WaPo: (pay wall)
Biden covid symptoms continue to improve, White House says
The president has completed his third full day of a new antiviral drug, his physician said in a letter released Sunday
President Biden, who tested positive for the coronavirus on Thursday, probably has the BA.5 variant and continues to experience mild symptoms that are improving, the White House said Sunday.
His physician, Kevin O’Connor, wrote in a letter that the president’s pulse, blood pressure, respiratory rate and temperature all remain normal, and he doesn’t have any shortness of breath.
“His predominant symptom now is sore throat,” O’Connor wrote, adding that it was an indication that his body is clearing the virus, which is “encouraging.”
The president has taken the antiviral Paxlovid for three days and will continue treatment, O’Connor said. He is also taking Tylenol and using an albuterol inhaler a few times a day for cough.
“The President is responding to therapy as expected,” O’Connor wrote in his latest letter. “The BA5 variant is particularly transmissible and he will continue to isolate in accordance with Centers for Disease Control and Prevention (CDC) recommendations.”
The White House said last week that it would go beyond CDC guidance and ensure that Biden remained in isolation until he tested negative. That goes beyond the CDC’s guidelines from December, which cut its recommended isolation time to five days if a patient’s symptoms were gone or were resolving and then said to wear masks for an additional five days. Some public health experts have criticized the revised CDC guidelines as insufficient, warning that many people who contract the coronavirus remain infectious after the first five days.
Biden, 79, who has been vaccinated and received two boosters, is the second U.S. president to test positive for the coronavirus. His symptoms have so far been much milder than they were for President Donald Trump, who spent three days at Walter Reed National Military Medical Center in October 2020 after he contracted the virus before the first vaccinations were rolled out.
Ashish Jha, the White House covid-19 response coordinator, said that the president has had 17 close contacts, including with members of Congress and the White House staff. All were being tracked by the White House medical unit, he added.
“None of them have tested positive as of late yesterday,” Jha said on ABC’s “This Week” on Sunday. “They are following CDC protocol, and we’ll continue to follow them.”
Asked if masking and distancing protocols were being rethought, Jha said that CDC guidelines were being adhered to.
“Protocols around the president I think have been very tight, but this is a president who likes to get out there, meet Americans, spend time with people,” he said.
“None of them have tested positive as of late yesterday,” Jha said on ABC’s “This Week” on Sunday. “They are following CDC protocol, and we’ll continue to follow them.”
Asked if masking and distancing protocols were being rethought, Jha said that CDC guidelines were being adhered to.
“Protocols around the president I think have been very tight, but this is a president who likes to get out there, meet Americans, spend time with people,” he said.
In recent months, Biden has stressed that Americans who are fully vaccinated can begin resuming their normal routines.
“Thanks to the progress we’ve made in the last year, covid-19 no longer need control our lives,” he said during his State of the Union address in March.
But new strains — including the highly transmissible BA.5 omicron subvariant, which is responsible for up to 80 percent of current infections in the United States — have continued to infect millions of Americans, although hospitalization and death rates are significantly lower than they were in the winter, when infections were also soaring. The virus is responsible for 125,000 new cases and more than 400 deaths each day, according to seven-day averages on The Washington Post’s coronavirus tracker.
Biden has continued to work while sick, meeting virtually with his economic team and speaking with staffers on FaceTime on Friday.
Journalists, including several television hosts on Sunday morning, have pressed the White House about why O’Connor, the president’s personal physician, has not directly briefed reporters about Biden’s infection.
World
Cases: 569,972,041
Deaths: 6,383,840
USA
Cases: 90,396,675
Deaths: 1,026,940
Related - WaPo: (pay wall)
Monkeypox is the latest global health emergency
Here's what to know.
The World Health Organization has declared monkeypox a global health emergency, as the once-rare virus spreads rapidly in Europe and other parts of the globe.
More than 16,800 cases of monkeypox have been reported in 74 countries this year. Many of those are in places that have never reported monkeypox infections before. In the United States, at least 2,890 cases have been identified, according to the Centers for Disease Control and Prevention.
Although the WHO has said the global risk of monkeypox is moderate, the virus is concerning health officials because it is transmitting in new ways about which they say they have little understanding. Where previous cases, including a 2003 U.S. outbreak, spread through human contact with animals such as rodents or primates, the current outbreak is concentrated among men who have sex with men.
