The Morning Dispatch: Making Sense of the Monkeypox

Happy Friday! We’re told there was a literal dumpster fire in Washington, D.C. yesterday. At this point, the jokes write themselves.

We hope you have a safe and fun 4th of July, we’ll see you in your inbox on Tuesday. 

Quick Hits: Today’s Top Stories

• The Supreme Court ruled 6-3 on Thursday that Obama-era Environmental Protection Agency regulations limiting coal plant emissions overstepped the agency’s existing congressional mandates. “A decision of such magnitude and consequence rests with Congress itself, or an agency acting pursuant to a clear delegation from that representative body,” Chief Justice John Roberts wrote, declaring the agency had improperly based its new regulations on “the vague language of a long-extant, but rarely used, statute.” The ruling will curtail efforts to sidestep congressional gridlock and achieve policy goals through regulation. President Joe Biden called it a “devastating decision that aims to take our country backwards.”

• The Court also ruled 5-4 yesterday that the Biden administration can end the Trump-era Migrant Protection Protocol—or “Remain in Mexico” policy—which required asylum seekers arriving at the United States’ southwestern border to wait in Mexico for their claims to be processed. 

• The Federal Reserve’s preferred measure of inflation, the personal consumption expenditures (PCE) price index, increased 6.3 percent year-over-year in May, the Bureau of Economic Analysis reported Thursday—the same annual rate from one month earlier. Even after stripping out more volatile food and energy prices, core PCE increased at a 4.7-percent annual rate in May, well above the Fed’s 2 percent target.

• The Commerce Department reported Thursday that, when adjusted for inflation, U.S. consumer spending decreased 0.4 percent month-over-month in May, after increasing by 0.3 percent each of the two months prior. Meanwhile, global markets wrapped up their worst first half of a year since 1970 yesterday, with the S&P 500 falling 21 percent through Thursday from the beginning of 2022.

• Dr. Peter Marks—director of the Food and Drug Administration’s Center for Biologics Evaluation and Research—announced Thursday the FDA would accept the Vaccines and Related Biological Products Advisory Committee’s recommendation from earlier this week and advise manufacturers seeking to update their COVID-19 vaccines to pursue a bivalent booster that incorporates both the original SARS-CoV-2 strain and Omicron’s BA.4/BA.5 subvariants. The agency hopes to have modified vaccines available for the public by early- to mid-fall 2022.

• The Commerce Department will block five Chinese companies from accessing U.S. technology in retaliation for those companies allegedly “providing support to Russia’s military” or industry in defiance of sanctions. National security advisor Jake Sullivan said Tuesday the U.S. wants to keep China from supplying Russia’s military and helping it evade sanctions.

• President Biden on Thursday backed Turkey’s purchase of modernized F-16 jets from the U.S. and expressed confidence that Congress would approve the sale—though the president clarified this was not a quid pro quo in exchange for Turkey dropping its block on Sweden and Finland’s accession to NATO. The U.S. ousted Turkey from a program to buy more advanced F-35 fighters after Turkey bought missile systems from Russia in 2019.

• The Labor Department reported Thursday that initial jobless claims—a proxy for layoffs—decreased by 2,000 week-over-week to 231,000 last week, remaining slightly above historic lows.

• The latest COVID-19 wave continues to hold more or less steady, with the average number of daily confirmed COVID-19 cases in the United States declining 2 percent over the past two weeks. The average number of daily deaths attributed to COVID-19 is falling precipitously, down 27 percent over the same time period.

• Democratic Sen. Pat Leahy of Vermont underwent surgery on Thursday to repair a broken hip after he fell the day before. At 82 years old, Leahy is currently the longest-serving member of the Senate and third in line for the presidency. He announced last fall he won’t seek reelection this November, and his office said he is expected to make a full recovery.

Is It Time to Start Worrying about Monkeypox?

In the Pre-COVID Times (PCT), it was relatively common to hear about a scary new virus or disease popping up somewhere it wasn’t expected to, only for it to fizzle out and fade from the headlines relatively quickly. Ebola. Swine flu. Zika. Each of these pathogens were serious—particularly in developing countries around the world—but did not rise to the level of concern created by COVID-19. And two-plus years into this pandemic, we’ll likely never look at those news stories about burgeoning outbreaks the same way again.

