Illinois hits 1,000 monkeypox cases: Arwady cautiously optimistic, new state health director reflects

Illinois passed 1,000 monkeypox cases Friday, a major milestone that comes less than three months after the disease first appeared in Illinois.

Of the state’s 1,005 confirmed and probable cases reported Friday, at least 807 have appeared in Chicago, and 46 Chicagoans have been hospitalized because of the illness. But the notable number also comes after Chicago and Illinois saw a slowing number of new cases for two straight weeks, public health data shows.

The stagnant growth led Chicago’s public health director Dr. Allison Arwady to share cautious optimism Tuesday.

“It’s too early to say things look really good, but definitely some signs of slowing of cases,” Arwady said as she shared national case counts. “We’re not seeing the potentially exponential growth that we were seeing early on.”

The local data shows “early signs of a possible plateau in new cases,” said Arwady, who presented a slideshow at her weekly Q&A Tuesday in which the phrase “good news” often appeared in green letters. The time it takes for the amount of Chicago monkeypox cases to double has dropped from 9.5 days throughout the entire outbreak to 31.9 days in the last two weeks, even while testing has increased, she added.

Monkeypox has spread to nearly every Chicago community, and the areas hardest hit align closely with the areas seeing the most vaccinations, according to Arwady.

“I would like to see more vaccination happening especially on the South Side,” Arwady said.

Her department plans to continue to focus on vaccinating at-risk Black and Latinx people, she added. While Black and Latinx people make up 22% and 31% of local monkeypox cases, they have made up just 12% and 17% of Chicagoans vaccinated through mid-August, CDPH data shows.

The state’s response is now being led by a new public health director, Dr. Sameer Vohra, whose first day leading the Illinois Department of Public Health was Aug. 1, the day Gov. J.B. Pritzker declared monkeypox a public health emergency. Vohra likens his new gig, which also has him juggling the ongoing coronavirus pandemic, to having a newborn baby.

“As much as you think through what it’s going to be like to be a parent, once you’re in it, you’re just experiencing it,” he told the Tribune.

But while first-time parents might have to deal with midnight cries, Vohra, born in Chicago’s Irving Park neighborhood, had to respond to the nation’s first daycare monkeypox exposure in his first week.

“It’s a very humbling job,” he said.

Reflecting on the state of the monkeypox outbreak, the new IDPH director noted that internal modeling had predicted that Illinois would pass 1,400 cases by mid-August. The faulty forecast suggests vaccination efforts and targeted messaging campaigns have worked, Vohra said, crediting partnerships with LGBTQ-focused groups and health care providers like Equality Illinois and Howard Brown Health.

“We are making a positive effort in decreasing the spread,” he said. “We’re showing the effects of our public health response. Of course, we want that public health response constantly to be better.”

The biggest challenge has been limited vaccine supply, Vohra said. The federal government has faced criticism for what some have described as unclear messaging and an avoidable vaccine shortage. Vaccine supply is now steadily increasing nationwide. Vohra didn’t offer specific criticism of the state and federal response to the monkeypox virus.

[ Chicago expands monkeypox vaccine access, OKs second doses as supply grows ]

“We can always do things better around public health,” he said.

As the virus spreads predominantly among gay and bisexual men, the state public health department plans to continue focusing its monkeypox efforts on the most at-risk, Vohra said. But with the disease popping up in new counties, the IDPH has started to work directly within other groups, including colleges and daycares, he added. People who aren’t at high risk should still know about the virus, which can infect anyone, Vohra said.

“Our goal is for that spread to be eliminated from all populations. But that risk is there,” he said.

Vohra supported the governor’s declaration of a state monkeypox public health emergency. The declaration ramped up the state’s response by allowing agencies to coordinate more efficiently and use new tools in the fight against the disease. A similar federal declaration came days later.

The monkeypox virus first appeared in Illinois in early June, weeks after it spread to America in a global outbreak. The smallpox-related illness was first detected in humans in 1970 and is endemic to parts of west and central Africa.

The dangerous virus can cause flu-like symptoms, swollen lymph nodes and painful, large rashes throughout the body and often around the genital area akin to pimples or blisters. Monkeypox symptoms can last up to four weeks.

Vohra said he loves Illinois. And he’s certainly been around it. The Chicago-native and child of immigrants grew up in west suburban Westmont. He was an undergraduate at Evanston’s Northwestern University, got a medicine and law dual degree from Carbondale’s Southern Illinois University, went to medical school in Springfield and did his pediatric training at the University of Chicago.

He has since been back at SIU, where he chaired a new department aimed at innovating in public health. The places he saw and the things he learned led him to think about health as “a great unifier.”

“Many of the challenges we face are similar ones,” he said. He’s optimistic that more community-led approaches to public health will bring people together.

[ Illinois health department urges schools to watch for monkeypox; COVID-19 measures pulled back ]

That unity will need to emerge in spite of division sparked by the COVID-19 pandemic and as the state continues to respond to the disease, which still kills around 10 people each day across Illinois.

Hospitalizations have stabilized across the state, he noted. Nearly 1,400 people are currently hospitalized with COVID-19 across Illinois hospitals, 148 of them in intensive care units, IDPH data shows. Recent decisions by Vohra’s IDPH to adopt CDC-recommended relaxations of school masking rules show that the pandemic is changing, he said.

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“It’s a real acknowledgement of that change in time, but really understanding that all of these available tools are there, the most effective tool still being vaccination,” he said.

The lessons learned fighting the coronavirus continue to help the IDPH do better, he said. Increased communication and comfort with responding fast are helping the department train medical practitioners in a new dose-sparing monkeypox vaccination method, he added.

Vohra knows that respiratory viruses like COVID-19 typically spread more in the winter. He hopes that continued public messaging and the arrival of an updated coronavirus vaccine will prevent a new wave of infections. There hasn’t been as much variance in the virus since the highly transmissible BA.5 strand caught on, he added.

“We’re doing everything in our power to plan for and prepare for a fall surge. My hope is that we won’t see one,” Vohra said.

For information on how to secure a monkeypox vaccine, visit the Chicago Public Health Department’s monkeypox vaccination page.

jsheridan@chicagotribune.com

Twitter: @jakesheridan_