The decision to place monkeypox on the highest alert level means the world is now confronting two viral diseases that have crossed that threshold. The coronavirus, which causes covid-19, was given the same label in January 2020. Monkeypox is far less transmissible, however, and global health officials are hopeful the current outbreak can be brought under control.
What is monkeypox?
Monkeypox is named for the animals in which it was discovered, but the WHO intends to rename it after scientists deemed the current name “discriminatory and stigmatizing.” The disease cropped up in 1958 among monkeys kept for research, according to the CDC — more than a decade before a human case was identified in the Democratic Republic of Congo.
Mass vaccination against smallpox “presumably” curbed monkeypox infections for a time among humans, researchers wrote in a 2005 article. But cases resurged, partly because of a lack of immunity in later generations, they say.
Monkeypox infections typically last two to four weeks, the CDC says, and begin with flu-like symptoms and swelling of the lymph nodes. Eventually, fluid-filled bumps — or “pox” — spread across the skin. Health officials have noted that the latest monkeypox cases often involve genital rashes that can be confused with syphilis or herpes.
The disease can spread through contact with animals, infected people and materials used by infected people, health authorities say. Examples listed by the CDC include contact with bodily fluids, contact with monkeypox sores and infection through “respiratory droplets” in a “close setting,” such as a shared household. CDC officials say lesions are the most significant source of spread, such as skin-to-skin contact with a person with rashes, or sharing bedding or clothing exposed to lesions, and that respiratory spread happens during prolonged face-to-face contact when a person has lesions in the mouth or throat.
Monkeypox can be deadly, but two major strains of the virus pose different risks. About 1 in 10 people infected with a Congo Basin strain have been found to die, according to the WHO, while a West African strain appeared to be fatal for about 1 in 100 infected people.
That milder strain is the one infecting people who were hospitalized in Britain, health authorities said.
Five people have died in the current outbreak, according to the WHO, all of them in Africa.
What happens now that monkeypox has been declared a global emergency?
The WHO labeled monkeypox a Public Health Emergency of International Concern on July 23, in a move expected to marshal new funding and spur governments into action. The global health agency’s announcement included recommendations to intensify surveillance, accelerate research into vaccines and therapeutics, and strengthen infection control in hospitals.
WHO Director General Tedros Adhanom Ghebreyesus told reporters that because the outbreak is concentrated at the moment among men who have sex with men, health officials believe it “can be stopped with the right strategies in the right groups.” He stressed that any containment measures should respect the “human rights and dignity” of gay and bisexual men, saying: “Stigma and discrimination can be as dangerous as any virus.”
How does monkeypox compare with the coronavirus?
Experts stress that monkeypox is different from the coronavirus that has infected millions.
Monkeypox is highly visible, making contact tracing and isolation easier. An existing smallpox vaccine could help protect the public if needed, said Aris Katzourakis, a professor of evolution and genomics at the University of Oxford. And “we don’t have the potential for something spreading through the globe at anything like the kind of rate that we saw with covid,” he said, because monkeypox transmits less easily between humans.
Still, the latest spate of cases stands out, Katzourakis said. The longer it continues, the more chance the virus has to mutate and improve its transmissibility.
“It’s either a lot of bad luck or something quite unusual happening here,” Katzourakis said.
“We don’t really have the sense yet of what’s driving it. … There isn’t a travel link that’s identified that brings these cases all together,” said Tom Inglesby, director of the Johns Hopkins Center for Health Security.
Monkeypox is known to spread through human contact with animals such as rodents or primates, but the virus has spread further this year through human-to-human transmission than previously reported.The risk to the public remains low, authorities say.
Is the smallpox vaccine effective against monkeypox?
Data suggests that the smallpox vaccine is about 85 percent effective against monkeypox, according to the CDC.
Although the smallpox vaccine stopped being administered to the U.S. general public in the 1970s — years after the disease was eliminated in North America — a supply was kept on hand. A new vaccine, ACAM2000, replaced the old one in the mid-2000s. In 2019, Jynneos was approved to prevent smallpox and monkeypox in high-risk adults 18 and older.
To control the spreading virus, the United States bought doses of the Jynneos vaccine, the only one specifically approved by the Food and Drug Administration to prevent monkeypox, to allocate based on the number of people at risk for monkeypox who also have preexisting conditions, such as HIV. But officials in New York and D.C. have said they do not have enough supply to meet the demand.