Which brings us to monkeypox. It’s been about six weeks since reports emerged of a series of small outbreaks in Europe and Canada, and there are now hundreds of cases in the United States. How worried do we need to be? Do public health officials have a plan in place to keep the virus contained? The Dispatch’s Mary Trimble gets into all that and more in a piece up on the site today.

Let’s start with the basics: What do we know about monkeypox and the current status of the outbreak?

The virus is characterized by a skin rash that often accompanies flu-like symptoms including fever, swollen lymph nodes, and muscle aches. The vast majority of people who contract monkeypox make a full recovery, but it’s possible that pregnant women and immunocompromised individuals may be at greater risk of severe illness.

Monkeypox was first discovered in the late 1950s in West Africa in—you guessed it—monkeys, with the first human cases identified in 1970. The vast majority of cases are historically found in central and west Africa, especially the Democratic Republic of Congo. 

Despite scientists having knowledge of the disease’s existence for more than half a century, “there are still a lot of unanswered questions,” said Dr. Isaac Bogoch, an epidemiologist and tropical disease specialist at the University of Toronto. Nonetheless, he added, “We’re not starting at square one.”

The current outbreak is being driven by direct contact with infected, symptomatic people.

“Most of the transmission in the past was animal-to-human,” Dr. Shon Remich, global head of Clinical Development and Operations at Takeda, a Japanese biomedical research firm, told The Dispatch. “The big concern at this particular time is that we’re seeing human-to-human transmission. Anytime a transmittable disease alters the way it gets transmitted from one host to another, it’s cause for concern.”

But there’s good news, too. According to Remich, it’s unlikely that the virus will mutate to become more contagious. Unlike COVID-19, an RNA virus, monkeypox is a DNA virus, which repairs mutations more effectively, leading to fewer new and dangerous strains.

Plus, monkeypox is not very contagious to begin with. It has a basic reproduction number of 0.5-1—that is, the average number of people infected for every contagious person. The original COVID virus infected two to three people per infectious person, with subsequent variants becoming increasingly transmissible, at a rate of around five to seven new infections per contagious person.

Person-to-person or person-to-animal contact isn’t the only way the virus is transmitted. Contaminated materials like clothes and bedsheets can also be vectors of spread, but frequent and thorough hand-washing is still the most effective mitigation strategy. It’s likely that there is also some limited respiratory spread, though not as significant as with COVID-19, Bogoch told The Dispatch.

Some communities are particularly vulnerable to contracting monkeypox. Many of the cases discovered so far are in the gay community—what epidemiologists call the community of “men who have sex with men” or MSM. “It’s not clear how the people were exposed to monkeypox,” the CDC website says, “but early data suggest that gay, bisexual, and other men who have sex with men make up a high number of cases.”

Another piece of good news: A vaccine already exists.

The monkeypox virus is similar to the virus that causes smallpox, though the diseases themselves are different and monkeypox is significantly less severe than smallpox. The WHO reports that the smallpox vaccine could be as much as 85 percent effective against monkeypox, and an additional vaccine specifically to prevent monkeypox was approved by the Food and Drug Administration in 2019, though it’s not yet widely available.

It’s still unclear if widespread vaccination will be necessary. Remich, who helped develop both the Ebola and COVID vaccines, says that vaccinating even specific members of the public writ large should wait until we know more about the vaccines and the spread of the virus.

Bogoch, however, suggests targeted vaccination in at-risk populations. That includes making vaccines available in places frequented by the MSM community, in sexual health clinics, to healthcare workers who treat at-risk populations, and in shelter and prison populations. These vaccines could be administered “pre-exposure prophylactically” or “post-exposure prophylactically”—before or after a person has come in contact with the virus to prevent infection.

The United Kingdom, which has recorded almost 800 confirmed cases mostly in the MSM community, has recently adopted this approach to vaccination, offering the smallpox vaccine to some men particularly susceptible to exposure. Similar programs in New York City and Washington, D.C., quickly ran through their supply of the two-dose Jyennos vaccine that they made available to the MSM community, men with multiple sexual partners, others in the LGBTQ community, and other high-risk individuals. The Biden Administration announced Tuesday that it would send increased stocks of the vaccine from the national stockpile to areas, like big cities, that needed it.

