The Massachusetts congressional delegation has called on Governor Charlie Baker to declare a public health emergency to combat the monkeypox outbreak in the state, a move that would follow in the footsteps of several other states and the federal government.
In a letter initiated by Representatives Ayanna Pressley and Seth Moulton, and signed by the state’s two senators and nine representatives, the legislators argue that such a declaration would “unlock resources to ensure that residents receive the urgent and robust response the moment demands” and allow “greater flexibility and more tools to enact a whole-of-government response.”
The letter was sent to Baker on Wednesday evening. In a statement to the Globe on Thursday, the Baker administration said that “nothing outlined in this letter would provide any additional resources.” The statement did not say whether the governor would consider declaring a public health emergency.
Two experts involved with the monkeypox response in Massachusetts – who were not aware of the letter but were asked on Wednesday about the potential value of declaring a public health emergency – found little practical benefit in such a declaration by the state, saying the major obstacles to vaccines and treatment could only be addressed at the federal level. But a third said a state declaration could open up additional resources.
Pressley’s office said that the declaration would raise public awareness and send a powerful message about the urgency of addressing the outbreak. The congresswoman’s staff said it would also allow flexibility in who could administer shots and enable the governor to prevent people from being fired for missing work when infected and required to isolate.
“Current case counts underscore the need to quickly test, vaccinate, and treat high-risk communities, collect and disclose demographic data, and embark on a multilingual and destigmatizing public education campaign,” the letter said. In addition to Pressley and Moulton, the letter was signed by Senators Elizabeth Warren and Edward J. Markey, and Representatives William R. Keating, Stephen F. Lynch, James P. McGovern, Jake Auchincloss, Lori Trahan, Katherine Clark, and Richard E. Neal, all Democrats.
As of Wednesday, Massachusetts was reporting 202 monkeypox cases, with 45 logged within the previous seven days. The federal government has allocated 26,000 doses of vaccine for Massachusetts, of which the state has requested 16,000. Nearly 9,112 doses had been administered as of Wednesday, as the number of clinics offering vaccine expanded from 4 to 14. The state has also added mobile providers to assist with vaccine administration.
The state began distributing vaccine in late June, when it was first made available by the federal government. In their statement, public health officials in the Baker administration said that they have “worked closely with local health departments and health care providers across Massachusetts, particularly in targeted communities like Provincetown and Boston, to promote vaccination, to amplify public awareness and messaging and to provide public health guidance about symptoms, spread, and how residents can protect themselves.”
Monkeypox causes fever, chills, fatigue, and swollen lymph nodes, but it is most notable for its distinctive rash involving lesions that scab over. These can be extremely painful, and the virus causes two to four weeks of illness that can be severe. But there have been no deaths in the recent outbreak in the United States. The virus, transmitted chiefly through skin-to-skin contact, has been spreading in networks of men who have sex with men, but can infect anyone.
When New York, California, and Illinois declared public health emergencies, that helped push the federal government to make its declaration last week, said Carl Sciortino, executive vice president of external relations at Fenway Health. But at this point, he said, “I don’t think there is any significant practical benefit to a state declaration.”
The federal emergency declaration on Aug. 4, in contrast, makes a major difference, paving the way for measures to stretch the vaccine supply and ease the paperwork that has limited access to antivirals.
Sciortino was highly critical of the federal government’s “bungled” response to the outbreak, but had no complaints about the state. “They have been well-coordinated and good partners in this so far,” he said.
Fenway Health has been able to conduct monkeypox testing and vaccination “without any regulation limitations that might benefit from a public health emergency,” Sciortino said. The state has provided funding to hire temporary staff for the vaccine clinic, which has administered 1,700 monkeypox vaccines and served 50 patients who became infected.
“Demand for vaccine appointments far outstrips the ability to deliver vaccine and vaccine availability,” Sciortino said. “On a national level, we are rationing vaccine.”
Dr. Kevin Ard, director of the Massachusetts General Hospital Sexual Health Clinic, said that more vaccine supplies are badly needed. At a briefing Thursday by the Infectious Diseases Society of America, Ard — cautioning that he is “not a policy expert” — said that a state declaration “would free up resources, which I think we do need.”
Dr. Paul Biddinger, medical director for emergency preparedness at Mass General Brigham, said an emergency declaration would send “an important signal” about the outbreak’s severity, but would accomplish little else.
“From a practical standpoint I don’t know that it changes that much in the state’s response,” he said. “I don’t believe there are state-level regulatory barriers that are impeding the response.”
Biddinger added, “There’s a lot of things the state has been doing well. They have been aggressive in creating vaccine clinics, in trying to expand testing both at the state lab and working with commercial labs.”
Still he said, “I think it’s important to make sure that clinicians and the public understand how serious this outbreak is.”