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While COVID Cases Drop In LA, More Than 1,000 People Test Positive For Monkeypox

Round and spherical shapes appear in gray on a white background.
A microscopic view of monkeypox virions.
(Courtesy CDC)
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More than 1,000 people have tested positive for monkeypox in Los Angeles County since the outbreak began in May, health officials reported Thursday.

The 1,036 cases include those reported by the Pasadena and Long Beach public health departments. California has the second highest number of monkeypox cases after New York.

“Since current vaccine supply is limited at this time, public health's focus continues to be on vaccinating residents who are at higher risk for monkeypox infection," County Health Officer Muntu Davis told a press conference Thursday. "Eligibility criteria remain gay or bisexual men and transgender persons who had multiple or anonymous sex partners in the last 14 days including an engaging in commercial and or transactional sex.”

A slide with information on monkeypox case demographics. Most cases are among men who have sex with men.
Courtesy of the L.A. County Dept. of Public Health)
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Cases have increased 33% since last week, when Public Health reported 779 cases on Aug. 10. Most cases are among men who have sex with men. California has reported 2,663 cases statewide, ranking it second among states in case numbers after New York, according to the Centers for Disease Control and Prevention.

At the same time, the supply of vaccines provided by the federal government has been cut.

L.A. County health officials found out Tuesday that the federal government slashed the county’s requested and expected monkeypox vaccine allotment by 60%.

Last week, the FDA told health care providers to split a one-dose vial of the monkeypox vaccine into five doses. The shift was good news for vaccine-strapped cities throughout the country because it meant what little supply is available could be stretched much further.

But then L.A. County and other cities and states were told that they would get significantly less vaccine than they’d requested. L.A. County expected to receive 14,000 vials of the vaccine this week, which would have yielded, when split, 70,000 doses for eligible residents. Instead, the county will receive 5,600 vials, which will yield only 28,000 doses.

On Thursday, HHS announced an “accelerated” phase three nationwide allotment that will consist of 442,000 doses of the vaccine, called Jynneos, that is available for states and jurisdictions to order. It’s unclear how many of those doses will be allocated to L.A. County.

“It makes me feel hopeful that over the upcoming weeks as we quickly administer doses that we receive we will be able to get more doses,” said County Public Health Director Barbara Ferrer.

A slide laying out vaccine eligibility criteria for the monkeypox vaccine in L.A. County.
Courtesy of the L.A. County Dept. of Public Health )

Jynneos is a smallpox vaccine that can also be used to prevent monkeypox amid the ongoing outbreak. The full-vial dose is injected into muscle tissue, but giving a smaller dose between layers of the skin — known as an intradermal injection — is also effective in preventing the painful viral infection.

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Public Health also reported the first monkeypox case among incarcerated people in an L.A. County jail, though Davis declined to say which facility had the outbreak. Public health has vaccinated about 300 at-risk people in jails over the past three weeks, Ferrer said. Davis also reported one case at a homeless shelter.

A line graph showing new COVID-19 cases dropping in L.A. County since the peak in July, 2022.
Courtesy of the L.A. County Dept. of Public Health)

COVID Cases Still Dropping

The community level of COVID-19 in L.A. County is medium, based on hospitalizations and cases, according to the CDC.

Known daily cases in L.A. County have fallen by 7% in the past week to 3,500 reflecting the declining cases across the nation. Statewide, California daily case counts were nearly twice as high a month ago as they are today. The decrease suggests the latest wave driven by fast-spreading subvariants of omicron peaked in July. Combined, BA.4 and BA.5 make up 94% of infections in the county.

Still, thousands of people are getting infected. Public Health reported 3,379 new cases Thursday, and the county’s positivity rate remains at 10%. That’s high, suggesting that cases are being significantly undercounted, since many people test at home and don’t report the results.

Hospitalizations have also decreased, though on average 993 COVID positive patients were in hospitals in L.A. County every day this week. State modeling predicts hospitalizations will continue to drop over the next three weeks, Ferrer said.

Fewer people are dying from the virus, with an average of 13 deaths reported daily.

Last week the FDA changed its guidance on at-home COVID tests. The agency advises that people who may have been exposed need to take as many as three at-home tests to ensure they don't have asymptomatic infections. Repeated testing was shown to catch more omicron cases in a large study cited by the agency.

The FDA changed their guidance based on the performance of at-home testing kits, which are expected to detect the virus at least 80% of the time when someone is infected. You could also get a much more sensitive PCR test that has to be sent to a lab, and will detect even trace amounts of the virus in your system.

What questions do you have about the pandemic and health care?
Jackie Fortiér helps Southern Californians understand the pandemic by identifying what's working and what's not in our health response.