Well, we want to talk about Monkey
Pox because that's something
that there is growing concern,
because now people are talking about
the supply and demand side of it.
People want to protect themselves.
There's a supply issue of nationwide.
What are we seeing?
Yeah, so it's a good question and
I do appreciate the opportunity
to talk to you about it.
One of my one of my passions is
good science, communication and
health literacy for the country,
especially in the last few years.
So I really appreciate it.
So in reality, just for some context,
maybe for your story and you can use
it or not want to remind everyone
that monkeypox is not COVID.
It's not spread through
aerosolization of the air,
it has a very low reproductive number.
It's actually quite tame.
And a reproductive number below one.
Which means if I have monkeypox,
it's very difficult for me to
spread it to more than one person
and it takes prolonged contact.
It's it's skin to skin all the things
you've probably been reading about.
So just to remind people, it's not.
It's not super transmissible and also
to remind everyone that you know
we're over 1000 cases now in the US,
about 40 states.
Keep that in perspective of
330 million in the population.
It's actually quite low.
No deaths in the US,
and so you know the vaccine issue is kind
of one that it's interesting to watch.
You know,
you certainly want to be prepared.
We have.
We have two types of
vaccines that are approved.
One's a little better than the other.
Genos is really the more effective 2
dose vaccine that doesn't cause many side
effects and and it's relatively newer.
And we had plenty of that as
we started this back in May.
So remember,
the first case was in May,
and we've distributed about it.
I think the last I looked at about
132,000 doses have been distributed by HHS.
I think Texas has got, you know,
several thousand of those.
There have been about 20 cases in in Texas
with a lot of them in in the Houston area,
so you know,
in my professional opinion,
I think we're fine,
but certainly we've been distributing
those vaccines to people at high risk in
immunocompromised individuals because
that's those who are at most at concern.
In general, when you get monkey pox,
it resolves in two to four weeks on its own.
Most people are not going
to have major issues.
They're going to isolate.
They're going to wait it out,
and it's going to go away.
That's kind of the the truth
behind the infection.
But having said that,
just to make sure that we have
plenty of vaccine on hand,
the national stockpile HHS has gone out,
they have ordered.
I believe two and a half
million additional doses.
That's supposed to be here
a little later in the year,
and then more recently you may
have seen that the United States
has went and obtained,
or at least they're on their way
about 800,000 doses from Denmark,
and those are coming in,
and they take a little bit of
time because those doses have to
come in at cold storage on planes,
and they can only get about 100
to 150,000 at a time delivered.
But those are coming.
They're starting to roll out.
Sorry to cut you off,
rolling out more and more.
I think that what I'm seeing is
there's kind of that concern with
people seeking that protection now.
And so when you have it only being
rolled out to certain groups of people
that have been exposed to somebody.
And so if somebody hasn't been exposed
and they want to get that protection,
do you think it's time to roll it out
to that population of people who maybe
don't know that they were exposed,
but they just want to be?
Protected
right? I think I think,
and I think most experts would say
this with me in healthcare officials.
They're really going to look at that
as a risk analysis, a risk analysis
because you can't just start handing out.
You know thousands of doses of monkey pox.
Because people just want it.
If you're not in a risk group.
If you haven't traveled to Africa.
If you haven't, you know had known exposure
with somebody that has had monkey pox,
then probably you're not going to be
on the highest priority right now.
Now, if something happens and we have,
you know, a greater community spread and
we start seeing clustering and and and
greater numbers pop up, that might change.
You know, you might go in and say,
OK, let's look at.
Let's look at Harris County at for example,
in Texas.
We see something happening there.
Let's go in and let's drop in.
You know,
several 1000 doses in X city and try
to ring that ring that vaccination
at airport around that area.
That's kind of the next level of effort,
usually from a public health standpoint,
but I don't see right now.
Especially in Texas.
I haven't really seen that
being talked about.
I know in New York,
if you've seen some of the
information in the last day or so,
they seem to really be requesting.
Lots of vaccine.
