for progress. Look, we had to make concessions to get 218 votes in the House and 51 in the Senate. So I’m disappointed at what got left behind but still thrilled that we can finally get relief to people struggling with high drug prices.”

Expected to lose seats in November, Democrats recognize the possibly fleeting opportunity before them.

Still, expect Celebration from party leaders Tomorrow around the vote, which will likely bring new measures to control drug pricing and an extension of ACA subsidies.

CDC LOOSES UP COVID GUIDANCE — The Centers for Disease Control and Prevention loosened its Covid-19 guidelines for isolation, testing and schools on Thursday as the country emerges from another bruising wave of cases and Americans’ Pandemic fatigue continues to deepen, Krista reports.

New school guidance: The CDC issued a flurry of new recommendations for schools ahead of the new year. It lifts previous recommendations that students Quarantine if exposed to someone positive for the virus, drops recommendations that schools limit students’ contacts by cohorting them in groups during the day and ends last year’s test-to-stay recommendation that schools could test exposed students for the virus as a way to avoid quarantine.

It also said that schools should no longer conduct Covid-19 routine testing for students who have no symptoms or haven’t been exposed to the virus, suggesting schools consider that only in response to an outbreak, a high community risk or a high-risk event at the school, like a prom or a large sports event.

New Quarantine advice: The school guidance is consistent with the new broader advice for the general population. The agency dropped its guidance that unvaccinated people or those not up to date on their vaccines Quarantine after exposure, advising they instead mask for 10 days and test after five days. The CDC now recommends Quarantine only for anyone who tests positive for Covid-19, suggesting they stay home for at least five days.

New testing advice: In line with FDA guidance also released today, the agency now recommends people using at-home Covid-19 tests should conduct repeat testing following a negative result within two or three days to cut down on the risk of unknowingly spreading the virus. For those with a known exposure to Covid-19, the FDA recommends testing three times. The agency also says that screening testing should no longer differentiate between unvaccinated, undervaccinated and vaccinated people.

FLORIDA BANS MEDICAID COVERAGE FOR GENDER-AFFIRMING CARE — Florida’s new rule banning providers from billing taxpayer-funded programs for gender-affirming care has been finalized, POLITICO’s Arek Sarkissian reports.

The rule comes as the state has looked to block such Therapies for young people and will take effect on Aug. 21.

Treatments like puberty blockers, hormone therapies or surgical procedures will be included in the policy, which was added to the rules governing the state’s $36.2 billion Medicaid program.

Medical associations, including the American Academy of Pediatrics and the American Medical Association, support gender-affirming care for adolescents. But medical experts said gender-affirming care for children rarely, if ever, includes surgery. Instead, doctors are more likely to recommend counselling, social transitioning and hormone replacement therapy.

RESEARCHING MONKEYPOX — The White House released an update of ongoing research priorities for the outbreak, hinting at possible future responses to the outbreak.

Ongoing research includes:

— Creating next-generation orthopox Therapeutics

— Tracking monkeypox through wastewater surveillance

— Examining the role animals could play in transmission

— Creating new tools to distinguish between people who have been infected and people who have been vaccinated

— Expanding modeling and research on transmission of the virus

Former Congressman Mike Bishop (R-Mich) and former EPA Administrator Andrew Wheeler joined the Advisory board of the White Coat Waste Project, a group working to stop tax dollars from being spent on animal research.

Tristan Daedalus, a Pat Fallon (R-Texas) and Matt Salmon (R-Ariz.) alum, has joined the taxpayer watchdog group White Coat Waste Project as its government affairs director.

Lizeth Zardeneta is now advance representative for HHS. She most recently was executive assistant and briefing book coordinator at the department.

The WHO says Monkeys aren’t to blame for monkeypox after a report of animals being harmed for fear of virus transmission, The New York Times’ April Rubin reports.

Covid-19 variants keep getting more contagious — The Wall Street Journal’s Brianna Abbott and Josh Ulick report on the reasons behind the trend.

Data from multiple states show a racial disparity in monkeypox cases, Stat’s Usha Lee McFarling, Katherine Gilyard and Akila Muthukumar write.

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