COVID-19 and Monkeypox - Provider and Partner Snapshot Randall Culpepper, MD, MPH
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COVID-19 and Monkeypox
Provider and Partner
Snapshot
Randall Culpepper, MD, MPH
Frederick County Deputy Health Officer
July 28, 2022
COVID Update Schedule
• Complete live 1 hour COVID-19 Community Updates
o 1st Thursday of each month from 12:00 to 1:00 pm
o Next live COVID updates Thursday, August 4, then September 1
• Pre-recorded 15’ COVID-19 Snapshot
o Every other Thursday on the same Teams link from 12:00 – 12:15
pm.
• All presentations posted on Frederick County Health Department
website:
o https://health.frederickcountymd.gov/389/Public-Health-Issues
Global 7-Day Rolling Average Cases (July 26, 2022)
Global 7 day ∆
30,000,000
25,000,000
6.7M cases/week
7.4M last week
20,000,000
15,000,000
10,000,000
5,000,000
0
Global 7-Day Rolling Average Deaths (July 26, 2022)
7 day ∆
120,000
13,700 deaths/week
100,000
18,900 last week
80,000
60,000
40,000
20,000
0
U.S. 7-Day Rolling Average Cases (July 26, 2022)
U.S. 7 day ∆
6,000,000
5,000,000
905K cases/week
890K last week
4,000,000
3,000,000 Estimate for every reported case there are 7 unreported
2,000,000
1,000,000
0
U.S. 7-Day Rolling Average Deaths (July 26, 2022)
7 day ∆
25,000
3,072 deaths/week
20,000
3,035 last week
15,000
10,000
5,000
0
CDC Community Transmission Level versus Community Level
(July 20, 2022)
No change in percentages from last week
Community Transmission Level (93% HIGH) Community Level (35% High)
CDC Community Transmission Level versus Community Level
(July 27, 2022)
Increased percentages from last week
Community Transmission Level (94% HIGH) Community Level (42% High)
Monitoring Variant Proportions, United States (July 23, 2022)
(78% 82%)
(13% 13%)
(9% 5%)
(BA.2: 0.6% 0.3%)
Maryland 7-Day Rolling Average Cases (July 26, 2022)
120,000
3rd highest case rate since pandemic began
100,000
80,000 11,750 cases/week
10,670 last week
60,000
40,000
20,000
0Maryland 7-Day Rolling Average Deaths (July 26, 2022)
500
450
46 deaths/week
400
350
42 last week
300
250
200
150
100
50
0Case Rates by County July 19, 2022 ALL but 2 counties are at the HIGHEST CDC Community Transmission Level (> 14.2)
Case Rates by County July 27, 2022 EVERY county is at the HIGHEST CDC Community Transmission Level (> 14.2)
Last 7 days in Maryland • 14% increase in adult acute beds (3% inc. prev. week) • No change in adult ICU beds (19% dec. prev. week) • 6% increase in new admissions nationally last week
Maryland COVID cases – 10-year age breakdowns (July 27, 2022)
Maryland COVID Summary (July 27, 2022) COVID-19 Cases o > 1,650 cases daily (inc.); 11,755 new confirmed cases last week o Statewide case rate = 27.8/100K (2.5% increase over last week) o 7-day test percent positivity = 10.9% (15% increase over last week) COVID-19 Hospitalizations o 14% increase in acute care hospitalizations over last 7 days o 0% change in adult ICU admissions over last 7 days
Maryland COVID Summary (July 27, 2022)
Predominant strains in our region
o BA.5 - predominant strain
■ Cases increased from 73% 79%
■ No evidence for more serious illness than other omicron subvariants
■ People previously infected may not be more protected
o B.4 - cases decreased from 15% 14.8%
o BA.2.12.1 - decreased from 11% 6.3% of casesFrederick County 7-Day Rolling Average Cases (July 26, 2022)
5,000
4,500
405 cases/week
4,000
403 last week
3,500
3,000
2,500
2,000
1,500
1,000
500
0Frederick County Monthly COVID Deaths (July 27, 2022)
70
5 deaths in last week; none since June 28 63
60
55
50
50
43 44
40
# of Deaths
35
30
24 23
21
19
20 17
15 16
14
11 11
9 9
10 7
6 6 6 5
4 4 4 4 3 2
0
Date ReportedApril 1 - 7 Jul 20 - 26
27
FHH All ICU Acute FHH All ICU Acute
Frederick Health Hospital 1 0 1 15 2 13
Acute and ICU Bed Stats 2
1
0
0
2
1
18
12
2
2
16
10
0 0 0 14 1 13
1 0 1 20 1 19
COVID-19 Patients in Acute Beds COVID-19 Patients in ICU Beds 1 0 1 23 1 22
1 0 1 22 1 21
120
100
# of Patients with COVID-19
80
60
40
20
0Frederick County Current Outbreaks (July 27, 2022)
FREDERICK COUNTY Last Week This Week MARYLAND
Long term care 16 16 179 (181)
Group homes 0 1 45 (39)
Treatment centers 4 7 --
Frederick Health Hospital / Hospitals 0 0 -- / 33 (34)
Schools (K-12) / Camps 0/2 0/3 5 (7) / NR
Daycare centers 6 4 58 (62)
Total 28 31 519 (505)
23 (21) statewide corrections and 0 (0) college outbreaksCOVID-19 Frederick County (July 27, 2022)
