As monkeypox continues to spread, with nearly 3,500 cases now reported in the United States, the Biden administration is weighing whether to declare the outbreak a public health emergency.
The administration may also name a White House coordinator to supervise the response, all in an effort to keep the virus from becoming endemic in the United States. On Saturday, the World Health Organization declared monkeypox a global health emergency.
Biden's decision could come this week, paired with an announcement that about 800,000 additional vaccines will be distributed after a U.S. Food and Drug Administration review, unnamed sources told the Washington Post.
Declaring an emergency could provide government agencies with the resources to collect data and fight the spread of monkeypox. Still, it won't address vaccine shortages or treatment barriers that have slowed the U.S. response to the virus.
A declaration is "a tool that could be used to both align with WHO and raise additional awareness, as well as provide significant justification for HHS [Department of Health and Human Services] to use [though limited] tools that would aid in the response," according to a memo sent to President Joe Biden on Sunday, a copy of which was obtained by the Post.
Monkeypox has now spread to about 18,000 people worldwide outside of Africa, where it has long been endemic. It is not linked to any deaths in the United States.
In the latest outbreak, symptoms includefever, lesions and severe pain that may last for weeks. Vulnerable people, including pregnant women and children, may experience other complications.
The virus is mostly spreading among the gay and bisexual community. However, two of the U.S. cases were in children who shared a home with an infected adult. There is no evidence of sustained transmission among broader population groups, federal health officials told the Post.
Still, some have claimed that the official U.S. response has been too slow.
White House officials have been among them, saying the decision is in the hands of HHS Secretary Xavier Becerra. Patients have had delays in getting test results. Doctors have noted bureaucratic barriers in accessing prescriptions. New York Mayor Eric Adams has called for a boost to rapidly declining vaccine doses, the Post reported.
"Our focus is on getting HHS to move as quickly as possible … it's about strengthening and accelerating the response, not just tacking on a different name," an official familiar with the response told the Post, saying Biden "is pushing HHS to get vaccine allocations out the door, and pushing FDA to get the vaccine cleared in the next few days, without cutting corners."
Meanwhile, Becerra told CNN on Monday that his department continues to weigh the decision.
"We want to get ahead of [monkeypox]. You don't want it to become a part of life. But how many people have died compared to COVID?" Becerra said. "Zero … We declare public health emergencies based on the data and the science, not on our worries."
Jennifer Kates, who leads global health policy for the Kaiser Family Foundation, said emergency declarations should be reserved for unique events, but that a 90-day emergency declaration could focus the response.
"In the case of monkeypox, those criteria are being met. It's crossing states, it's spreading rapidly, it's never happened here before, and it has all these risks associated with it," Kates told the Post.
While some worry it's too late to contain the virus, the administration points to the U.S. stockpile of treatments and vaccines, as well as increased availability of testing.
"There is no other place in the world where they have 300,000 doses of vaccines … distributed to the states, as we have here in America," Becerra said Monday.