Day: August 2, 2022

US Sues Idaho Over Abortion Law

The United States sued Idaho on Tuesday over a state law that it says imposes a “near-absolute ban” on abortion and also sought to block the Western state from prosecuting or disciplining doctors, according to a court filing.

The lawsuit, filed in U.S. District Court for Idaho, seeks a preliminary and permanent injunction against the state prohibiting enforcement of the law and asked the court to rule that the state law violates federal statutes.

The lawsuit also alleges the state law interferes with the United States’ pre-existing agreements with hospitals under Medicare, referring to the federal health care program for seniors.

“Today, the Justice Department’s message is clear … if a patient comes into the emergency room with a medical emergency jeopardizing the patient’s life or health, the hospital must provide the treatment necessary to stabilize that patient,” U.S. Attorney General Merrick Garland said at a news conference in Washington announcing the filing.

“This includes abortion, when that is the necessary treatment,” Garland added.

Tuesday’s lawsuit marks the Justice Department’s first legal battle over reproductive rights since the Supreme Court in June overturned the landmark 1973 Roe v. Wade ruling that recognized women’s constitutional right to abortion.

Idaho in March became the first state to enact a six-week abortion ban modeled on a Texas law that empowers private citizens to sue abortion providers. The law bans abortion before many women know they are pregnant.

more

India Reports First Death Due to Monkeypox 

India is accelerating action against the monkeypox virus after reporting its first death due to monkeypox in the southern state of Kerala, that of a 22-year-old man who had recently returned from the United Arab Emirates.

The death of the young man is the first due to monkeypox in Asia, where several countries have reported outbreaks of the viral infection that has been declared a global public health emergency by the World Health Organization.

Kerala health authorities announced the death on Monday after it was confirmed that the man had monkeypox. He had died in a hospital on Saturday, about a week after returning from the UAE, where his family said he had tested positive for the infection. By the time doctors were informed, he was already critical.

Samples from the man that were tested in India also detected the virus, according to Kerala Health Minister, Veena George.

This is the fourth monkeypox death reported globally outside Africa. So far there have been two monkeypox related fatalities in Spain and one in Brazil.

Kerala health authorities said that about 20 persons, who had been in contact with the 22-year-old, are being monitored. Passengers who were on the flight with him from UAE to Kerala have also been contacted and authorities have urged people with symptoms to inform doctors.

After the death was reported in Kerala, the federal government said it is setting up a task force to monitor the outbreak in the country.

Fifteen laboratories have been designated to diagnose monkeypox while some states, including the capital, New Delhi, have set up isolation wards.

India has so far detected six cases of the viral disease – four in Kerala and two in New Delhi.

Meanwhile the government has invited domestic vaccine makers to consider making shots against monkeypox after the country reported some cases of infection.

The Indian Council of Medical Research, the federal medical research organization, said last week that it is willing to share the monkeypox virus strain it has isolated to aid the process of developing a vaccine. India is a major vaccine producer.

Vaccines already exist for monkeypox, including those used to eradicate smallpox. Experts have said that unlike COVID 19, mass vaccinations against monkey pox will not be necessary.

Monkeypox, which was first discovered in a monkey, is related to the smallpox virus, which was eradicated in 1980, but is far less severe.

The disease has been found in more than 70 countries where it is not endemic. According to The U.S. Centers for Disease Control and Prevention more than 23,000 monkeypox cases have been detected since January in these countries.

In a statement last week, the World Health Organization’s regional director in South East Asia, Poonam K. Singh, said the risk of a monkeypox outbreak in the region was “moderate but the potential of its further international spread is real.” She said that “We need to stay alert and be prepared to roll out an intense response to curtail the spread of monkeypox.”

more

US Monkeypox Response Draws Criticism

The public health response to the outbreak of monkeypox in the United States has so far failed to prevent significant community spread of the disease, leading to a call for a reassessment of the strategy for containing it.

Since the first reported U.S. case of the outbreak on May 17, the number of infections has soared to more than 5,000, with the majority found among men who have sex with men.

Although reporting of case numbers is scattered across different agencies, the U.S. appears to account for more than 25% of global cases identified during the current outbreak, which the World Health Organization has identified as a “public health emergency of international concern.”

‘You have to act fast’

Infectious disease experts have been dismayed by what they saw as a lack of urgency on the part of U.S. public health agencies in the early weeks of the outbreak.

“What I expected to see would have been a more vigorous kind of a response based on lessons that we’ve learned from … COVID-19, as well as lessons we’ve learned from the HIV response,” Dr. Wafaa El-Sadr, founder and director of ICAP at Columbia University Mailman School of Public Health, told VOA.

“When you have an outbreak, the most important thing is you have to act fast, you have to mobilize, and … you have to rally all your assets to work together really quickly to be able to do what’s needed,” El-Sadr said.

