The Board to receive a verbal update on the Monkey Pox outbreak.
Minutes:
6.1 Dr Nicola provided a verbal update on monkey pox and began by thanking Adam Gray, General Manager – HIV (human immunodeficiency virus), GUM (Genito Urinary Medicine) and Dermatology at Chelsea and Westminster Hospital NHS Foundation Trust for his support and work. Dr Lang briefly described the epidemiology of the disease and the scale of the problem. There were currently 910 cases nationally and the number was increasing, with a doubling rate of every 12 days. About two thirds of cases were in England (873) and of these, 590 had been reported in London. Chelsea and Westminster hospital was extremely experienced in providing sexual health treatment and services, seeing about 30-40 cases per day, the majority of whom were male and who identified as being gay or bisexual, or who had sex with men. A robust local system had been established working with local sexual health services and the UK Health Security Agency (UKHSA, previously known as Public Health England). UKHSA had delivered all contact tracing activities and risk assessments. The entire local NHS system was working together, with Imperial hospital forming part of the patient pathway. After a patient was seen by Chelsea and Westminster hospital, an Imperial hospital virtual ward nurse would follow up to check on whether further medical treatment or support was needed particularly to those who were unable to self-isolate. In terms of communication, advice and information has been provided to at risk groups. Dr Lang confirmed that despite the rate it was not as easy to catch as Coronavirus and that the Small pox vaccination offered protection.
6.2 Councillor Helen Rowbottom asked what infrastructure was in place to offer effective local support and if this was like the infrastructure established in response to Coronavirus. Dr Lang responded that similar methods were being used to track cases but acknowledged that there was an implied stigma linked to Monkey Pox. Dr Lang reported that the London Coronavirus Response Cell (renamed the London Monkey Pox Response Cell) had pivoted from Coronavirus to Monkey Pox. Dr Lang stated that it was important for people to confidentially access sexual health services and to trace any contacts an infectious person might have had. The at-risk group was one that might feel stigma and required reassurance. A key difficulty with infectious diseases was to ensure that cases were identified, and support provided to help prevent the spread of infection. The UKHSA had confirmed that there was sufficient vaccine available but a controlled and steady roll out was required, with the priority being to vaccinate those who had been contact traced.
6.3 Councillor Natalia Perez welcomed the update and sought further information about any prevention awareness campaigns and what measures had been put in place to reach out to those communities most affected. Dr Lang responded that much of the outreach work had been undertaken through specialist channels such as the Terrance Higgins Trust. The local authority was not directly involved in this as communications were being led by sexual health experts. Specific information was also being channelled through social applications such as Grindr. There had also been webinars which offered a communication platform that was both coproduced and culturally competent and led by UKHSA.
6.4 Carleen Duffy enquired if it was possible for people to swab test anonymously. Dr Lang confirmed that this was not currently possible, and people would have to attend a sexual transmitted disease (STD) clinic, which offered highly specialised services. This might change if or when numbers potentially increased.
6.5 Dr James Cavanagh commented that this was an emerging issue affecting an exclusive group and that services were trying to mitigate by establishing patient pathways. There was a risk that health staff might need to isolate which would then impact on the post-Covid recovery work. Monkey pox mimicked chicken pox with a similar patient pathway. GPs would shortly be attending a seminar on the epidemiology, treatment, and prevention of the disease to ensure that the right care was offered, and exposure limited. Dr Cavanagh commented on the discharge process which required sensitivity as some patients who needed to isolate may not have revealed their sexual status. There was also an expectation that Monkey Pox will cross genders but that the overall NHS response was ahead of the curve.
6.6 Nadia Taylor asked about how hygiene awareness was being raised, how this compared to Coronavirus, and what reassurance could be provided. Dr Lang responded that the Small Pox vaccine offer was in place, but she hoped to see stronger messaging about prevention. Communication and messaging were currently being discussed at London level, but this was a complex and sensitive area. Dr Cavanagh reiterated that Monkey Pox was not as contagious as Covid, requiring prolonged exposure and that currently, specific groups were being targeted for support and prevention. Sarah Lumgair recognised the difficulties that people experienced in feeling unable to reveal information about their sexual health and status. Individuals could be referred to People Arise Now to receive basic support and that advice could be provided in multiple languages.
6.7 Councillor Coleman asked if there was a need for stronger messaging before other groups became affected, referencing the stark HIV health campaigns from the 1980s. Dr Lang commented that communication could be provided in a way that was non-stigmatising, to warn and inform, but it was not warranted until a tipping point of STD clinical cases was reached. Dr Cavanagh confirmed that GPs were able to send out text message alerts to patients about this but emphasised the importance of maintaining a nuanced approach as there was currently an extremely low risk to heterosexual groups. Councillor Coleman welcomed the verbal update and noted that the outbreak would continue to be carefully monitored.
RESOLVED
That the verbal update was noted.