People in the general population who have been exposed to monkeypox should get one of the vaccines, said Ruth Karron, a professor and director of the Johns Hopkins Vaccine Initiative at the Bloomberg School of Public Health. And, she said, because the incubation period for monkeypox is long — up to two weeks — some data suggests that people who get vaccinated after exposure or infection may be able to avoid illness or experience a milder case.
The CDC recommends that people get vaccinated within four days of exposure to prevent infection, but there may still be benefits up to 14 days. People in this situation should contact their doctor for guidance.
As for people who received the smallpox vaccine decades ago, health experts say they may still have some protection against monkeypox, but probably not enough. According to the CDC, those who have not had a smallpox vaccine within the past three years should consider getting one if they are exposed to monkeypox.
“We should also bear in mind that we are still trying to figure out what’s going on with monkeypox because this pattern of infection is not one we’ve seen before,” Karron told The Washington Post. “But still, we have very, very, very few cases, and I don’t think we are going to see a large outbreak.”
The WHO is discouraging mass vaccination for the virus, which can be treated with antiviral medicines and vaccines stockpiled in the event of a smallpox outbreak, because there is limited clinical data and an insufficient global supply. The U.N. health agency is developing a plan to make vaccines and treatments more accessible.
Has monkeypox made it to the United States before?
Monkeypox made its way to the United States for the first time in 2003, researchers say. That outbreak was the first time that human monkeypox was reported outside of Africa, according to the CDC.
At the time, dozens of cases were reported in the Midwest, mostly among people who were exposed to prairie dogs apparently infected by rodents from Ghana, according to the CDC. Two children fell seriously ill and recovered, the CDC said.
An infection reported May 18 in Massachusetts was the first case of monkeypox identified in the United States this year, health officials said.
The World Health Organization has declared monkeypox a global health emergency, as the once-rare virus spreads rapidly in Europe and other parts of the globe.
More than 16,800 cases of monkeypox have been reported in 74 countries this year. Many of those are in places that have never reported monkeypox infections before. In the United States, at least 2,890 cases have been identified, according to the Centers for Disease Control and Prevention.
Although the WHO has said the global risk of monkeypox is moderate, the virus is concerning health officials because it is transmitting in new ways about which they say they have little understanding. Where previous cases, including a 2003 U.S. outbreak, spread through human contact with animals such as rodents or primates, the current outbreak is concentrated among men who have sex with men.
The decision to place monkeypox on the highest alert level means the world is now confronting two viral diseases that have crossed that threshold. The coronavirus, which causes covid-19, was given the same label in January 2020. Monkeypox is far less transmissible, however, and global health officials are hopeful the current outbreak can be brought under control.
What is monkeypox?
Monkeypox is named for the animals in which it was discovered, but the WHO intends to rename it after scientists deemed the current name “discriminatory and stigmatizing.” The disease cropped up in 1958 among monkeys kept for research, according to the CDC — more than a decade before a human case was identified in the Democratic Republic of Congo.
WHO to rename monkeypox after scientists call it ‘discriminatory’
Mass vaccination against smallpox “presumably” curbed monkeypox infections for a time among humans, researchers wrote in a 2005 article. But cases resurged, partly because of a lack of immunity in later generations, they say.
Monkeypox infections typically last two to four weeks, the CDC says, and begin with flu-like symptoms and swelling of the lymph nodes. Eventually, fluid-filled bumps — or “pox” — spread across the skin. Health officials have noted that the latest monkeypox cases often involve genital rashes that can be confused with syphilis or herpes.
The disease can spread through contact with animals, infected people and materials used by infected people, health authorities say. Examples listed by the CDC include contact with bodily fluids, contact with monkeypox sores and infection through “respiratory droplets” in a “close setting,” such as a shared household. CDC officials say lesions are the most significant source of spread, such as skin-to-skin contact with a person with rashes, or sharing bedding or clothing exposed to lesions, and that respiratory spread happens during prolonged face-to-face contact when a person has lesions in the mouth or throat.
Monkeypox can be deadly, but two major strains of the virus pose different risks. About 1 in 10 people infected with a Congo Basin strain have been found to die, according to the WHO, while a West African strain appeared to be fatal for about 1 in 100 infected people.
That milder strain is the one infecting people who were hospitalized in Britain, health authorities said.
