Chicago Department of Public Health Commissioner Dr. Allison Arwady said Wednesday that in order for local health departments to respond quickly to critical outbreaks such as the monkeypox virus, they are going to need greater flexibility in spending from the federal government.
Arwady also shared new guidance that will allow the current monkeypox vaccine stock to inoculate five times more people per vial.
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At a news conference Wednesday, Arwady said more than 90% of the city’s public health department money comes from the federal government and is often tied to specific diseases in bills passed by Congress. Right now, money earmarked for specific parts of the COVID-19 response that are going unused cannot be redirected to fund the city’s response to the monkeypox health emergency, she said.
“We’ve not been able to use our unspent COVID funds to address the MPV outbreak. We’ve not received a single dollar (for the monkeypox virus),” Arwady said. “We actually don’t need significantly more money. But we need flexibility to use the funding that we have right now to spend on MPV.”
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Arwady said she wants to see the federal government fund disease prevention in a way that empowers flexibility and is tied to population levels. Stable, consistent funding would allow CDPH to build permanent infrastructure to look for reemerging diseases, identify new variants and respond to critical outbreaks, Arwady said.
“I have no ability right now to fund that beyond two years from now when the COVID money runs out,” she said. “This is a big deal. All over the country, public health organizations are not set up well to build and sustain.”
Monkeypox emergency declarations from the state and federal governments may help increase funding flexibility, Arwady added. But it’s already too late: “I needed this flexibility back in June when the first cases were here,” she said.
[ Gov. J.B. Pritzker declares monkeypox virus a statewide public health emergency ]
Chicago’s monkeypox case count climbed to 584 Wednesday and vaccine demand has far outpaced supply among the at-risk populations targeted by the health department, which includes people directly exposed to the disease and men who have sex with men anonymously or with multiple partners.
But a new U.S. Food and Drug Administration decision permitting the main monkeypox vaccine to be administered just below the skin will soon allow up to five times as many vaccinations per vial.
“This is excellent news, but because it is a much less common administration approach, it will require a significant shift in operations over the next few weeks,” the CDPH said in a statement Wednesday. The CDPH has ordered thousands of the smaller needles and syringes required by the new procedure and will be working with state and federal authorities to train people how to deliver the intradermal shot.
Chicago’s monkeypox response is also buffeted by new shipments of vaccine doses, Arwady said. Around 13,000 doses from the federal government arrived last Wednesday, she said, and another 20,000 are expected soon.
“It’s not something we could do earlier on, not cause we don’t know how, but because we didn’t have vaccine,” she said.
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The city is using codes to schedule new monkeypox vaccine appointments. The codes, which change every week, are first released to health care providers and community-based organizations that work with people who often have limited access to health care services, such as African Americans and Latinos.
The city has 3,000 vaccine appointments at large clinics this weekend, Arwady said.
Cases continue to predominantly affect gay men and other men who have sex with men, a trend that health officials say stems from tight sexual networks. But there’s no biological reason why men who have sex with men have been so far hit hardest by the virus and nothing to stop it from spreading more aggressively within other populations, authorities have reiterated.
The smallpox-related monkeypox virus was first detected in humans in 1970 and is endemic to parts of west and central Africa. The illness often begins with flu-like symptoms and swelling of the lymph nodes before progressing to painful, large rashes throughout the body and often around the genital area that look like pimples or blisters. Monkeypox symptoms can last up to four weeks
For information on how to secure a monkeypox vaccine, visit the Chicago Public Health Department’s monkeypox vaccination page.
jsheridan@chicagotribune.com
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Twitter @jakesheridan_
