The Biden administration declared a national health emergency for the rising cases of Monkeypox on Aug. 4. Pair that with one New Yorker contracting Polio and a new COVID-19 variant, a question …
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The Biden administration declared a national health emergency for the rising cases of Monkeypox on Aug. 4. Pair that with one New Yorker contracting Polio and a new COVID-19 variant, a question remains: should Coloradans be concerned?
According to experts, it depends on the situation, and vaccination stands as the common denominator for defense strategies.
As of Aug. 4, there have been 6,617 confirmed Monkeypox cases across the U.S. and 79 in Colorado, according to the Centers for Disease Control and Prevention and the Colorado Department of Public Health and Environment.
Dr. John Douglas, executive director at Tri-County Health Department, said even though cases are low, they are doubling every eight days in the U.S.
According to Jefferson County Emergency Preparedness and Infectious Disease Director Christine Billings, Monkeypox is a rare disease in the same family of viruses as the variola virus, which causes smallpox.
Monkeypox is rarely fatal and milder than smallpox, she said. Symptoms include fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, respiratory symptoms and a rash located on or near the genitals. A painful rash or lesion usually will show up at that site where someone comes in contact with the virus.
Symptoms usually start within three weeks of exposure to the virus.
Douglas said Monkeypox can spread to anyone through close personal contact. That can look like close physical contact, sharing towels, shared bed linens or sexual activity.
Right now, cases have been rising for men who are having sex with other men. Douglas said the outbreaks are related to parties and gatherings where there was likely very close personal contact, but no one exactly knows.
“It might have been sexual contact, it might have been hugging, might have been sharing towels, things like that where we know we can see transmission,” he said.
Men who have sex with men account for the vast majority of cases — between 95% and 99% — and Douglas said the effort is getting those at risk vaccinated.
“If you use somebody else's towel and you dried your back off, you can get it on your back. If you've got it on your arm and then you touched your face, you can sometimes transmit it from one place on your body to another. If it's contact involving your areas of intimate exposure during sex, your genital area or your anal area, you can see lesions show up there,” Douglas said.
There is treatment available and if someone gets a rash, a sore or a blister in an area where they had close contact with others, they should see a doctor as it could be Monkeypox.
“We're most worried about it right now because it's pretty uncomfortable to have it even though it's not nearly as bad as COVID and certainly not as bad as Smallpox,” Douglas said.
To avoid the virus, Douglas recommends men having sex with men to reduce their sexual partners or abstain from having sex. As well, get the vaccine when possible.
Douglas said the health emergency declared by Biden may send more resources for education, testing and vaccines.
While average COVID-19 cases are on the decline in Colorado, Douglas notes that a large number are left out of the count.
“Some estimates are that as many as only one in seven of people infected are actually being picked up through the surveillance,” he said.
However, another measure officials use is wastewater surveillance since the virus is secreted through stool and that presence has been declining for the past four weeks.
The reason for the most recent uptick in cases is due to a new variant called BA.5. Douglas said it’s more contagious and somewhat immune evasive.
“If you've been previously vaccinated, frankly, even up-to-date vaccination, or if you've had previous infection — those two ways of getting immune protection — don't seem to work as well against BA.5 as some of the earlier variants,” he said.
Even so, vaccination still leads to a much lower chance of becoming reinfected with the BA.5 variant.
“Unvaccinated individuals are more than twice as likely to be reinfected than people who have received the third booster,” Billings said, “Reinfection, as the definition, is having a positive test for COVID-19 and then testing positive again, after your symptoms have resolved within a 90-day timeframe,” she said.
Despite rising cases, hospitalizations and deaths remained low and the BA.5 variant doesn’t appear to be more serious.
With each new variant, the severity has continually decreased, and whether that will continue with the next variants is hard to predict. Billings noted scientists look at two characteristics to determine the level of severity.
“How easy does it create an infection and how easily does it spread? And we look at its severity, and severity has an immune escape component to it. So does it evade the immunity that a body has already established either through vaccination or natural infection?” she said.
That’s why both Billings and Douglas do not think COVID-19 is over, because each new variant can behave very differently.
“We are so much more knowledgeable in how to protect and move with the curve that the virus throws at us,” Billings said.
Douglas explained that determining whether the public reached herd immunity for COVID-19 is difficult because the virus is constantly evolving.
He said that if immunity levels, mostly through vaccination, are at 92% or greater, then transmission is unlikely. However, since COVID-19 varies frequently, it’s very difficult to measure immunity.
Billings said that if the virus stops producing variants, then it could warrant herd immunity.
She said the fact that a summer spike occurred, which for respiratory illnesses usually occurs in the winter, is a sign herd immunity hasn’t been reached.
With the upcoming fall and winter seasons, mask mandates from Jefferson County Health Department and Tri-County Health Department don’t seem likely.
Douglas said unless a new variant that was more severe and very immune evasive than past variants, a mandate isn’t in the future. But both Billings and Douglas said the departments will always recommend masking based on situations.
“If I am unvaccinated and we're at a high (case) level and I'm going to an indoor concert, I probably want to put a mask on. If we're in CDC level low or medium and I'm at an outdoor event, I probably would think about my individual risk: am I at risk for severe complications? (If so,) then I'd probably wear a mask. But if you're fully vaccinated and we're in CDC level low, mask-wearing is recommended, but it's not necessarily something that would be the first tool that I would pull out of my COVID toolbox for mitigation of COVID,” Billings said.
Blast from the past
Billings said the department is aware of one case of polio in New York.
She said the Center for Disease Control is working to understand how and where the individual was infected. There is no cure for the disease, but it is preventable through safe and effective vaccination.
For Coloradans, there is no immediate risk. The most effective defense against the disease is vaccination.
“There is no immediate risk to residents in Jefferson County, however individuals who are unvaccinated, including those who are pregnant, those who have not completed their polio vaccine series previously, or community members who are concerned they might have been exposed, should get vaccinated,” Billings said.
Douglas notes few remember the initial outbreak in 1948.
“Very few people remember what it was like with polio. It was a horror show,” he said.
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