I haven't dug into that too deep,
but you know,
in certain communities we know
this is kind of in certain
communities of sexual behavior and
that tends to be more concerning.
Obviously in those populations,
so perhaps that's part of it.
If you have higher populations
of those practices,
then you might look at that as
a way to to control the disease,
but I haven't seen that really
in Texas right now.
Yeah, and that's what I saw out of New York,
and I believe I want to make sure I'm.
Through on this, but I believe I
saw that cases there are doubling.
So they've had these large clinics,
so much demand that they're having
to shut down and wait until they
have the supply and they have
it available for people there.
So is it time to have that
same availability in Texas?
You know, without knowing the actual
numbers at this at this time,
I just don't know the demand in Texas,
but everything I've seen up
through about several days ago,
I don't believe there's a
need right now for that.
Again, if that's if that's
changed in in the last 24 hours,
that may not have come
out through my sources,
but if it starts doubling
or you start seeing,
you know hundreds of cases versus dozens
and maybe even thousands of cases hundreds.
It will kind of depend on what's
happening is that spread out through
our entire state or all of a sudden?
Are you seeing you know 700
cases pop up in Travis County in
Austin or something like that?
That is when I think public
health officials would look at
that situation and perhaps start
with a more localized effort to
utilize vaccination a little more
effectively if they needed to.
Again, it really comes down to.
You know there's a lot of
things going on here,
and so one of the things you can
do with monkeypox a little more
effectively is contact trace.
It's a slower acting transmission.
If you find 10 people that have
it and you can identify their
contacts and you can get those
people notified and and maybe you
do vaccinate those individuals
and you get everybody isolated,
you don't necessarily have to come
in and just try to mass vaccinate
a city and and remember you have
to keep in mind supply and demand.
You don't want to burn up vaccine
when you don't need to.
So all of those considerations from
a public health standpoint have
to be taken into consideration.
Is there any other Intel you could
share with the state's vaccine supply?
What we anticipate to get?
I understand that I believe it's up
to the counties to order the supply,
but does the state expect to have?
Larger number of doses here coming up.
Information my source is I don't really.
I really don't have a lot of information
that you probably don't have right now.
I know that. The leaders and the
Public health department staff.
When I look in in that area and
talk to some of my individuals,
they talk about that about 200 doses
have gone out statewide and about
half of those have gone to the
Houston area for whatever reason.
And. Ultimately, Texas has been
saying we have plenty in in in,
you know, supply if something happens.
So that's about all I know.
At this point I would imagine Texas has,
you know, several 1000 doses on hand,
because because that's kind
of what has happened.
They've distributed it based on
population and needs around the country.
And of course,
New York has been pushing
pretty hard the last few days,
so they may be first in line
if if that's deemed necessary.
It seems that as we learn more
about this because it's new
and it seems like you know,
we're barely getting through COVID,
and now there's this whole other
thing that people are beginning
to worry a little bit about.
And so when you look at transmissibility,
we're starting to learn more,
and I remember with COVID that kind
of changed as we learned more.
Is this transmissible by
particles in the air?
Not to anything that historically
is known or anything that's
currently happening to my knowledge.
Again, for context,
I'm going to back up a little bit.
I'm I really appreciate you asking
that question because you know SARS.
Kobe 2 is a novel virus.
We had really 0 information and in
our assumption when we started out was
that it was going to behave like flu.
That was actually a poor surrogate.
Now we know that it's it's aerosolized,
it is often asymptomatic.
And so the the traditional model
is you deal with people that have
symptoms a lot of times you don't
know that with COVID it's just being
spread by asymptomatic people.
That is not typically the case
with monkeypox.
We have a pretty good handle on it
from really probably 7-8 decades ago.
We first, you know,
identified it back in the 50s
we we had vaccines for it.
We have antivirals for it.
We understand the transmission now.
Could something change a little bit?
Sure, I mean viruses are equal opportunity.
At infecting and changing,
that's what they do.
In fact,
I often say viruses are going to virus.
You can do everything you want
to do and they will surprise you.
Viruses will make you look
really stupid at times.
