COVID-19 Plateaus in NM as DOH Amps Up Monkeypox Response

So far, the state has reported 10 monkeypox cases

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While reported COVID-19 cases remain high in New Mexico, on average, the caseload has leveled out, Acting Health Secretary Dr. David Scrase said today during a monthly update on the pandemic expanded to include information on monkeypox.

The update comes as cases rise across the country—6,617 at press time—and the Biden administration has declared monkeypox a public health emergency. New Mexico currently has 10 cases, all of which were contracted out of state, Scrase and Acting state Epidemiologist Dr. Laura Parajón said.

As for COVID-19, the Centers for Disease Control and Prevention Aug. 4 weekly update for COVID-19 “community levels,” a framework that combines case rates with two hospital metrics and, for the prior seven day period, shows eight counties—three fewer than last week—have “red” or high levels. Santa Fe County remains “yellow” or medium. Seven counties—the same as the week prior—have “green” or low levels.

The CDC’s recommendations include indoor masking for people living in counties with high community levels. The community levels page has accompanying recommendations at the bottom of the page. The CDC also provides a quarantine and isolation calculator. Scrase encouraged residents to continue monitoring the CDC community levels and taking the appropriate precautions, as illustrated in the chart below.

According to the state health department’s most recent report on geographical trends for the seven-day period of July 25-31, McKinley County had the highest daily case rate per 100,000 population: 68.2, followed by Roosevelt County at 66.8 and Doña Ana County at 55.2; Santa Fe County’s case rate was 42.2, a decline from 46.6 last week. New Mexico recorded 6,300 total cases statewide over the seven-day period, a 5% decrease from the week prior.

“In general, New Mexico has plateaued in cases,” Scrase said, although there is no evidence yet of a decline in cases, he added, referencing the chart below. Case reports represent only reported PCR cases, not home testing. Today, New Mexico reported 930 new cases, bringing the statewide total to 595,553 thus far.

Hospitalizations also have plateaued, he noted, but are much lower than they were in January and February, “which means that the disease itself seems to be causing a lot less hospitalizations as a percentage of people who get COVID,” he said, and fewer with the current BA.5 variant. “So that’s good news for us, right? It’s a less virulent, less aggressive variant in some ways.” The number of patients also has dropped and only represents approximately 4% of hospitalized patients. DOH also has logged a significant uptick in utilization of Paxlovid, the oral treatment for COVID-19, which has risen from perhaps 100 people a week last February to now 4,000 people a week. As of today, 164 people are hospitalized with COVID-19, six of whom are on ventilators.

In “not as good news,” he said, deaths from COVID-19 appear to be rising again, although the “death rate” from this Omicron variant appears lower than the Delta variant and even earlier versions of Omicron, he said. “I think we’re still we’re still not out of the woods,” he said, “anytime you’re having 10 deaths a day for a really long time that means a significant impact on individuals and families and communities that we can’t forget.” Nonetheless, “at the same time the good news is of people being hospitalized as a proportion of total cases, and that’s less deaths as a proportion of total cases.” The state reported six new deaths today, bringing the total number of statewide fatalities to 8,273. Santa Fe County has had 330 total deaths. The health department’s most recent mortality report lists 32 deaths in the last 14 days.

“The key things we can all do...are know our community levels,” Scrase said, and “follow the CDC guidance for low medium and high levels.” In addition, he discussed the potential new vaccines, possibly next month, targeting the Omicron variant, as well as the roll-out of the Novavax vaccine, which the Food and Drug Administration approved for emergency use last month. Unlike the Pfizer and Moderna RNA vaccines, Novavax is an “old-school” protein-based vaccine and available for people 18 years and older. Thirteen New Mexico providers have ordered Novavax and people can schedule it through vaccinenm.org.

“And so for those of you who are concerned about experimental nature of a vaccine,” Scrase said, “that barrier has not been removed.”

COVID-19 Resources

Vaccine registration; Booster registration Free at-home rapid antigen tests; Self-report a positive COVID-19 test result to the health department; COVID-19 treatment info: oral treatments Paxlovid (age 12+) and Molnupiravir (age 18+); and monoclonal antibody treatments. Toolkit for immunocompromised individuals. People seeking treatment who do not have a medical provider can call NMDOH’s COVID-19 hotline at 1-855-600-3453. Vaccines for children: Parents of children ages 6 months to 5 years can now schedule appointments for vaccinations at VaccineNM.org.

Monkeypox

As for monkeypox, Parajón said the state has a limited supply of the JYNNEOS vaccine, with 956 doses available as of this week and 2,600 more coming between now and October. The monkeypox vaccine includes two doses, given four weeks apart, but second dose administration can be delayed to allow more people to be vaccinated. People at risk for monkeypox and interested in the vaccine should call 1-855-600-3453.

Anyone can contract monkeypox, which spreads in a variety of ways, including: sexual or intimate contact; respiratory secretions; direct contact with the monkeypox rash or scabs; contact with objects used by someone who has monkeypox. According to the World Health Organization, most reported cases “have involved mainly, but not exclusively, men who have sex with men.” Parajón acknowledged that demographic has initially had the most cases, but said “We don’t want to stigmatize people. Anyone who comes in contact with monkeypox is at risk of getting monkeypox. We want to make sure that people know that anybody can get monkey pox. Right now, it’s in one group in particular. And so that is a high risk group.” She said when people call the vaccine number above, they will be asked a series of questions to determine if they are eligible for the vaccine. Scrase said DOH also has had “a pretty intensive communication effort with communities at high risk” to help “us get this message out.”

Monkeypox typically starts with flu-like symptoms, Parajón said, such as “fever, headaches, fatigue, muscle aches and swollen lymph nodes” followed by a rash similar, she said, to syphilis, Herpes, chickenpox or even poison ivy. It’s also possible for people to experience the rash or blisters without a fever. The rash will often manifest in the genital or anal area and can be painful.

Anyone who thinks they may have been exposed or have monkeypox should contact their health provider or a public health clinic to arrange testing and avoid close contact with people. Monkeypox, Parajón noted, is rarely fatal.

According to the CDC, scientists are still researching If the virus can be spread when someone has no symptoms; how often it is spread through respiratory secretions; when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions; and whether monkeypox can be spread through semen, vaginal fluids, urine or feces.

Bette Korber, the theoretical biologist at Los Alamos National Laboratory who first identified COVID-19′s D614G mutation and is an expert on viral evolution, tells SFR she’s also been looking at the monkeypox virus through a collaboration with the CDC to study its evolutionary mechanism, which she describes as unusual. She also emphasized the distinction between COVID-19 and monkeypox, given the transmission mechanisms are more limited for the latter. Still, she said, “it is transmissible by touch and we have to be cautious and careful. But, she noted, “we’re…starting out with a vaccine,” for monkeypox, she said, “so if we could figure out how to deploy that…we might really be able to turn things around. People who are in high risk communities should be careful and those things may help us…be able to confine this, but it’s still moving really fast. It’s increasing in number at a high pace.”

The health department’s next news conference is scheduled for Sept. 15.