FDA authorizes a new monkeypox test for emergency use, the Covid-19 public health emergency is expected to be extended for the 12th time, and more in this week's roundup of monkeypox and Covid-19 news.

Monkeypox:

• Both New York City and New York state governments have ended their monkeypox states of emergency as cases in the city dwindle down to an average of three per day. In addition, NYC has closed its mass vaccination sites and ended its mobile vaccination program for monkeypox, which deployed vans outside community centers, nightclubs, and sex parties. Through its monkeypox vaccination campaign, the city administered roughly 100,000 first doses and 50,000 second doses. According to Peter Meacher, CMO at the Callen Lorde sexual health clinic, these vaccinations were enough to help NYC bring its outbreak to "the tail end." Currently, monkeypox vaccinations are being transitioned to outpatient and sexual health clinics run by NYC's hospital system and private providers. Going forward, NYC said it hopes to make monkeypox vaccination part of routine care to reduce the risk of infection. (Otterman, New York Times, 11/17)

• FDA on Tuesday authorized Roche's monkeypox test for emergency use. The test detects monkeypox DNA from swab specimens collected from individuals who have a suspected infection and will be conducted on Roche's cobas systems, which can also detect HIV and hepatitis B and C. According to FDA, testing will be limited to laboratories that can perform moderate or high complexity tests. So far, more than 28,000 monkeypox cases have been reported in the United States, and the outbreak is still considered to be a federal public health emergency. (Reuters, 11/15)

  Covid-19:

• The federal Covid-19 public health emergency (PHE) is expected to extend past its current Jan. 11, 2023, deadline after HHS did not notify states or health providers of any plans to end it. "The COVID-19 Public Health Emergency remains in effect, and as HHS committed to earlier, we will provide a 60-day notice to states before any possible termination or expiration," an HHS spokesperson said. If the PHE is formally renewed by HHS Secretary Xavier Becerra, its new deadline for ending would be in April 2023. Currently, daily Covid-19 case and death rates are declining, but more than 300 people are still dying from the disease each day. In addition, many public health officials are predicting the United States will face another Covid-19 surge this winter as more people gather indoors. (Weixel, The Hill, 11/14; Morse, Healthcare Finance, 11/15)

• Major life stressors, such as financial or food insecurity or death of a loved one, may increase the risk of hospitalized Covid-19 patients developing long Covid later on, according to a new study published in the Journal of Neurological Sciences. For the study, researchers from NYU Langone Health used telephone survey tools to follow up with patients who were hospitalized with Covid-19 in the health system between March 10, 2020, and May 20, 2020. Of the 790 patients, 451 completed at least one follow-up at 6 or 12 months. Among this group, 17% died between their discharge and the one-year follow-up, and 51% reported major life stressors one year later. According to multivariable analyses, patients with significant life stressors were twice as likely to experience long Covid symptoms, including depression, brain fog, fatigue, and more. "Our study is unique in that it explores the impact of life stressors—along with demographic trends and neurologic events—as predictors of long-term cognitive and functional disabilities that affected quality of life in a large population," said Jennifer Frontera, a professor of neurology at NYU Langone and the study's lead author. "Therapies that lessen the trauma of most stress-inducing life events need to be a central part of treatment for long COVID, with more research needed to validate the best approaches." (Carbajal, Becker's Hospital Review, 11/10)

• Global Covid-19 deaths have dropped almost 90% since February, going from 75,000 weekly deaths to just over 9,400 earlier this month, according to the World Health Organization (WHO). WHO Director General Tedros Adhanom Ghebreyesus said this significant decline in deaths is a "cause for optimism," but urged people to be vigilant as new Covid-19 variants continue to emerge. "We have come a long way, and this is definitely cause for optimism. But we continue to call on all governments, communities and individuals to remain vigilant," he said. "Almost 10,000 deaths a week is 10,000 too many for a disease that can be prevented and treated." According to Maria Van Kerkhove, WHO's technical lead on Covid-19, the coronavirus is "still a pandemic, and it's still circulating quite rampantly around the world." For the week ending Nov. 6, WHO reported over 2.1 million new Covid-19 cases—a number that Kerkhove said likely a "substantial underestimate" with testing and surveillance now on a decline. (Keaton, Associated Press, 11/9)

• During the omicron wave in the summer, infants six months and younger had the highest Covid-19 hospitalization rates compared to every other age group aside from older adults over 65, according to a new CDC report. Between April and July, hospitalization rates for children six months and younger, who are too young to be vaccinated, increased 11-fold to rates similar to those among older adults ages 65 to 74. "COVID-19 vaccination during pregnancy might provide protection to infants younger than 6 months old who are currently ineligible for vaccination," CDC said. "To protect themselves and their infants, people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future should stay up to date on COVID-19 vaccinations, as recommended by CDC and the American College of Obstetricians and Gynecologists." (AHA News, 11/10; Bean, Becker's Hospital Review, 11/11)