Five people have died in the current outbreak, according to the WHO, all of them in Africa.
What happens now that monkeypox has been declared a global emergency?
The WHO labeled monkeypox a Public Health Emergency of International Concern on July 23, in a move expected to marshal new funding and spur governments into action. The global health agency’s announcement included recommendations to intensify surveillance, accelerate research into vaccines and therapeutics, and strengthen infection control in hospitals.
WHO Director General Tedros Adhanom Ghebreyesus told reporters that because the outbreak is concentrated at the moment among men who have sex with men, health officials believe it “can be stopped with the right strategies in the right groups.” He stressed that any containment measures should respect the “human rights and dignity” of gay and bisexual men, saying: “Stigma and discrimination can be as dangerous as any virus.”
How does monkeypox compare with the coronavirus?
Experts stress that monkeypox is different from the coronavirus that has infected millions.
Monkeypox is highly visible, making contact tracing and isolation easier. An existing smallpox vaccine could help protect the public if needed, said Aris Katzourakis, a professor of evolution and genomics at the University of Oxford. And “we don’t have the potential for something spreading through the globe at anything like the kind of rate that we saw with covid,” he said, because monkeypox transmits less easily between humans.
Still, the latest spate of cases stands out, Katzourakis said. The longer it continues, the more chance the virus has to mutate and improve its transmissibility.
“It’s either a lot of bad luck or something quite unusual happening here,” Katzourakis said.
“We don’t really have the sense yet of what’s driving it. … There isn’t a travel link that’s identified that brings these cases all together,” said Tom Inglesby, director of the Johns Hopkins Center for Health Security.
Monkeypox is known to spread through human contact with animals such as rodents or primates, but the virus has spread further this year through human-to-human transmission than previously reported.The risk to the public remains low, authorities say.
Is the smallpox vaccine effective against monkeypox?
Data suggests that the smallpox vaccine is about 85 percent effective against monkeypox, according to the CDC.
Although the smallpox vaccine stopped being administered to the U.S. general public in the 1970s — years after the disease was eliminated in North America — a supply was kept on hand. A new vaccine, ACAM2000, replaced the old one in the mid-2000s. In 2019, Jynneos was approved to prevent smallpox and monkeypox in high-risk adults 18 and older.
To control the spreading virus, the United States bought doses of the Jynneos vaccine, the only one specifically approved by the Food and Drug Administration to prevent monkeypox, to allocate based on the number of people at risk for monkeypox who also have preexisting conditions, such as HIV. But officials in New York and D.C. have said they do not have enough supply to meet the demand.
People in the general population who have been exposed to monkeypox should get one of the vaccines, said Ruth Karron, a professor and director of the Johns Hopkins Vaccine Initiative at the Bloomberg School of Public Health. And, she said, because the incubation period for monkeypox is long — up to two weeks — some data suggests that people who get vaccinated after exposure or infection may be able to avoid illness or experience a milder case.
The CDC recommends that people get vaccinated within four days of exposure to prevent infection, but there may still be benefits up to 14 days. People in this situation should contact their doctor for guidance.
As for people who received the smallpox vaccine decades ago, health experts say they may still have some protection against monkeypox, but probably not enough. According to the CDC, those who have not had a smallpox vaccine within the past three years should consider getting one if they are exposed to monkeypox.
“We should also bear in mind that we are still trying to figure out what’s going on with monkeypox because this pattern of infection is not one we’ve seen before,” Karron told The Washington Post. “But still, we have very, very, very few cases, and I don’t think we are going to see a large outbreak.”
The WHO is discouraging mass vaccination for the virus, which can be treated with antiviral medicines and vaccines stockpiled in the event of a smallpox outbreak, because there is limited clinical data and an insufficient global supply. The U.N. health agency is developing a plan to make vaccines and treatments more accessible.
Has monkeypox made it to the United States before?
Monkeypox made its way to the United States for the first time in 2003, researchers say. That outbreak was the first time that human monkeypox was reported outside of Africa, according to the CDC.
At the time, dozens of cases were reported in the Midwest, mostly among people who were exposed to prairie dogs apparently infected by rodents from Ghana, according to the CDC. Two children fell seriously ill and recovered, the CDC said.
An infection reported May 18 in Massachusetts was the first case of monkeypox identified in the United States this year, health officials said.
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