Facing criticism at the end of June, the White House announced what it called the “first phase” of a national monkeypox vaccine strategy designed to “help immediately address the spread of the virus by providing vaccines across the country to individuals at high risk.” The administration said that it would “rapidly deploy vaccines in the most affected communities and mitigate the spread of the disease.”

Similar to smallpox

The monkeypox virus comes from the same family as the deadly smallpox virus, but infections with the disease tend to be far less severe and are rarely fatal.

The disease typically presents with a fever and body aches, followed by the eruption of skin lesions, which can occur all over the body but which are often found on the face and hands.

Though the disease is rarely fatal, the skin lesions can cause severe pain lingering over several weeks.

International scope

According to data collected by the World Health Organization, diagnosed new cases of monkeypox have been concentrated in Europe and North America during the latest outbreak, with more than 14,000 reported in the WHO’s European Region and nearly 6,800 in North America.

By contrast, there are far fewer cases in other regions tracked by WHO. The agency’s African Region has reported only 328 cases, and numbers are far lower in the Western Pacific Region (65), the Eastern Mediterranean Region (26) and the South-East Asia Region (6.)

It should be noted that case numbers are affected by countries’ capacity to test and report active cases of monkeypox, meaning that in some developing countries, the numbers reported to the WHO may represent an undercount.

More manageable than COVID

Monkeypox is the sort of disease that the U.S. public health infrastructure ought to be able to combat effectively.

First, because it spreads primarily through close skin-to-skin contact, it is far less contagious than the virus that causes COVID-19, which can be transmitted through the air.

In addition, effective tests to diagnose the disease are available, as is a vaccine to prevent infection. There is also a highly effective treatment available for infected people.

However, the public health response in the U.S. has so far failed to take full advantage of the opportunity to counter monkeypox.

In a July 15 letter to senior public health officials, including Secretary of Health and Human Services Xavier Beccera and CDC Director Rochelle Walensky, a group of physicians and activists complained, “Multiple unnecessary regulatory barriers to treatments, diagnostics, and vaccines have prevented people in the United States from accessing medical countermeasures necessary to protecting their health, allowing the continued spread of monkeypox virus.”

Delays and confusion

While tests exist that can reliably identify cases of monkeypox, in the early weeks of the outbreak only labs affiliated with the Centers for Disease Control were authorized to administer them, creating significant backlogs in testing. They have since been made available to several large commercial laboratory chains, but the initial delay may have contributed to the early spread of the disease.

Even though there is an effective vaccine against monkeypox, U.S. officials failed to order new doses to add to the country’s limited stockpile until June, the month after the disease began spreading. In addition, U.S. regulators did not approve the use of a facility in Denmark, where the vaccine is manufactured, until the middle of July.

While the medication tecovirimat is known to be highly effective against smallpox and has shown success against monkeypox as well, at the beginning of the outbreak, the CDC required doctors to go through an onerous application process for each patient, greatly slowing the distribution of the medication.

‘Public health failure’

In a blistering op-ed published in the New York Times on Saturday, former Food and Drug Administration commissioner Dr. Scott Gottlieb wrote, “Our country’s response to monkeypox has been plagued by the same shortcomings we had with Covid-19. Now if monkeypox gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times not only because of the pain and peril of the disease but also because it was so avoidable.”

He continued, “Our lapses extend beyond political decision making to the agencies tasked with protecting us from these threats. We don’t have a federal infrastructure capable of dealing with these emergencies.”

CDC Director Rochelle Walensky has challenged criticisms from Gottlieb in the past. Earlier in July, she said in a statement to CNN, “It is true that we have work to do — here and internationally — and are likely to see more monkeypox cases in the near term, but it is possible to significantly decrease the number of cases and contain the current monkeypox outbreak through education and increased testing and access to vaccines – all priorities we’ve made dramatic progress on.”

The CDC has launched an effort to support case identification and contact tracing nationwide, as well as support for testing and “case confirmation.” In addition, the agency has expanded outreach to medical professionals to help them identify cases of monkeypox and has expanded its efforts to communicate information about the disease to the public, particularly to the populations most at risk.

CDC researchers are also investigating the nature of the disease, including precisely how it is transmitted and what course the illness typically takes once a person is infected.

At a global level, the CDC reports that it is sharing information with other countries to help coordinate a global response to the virus. This includes close cooperation with the government of Nigeria in an effort to sequence the DNA of the virus, in order to better understand its evolution.

Window is closing

El-Sadr, of Columbia University, told VOA that while she is concerned about the response to the disease this far, she believes there is still an opportunity to bring it under control.

“We have enough tools already,” she said. “If we could just mobilize and communicate and utilize those tools, I think we have a shot at stopping this outbreak. But the window of opportunity closes very fast when it comes to outbreaks and that’s the reason why there’s a profound need for urgency.”

Failure, she said, could leave the U.S. facing the prospect of monkeypox becoming endemic in the country, meaning that it would persist at a fixed level in the country even if no additional infected people arrive from other countries.

more