Georgia is not declaring a health emergency due to monkeypox outbreak

“Fortunately there is currently no state-level unmet need that would necessitate a new State of Emergency Order” -- Governor’s office

A small but growing number of states are declaring a state of emergency to bolster their response to a monkeypox outbreak infecting more than 11,500 people in the U.S.

Georgia, which ranks fourth in the country for the most monkeypox cases, is not one of them. At least for now.

A spokesman for Gov. Brian Kemp, Andrew Isenhour, told The Atlanta Journal-Constitution that state officials are equipped to respond to the outbreak, and “fortunately there is currently no state-level unmet need that would necessitate a new State of Emergency Order” for the monkeypox outbreak.

Declaring a state emergency allows states more flexibility to divert resources to an infectious disease outbreak.

In an e-mail, Isenhour said Georgia currently has enough medical professionals to administer the monkeypox vaccine but said more doses are needed, adding that state health officials will continue to request more doses be allocated from the federal government until “demand is fully met here in Georgia.”

States generally have broad authority to act to prevent and control disease spread, such as issuing isolation or quarantine orders, without having to issue an emergency declaration. Stacie Kershner, deputy director at the Center for Law, Health & Society at Georgia State Law, said state officials have to make calculations about whether an emergency order for the monkeypox outbreak is needed to free up resources and ramp up their response.

Credit: Georgia State University

Credit: Georgia State University

“It is a delicate balance. And it’s, it’s something where a state wants to weigh all the factors and decide whether to issue an order right now or wait to see if that becomes more necessary,” Kershner.

The number of monkeypox cases in Georgia increased to 951 late Monday, up from 211 cases three weeks ago.

For now, Georgia appears to be in the “wait and see” group, she says.

When available time, personnel, and resources are not enough to address a communicable disease threat, states will consider declaring a public health emergency to allow them to do everything from diverting personnel from their regular duties to help with outbreak response, suspend normal bureaucratic processes for hiring or purchasing in order to act quickly.

Related to vaccines, the emergency order could help facilitate distribution, by allowing more people such as EMTs to administer vaccines. But this doesn’t increase the available quantity of vaccines right now, she said. For monkeypox, much of the problem is access to vaccines from the federal government. There isn’t much that the state can do at this point to speed that along, she said.

“I don’t really understand a wait-and-see approach,” said Nathan Townsend, manager of prevention services for NAESM, an organization that works to address health issues of gay Black men. He has been working to get individuals vaccinated against monkeypox.

Whether or not the state issues an emergency, what’s important is that the government is taking the necessary steps to control the outbreak, Townsend said. He said the scarcity of vaccines is the most pressing and urgent problem, but state health officials need to improve communication about where and how to get the vaccine. Georgia Department of Public Health late Monday announced a centralized online vaccine signup where anyone can sign up for either monkeypox or COVID-19 vaccinations.

The federal government recently declared a public health emergency to boost the response to the monkeypox outbreak. The announcement frees up money and other resources to fight the virus, which can cause fever and body aches, and pimple-like bumps on many parts of the body.

The declaration by the Department of Health and Human Services comes as the Biden administration has faced criticism over the pace of monkeypox vaccine availability. The White House said it has made more than 1.1 million doses available and has helped to boost domestic diagnostic capacity to 80,000 tests per week.

The Biden administration has authorized a new way to inject a monkeypox vaccine in an effort to stretch the low supply. The Food and Drug Administration issued an emergency use authorization to allow smaller doses of the Jynneos vaccine to be injected just under the skin, which will increase the number of doses available up to fivefold.

This could be translated into a sudden increase in doses, and NAESM’s Townsend said Georgia may need to reconsider issuing a state of emergency to help administer all of these doses quickly.

Governors in California, New York and Illinois have also declared a state of emergency in response to the monkeypox outbreak. Some cities, including New York City and San Francisco, have also made their own emergency declarations.

The monkeypox virus spreads through prolonged skin-to-skin contact, including hugging, cuddling and kissing, as well as sharing bedding and towels. Most cases so far have occurred in men who have sex with men but health officials emphasize that the virus can infect anyone.

There have no reports of any deaths in the U.S. during this growing outbreak so far A few deaths have been reported in other countries.

Under the federal declaration, HHS can draw from emergency funds, hire or reassign staff to deal with the outbreak and take other measures to control the virus.

For example, the announcement should help the federal government to seek more information from state and local health officials about who is becoming infected and who is being vaccinated. That information can be used to better understand how the outbreak is evolving and how well the vaccine works.

Those who do contract monkeypox – barring any complications – are able to isolate and recuperate at home, resulting in no strain on hospital resources; and because monkeypox is not highly transmissible outside of extended, close personal contact, there is no social distancing protocol for the general population, Isenhour said.

“I do want to re-emphasize, though, that there is no lack of concern or readiness for further action on the state’s part,” said Isenhour. He said the Kemp administration and health officials are monitoring the spread of the virus closely. He didn’t rule out declaring one in the future.