Worth Your Time

• When a diet shake company needed an edge on the competition—and when a company wanted to change the fate of Nigeria’s oil fields—they turned to a ring of Indian hackers-for-hire. Filtering through more than 80,000 emails sent by the hackers, Reuters has found 35 legal cases since 2015 in which the group (motto: “You desire, we do!”) tried to steal passwords from parties embroiled in lawsuits, targeting at least 75 U.S. and European companies and 108 law firms. And in some cases, stolen documents altered the lawsuits’ outcomes. “Millions of dollars are being made by hackers, investigators and their instructing law firms from these illegal activities,” one victim told Reuters reporters Raphael Satter and Christopher Bing. “The hack-for-hire companies may be thousands of miles away, but the victims are often U.S. citizens on U.S. soil.”

• In addition to its mass detainment of Uyghurs and other ethnic and religious minorities, China has been systematically stamping out their culture—or reshaping it into a tourist attraction. A Buzzfeed News analysis of years of videos and pictures taken by tourists in a major Uyghur city shows that as mass internment began around 2017, surveillance cameras and Chinese flags appeared in mosques and on storefronts. In some photos, police officers paused to check that they were properly installed. Since 2019, some of the most visible checkpoints and barbed wire have disappeared, while people dressed in previously little-worn traditional Uyghur clothing dance for tourists. “The city is completely changed,” Islam historian Ryan Thum told reporters Alison Killing, Megha Rajagopalan, and Christo Buschek.“It’s absolutely Disneyfication. It’s an alien place—a theme park.”

• It’s official: Biden is on board with changing the filibuster to get a big abortion access bill through the Senate. But since Sens. Joe Manchin and Kyrsten Sinema still aren’t interested, that idea is going nowhere. “The conditions are set for one of the Biden administration’s favorite ploys: assuring the various party factions that all their dreams would come true but for the dastardly senatorial duo,” Matthew Yglesias writes in Bloomberg. But, Yglesias argues, the bill that Biden supports goes farther than Roe v. Wade ever did, and exacerbates an already entrenched debate—why not instead throw the presidential weight behind narrower legislation? “There should be bills seeking to set federal floors—not ceilings—on abortion rights,” Yglesias writes. “A guarantee of access to therapeutic abortions to protect the life and health of the mother. A guarantee of access to abortions within the first 10 weeks of pregnancy. A guarantee of access in cases of rape or incest. These positions are all very popular, and it’s conceivable that some of these bills would actually secure 60 votes and pass.”

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Toeing the Company Line

• On yesterday’s episode of Advisory Opinions, David and Sarah dive into the Supreme Court’s decision on how Oklahoma prosecutes crimes on Native American reservations. They also take a look at a suprising death penalty decision from last week and debate whether the Justice Department should prosecute Donald Trump for his actions on and leading up to January 6. 

• In lieu of a regular newsletter this week, Thursday’s edition of The Current features video from a Ronald Reagan Institute panel that Klon joined last week on lessons learned from the early days of the Russia-Ukraine war.

• The Supreme Court may have technically ruled in President Biden’s favor on Thursday when it allowed him to end the Trump administration’s Remain in Mexico policy, but Biden would have been better off politically if it hadn’t. “This is just the latest unfortunate victory for the 46th president,” Chris writes in this week’s Stirewaltisms (🔒). “It’s a string that runs all the way back to January 2021 when Democrats unexpectedly took control of the Senate following a matched set of surprise wins in Georgia’s Senate runoffs.”

• Chris and Jonah join Sarah on today’s Dispatch Podcast for a conversation about the political aftermath of Dobbs v. Jackson as states begin to grapple legislatively with the post-Roe era. Plus: What made Cassidy Hutchinson’s testimony before the January 6th Committee so different? And why won’t Democratic groups stop boosting election-denying Republicans?

• On the site today, The Dispatch’s Mary Trimble covers the spread of monkeypox and the ramifications for public health.

Let Us Know

How are you celebrating the 4th of July weekend? And what was your favorite part of Independence Day as a kid?