CDC Community Transmission Level = HIGH (case rate > 100, Test % POS > 10)
CDC Community Level = Low (case rate < 200, admit rate < 10, % beds < 10)
Weekly cases (7 day rolling average) 405
Case rate per 100K HIGH Community Transmission (>= 14.3 or 100) 22.3 (155)
% Positivity HIGH Community Transmission (>= 10.0%) 14.2%
Deaths last 7 days 5
% of population 5+ years of age fully vaccinated 84.4%
New COVID-19 admissions per 100,000 population < 10 (5.3)
% staffed inpatient beds with COVID-19 patientsFour things everyone can do now 1. Wear face coverings 2. Stay up-to-date with the COVID vaccinations 3. Get tested and test frequently PCR and/or at home rapid Ag test (at least 2-3x if negative and exposed with symptoms) 4. Access treatments early if infected
Monkeypox Update
Monkeypox: Current Global Situation (July 27, 2022)
Country Cases
20,638 total cases U.S. 4639
(5,260 new cases in last 7 days) Spain
Germany
3738
2459
U.K. 2432
France 1837
Netherlands 818
Canada 745
Brazil 696
Portugal 588
Italy 426
Belgium 393
Switzerland 251
Peru 224
DRC 163
Israel 121
Nigeria 117
Austria 115Monkeypox: Current Situation in the US: (July 27, 2022) State Cases
New York 1,228
4,639 total cases California 799
Illinois 385
2,316 new cases last 7 days (1,397 previous week) Florida 332
Georgia 312
Texas 287
D.C. 205
Pennsylvania 114
Massachusetts 113
Washington 103
New Jersey 102
Maryland 101
Colorado 53
Oregon 51
Arizona 41
Virginia 39
Indiana 37
Connecticut 28
Louisiana 28
Michigan 28
Minnesota 28
https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html Utah 26 22Monkeypox cases reported to CDC (July 26, 2022)
MONKEYPOX: LESIONS 28
What Have We Learned During 2022 U.S. Monkeypox Outbreak
(July 15, 2022)
• Transmission - cases have NOT reported for any person with monkeypox:
■ During brief interactions (such as a brief conversation)
■ Between people in close-proximity and for a long duration (e.g., passengers
seated near a person with MPX on an airplane)
■ During healthcare encounters
• Deaths – no deaths reported due to monkeypox in the U.S. or Europe
• Some epidemiologic characteristics different than previous MPX outbreaks
o Direct skin-to-skin contact, including sexual and/or close intimate contact,
is the predominant exposure route for persons with MPX in the U.S.
o Most people with MPX have been adults not requiring hospitalization.Isolation and Prevention Practices for People with MPX
• Infectious from onset of symptoms until all symptoms resolved, including full healing of the rash
with formation of a fresh layer of skin.
• CDC recommends remain in isolation for duration of illness (~ 2-4 weeks)
• If unable to remain fully isolated throughout illness, do the following:
o Symptomatic with fever or any respiratory symptoms (e.g., sore throat, nasal congestion, or
cough)
■ Remain isolated at home unless necessary to see healthcare provider or for an emergency.
■ Avoiding close or physical contact with other people and animals.
■ Cover lesions, wear a well-fitting mask, and avoid public transportation when leaving home
o Rash but no fever or respiratory symptoms
■ Cover all parts of the rash with clothing, gloves, and/or bandages.
■ Wear well-fitting mask when interacting with others until rash and all symptoms resolvedIsolation and Prevention Practices for People with MPX • Do not share items worn or handled with other people or animals. • Launder or disinfect items worn or handled and surfaces touched by a lesion. • Avoid close physical contact, including sexual and/or close intimate contact • Avoid sharing utensils or cups. Clean and disinfect items before use by others. • Avoid crowds and congregate settings. • Wash hands often especially after direct contact with the rash.
MDH Monkeypox Specimen Submission Guidelines
• 2 Dry swabs from lesion/pustule, etc. (one for testing by MDH, one for testing by CDC if
needed)
o Use Polyester, Dacron, etc.
o Place each swab in separate, sterile, dry container with screw-cap lid (e.g., Conical
tube, specimen cup)
o Can send multiple body sites
• 1 VTM swab (for reflex testing if negative for orthopox)
• Scab or crust of lesion, if able to de-roof, can also be sent
o Place in dry, sterile, screw cap container
• MDH storage and shipping instructions:
https://health.maryland.gov/laboratories/docs/20220617155419.pdfThank you!
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