If you think you understand them.
So their goal is to infect,
amplify and move on,
and that's what they do.
But we do understand monkey pox if
we look at the history and we kind of
looked at what's happened up to now.
So again,
I I think most experts would agree
that we're not in a panic mode by
any any sense of what's happened.
As you compare it to COVID,
but certainly what I've been
mentioning to many new services
and and colleagues and friends is
that it's really a good reminder.
You know everybody.
Everybody was kind of done with COVID, right?
Even though it's not done with us.
So general population in general,
you know they're kind of done with it,
and that's understandable.
Monkey pox,
when that happened in May in reality
for me as a longtime public health
professional going back almost 3 decades,
I've been dealing with this
for three decades.
There's always something coming up
and and the public and the government
and professional organizations are
going to have to learn this lesson.
I'm afraid.
Over and over again that we
can't let our guard down.
We need to have surveillance in
real time all the time, eternally.
We need stockpiles of things
that we can ramp up.
Actively and quickly,
and we need funding to support that.
And it's not a popular thing
with respect to funding,
but it's it's as important as
the Department of Defense.
In my opinion,
microbes are just as deadly
as enemies and terrorists,
and in fact they're more deadly.
If you look at the data.
We have one other question that
just popped up came to mind is
the rate at which it has spread.
Does it surprise you at all?
Is it typical with this sort of illness?
You know a little bit.
You know, one of the things you
have to remember up until we've
had a couple of these incursions
into the US and O3, we had a A.
Population of Animals that came out
of Ghana actually popped through
Texas and then got spread out of
over about 6 cases I was working
at the Department of Health and
Austin when all that happened.
So that was our first kind of surprise
and then we had a couple of travel
associated cases in 18 and 21 to
Maryland and some other states.
But typically we don't deal
with this in the United States.
This is more of an African continent
and some other places that you see
it and it's quite regular there.
It's it's endemic, it moves.
Brown, they have hundreds of cases at a time.
They have some mortality,
not crazy mortality,
but some, and so you know,
I think it's just against something
we're not used to seeing.
And. It is kind of different,
and I think that's why you see the concern
a little bit with respect to you know,
kind of what's going on.
It's in this population of people
that seem to be confined primarily
to gay people or men who have sex
with men and things like that,
but it's still not been.
To date, right now there,
there's still no one saying this is
a sexually transmitted infection.
It's a close contact,
prolonged exposure infection,
which can occur in anyone.
Any group of people, whether it's intimate,
whether it's sexual intimacy or not,
it can be another routes.
And so I guess that's the surprise
when you ask me.
And my surprise,
it's just kind of interesting from a
scientific standpoint that it's in
those groups and it's popping up.
You know, over 40 states now.
So are we. Are we testing better?
Do we have better diagnostics and
we're seeing it better because we're
looking for it? That tends to happen.
If you're not looking for it,
you wouldn't know it's around and.
And so all those factors are kind of
interesting to me as a scientist.
Do you feel that more testing around
it and a better understanding it is
needed to make sure that a group of
marginalized group isn't stigmatized?
Yeah, absolutely.
I mean, that's one of the things
I've been carefully discussing
with multiple individuals is that?
Umm? You know it's really not
about any individual group.
Again, what I said earlier,
viruses or equal opportunity infectors they
will they will they have no bias right?
And so going all the way back to HIV
and hepatitis C and how people try to
stigmatize different groups of people.
That's not what we want to do.
We want to identify the agent we want to
identify those who are infected and we
want to get them isolated and treated.
A vaccinated if necessary and approach
it from a public health standpoint.
Not from a group of people that might be,
you know, worried about it now,
having said that.
We are watching that type of of
community dynamics so that perhaps
we can be more preventative or
educational so that people do
understand that that close contact
is part of the transmission cycle,
and so that's just the reality of
the biology of the virus and how
how it moves through populations.
Well, you've been amazing in sharing so much.
Thank you so much for going
in depth with everything.
I think as people start to
learn more about it and try to
get a better understanding.
This is definitely a big.