On Monkeypox, Health Secretary says states 'must work with us'

The suggestion that states need to do more seemed to surprise state and local authorities, who said in interviews that they were generally happy with the federal government's response.< /p>

WASHINGTON — With monkeypox cases rising and vaccine doses scarce, President Biden's health secretary suggested Thursday that states and localities bear some of the blame for what critics have called a misguided response.

"We don't police public health in all 50 states , in the territories and in the tribal jurisdictions," said Xavier Becerra, the secretary of health and human services, in response to a reporter's question about the possibility of eliminating the virus. “We rely on our partnership to work with them. They have to work with us. Still speaking of states, he added, "they are ultimately the ones who determine how health care is administered in their jurisdictions."

Mr. Becerra's comments came as San Francisco, which like New York has one of the highest rates of monkeypox cases in the United States, declared its own public health emergency. Officials said the move would allow the city to be reimbursed by California and the federal government as it works to combat its outbreak.

In Washington, however, Mr. Becerra said his agency is still considering whether to declare a national public health emergency. His suggestion that states and localities need to do more seemed to surprise state and local officials, who said in interviews that they were generally happy with the federal government's actions, despite the vaccine shortage.

"We believe the federal response was strong and they worked with us," said Dr. Marcus Plescia, chief medical officer for the Association of State Health Officials and territories. "There will just be a little lag between when we find out about these things and when we can really scale up the interventions we have."

The secretary may -being tempted to deflect criticism from advocates of people living with HIV. and AIDS, who are at disproportionate risk of contracting monkeypox and have expressed dissatisfaction with the response.

The Centers for Disease Control and Prevention reported Thursday that the United States has now confirmed more than 4,600 cases of monkeypox, which has already been declared a global health emergency by the World Health Organization. The number of cases in the United States is among the highest in the world, and the figure is almost certainly an underestimate. Men who have sex with men account for 99% of confirmed cases so far.

On Wednesday, the Food and Drug Administration announced that it had cleared nearly 800,000 additional doses of Jynneos, the monkeypox vaccine. On Friday, the administration will begin allowing states to order doses, using the same ordering system it has put in place to handle coronavirus vaccines. Becerra said his agency has also purchased an additional 5.5 million doses of the vaccine and will have obtained more than 6.9 million doses, in total, by May 2023.

James Krellenstein, a founder of PrEP4All, an AIDS advocacy group, said it's not fast enough. He blamed the F.D.A. for not acting more quickly to increase supply and for delaying an inspection of the vaccine maker's manufacturing plant in Denmark.

But Dr Robert Califf, the F.D.A. commissioner, told reporters on Thursday that his agency had acted "much faster than expected", considering that it had to not only inspect the factory but also ensure that the vaccine was effective. "The only thing worse than not having a vaccine," he said, "is having a vaccine...