Dallas County Health accepts some input on monkeypox reporting. Not good enough.
Not all my suggestions are implemented but some of the suggestions have been.
Introduction
It seems that some of my recommendations were adopted after my presentation that was given to the Dallas County Commissioners Court on October 4, 2022.
I will have a current status report at the end of this report on the Dallas County webpage.
This was my report on my presentation to the Dallas County Commissioner’s Court.
What was implemented and improved.
First thing the graph of the cases clearly shows that the recent data is incomplete.
This is the footnote.
So you are visually flagged that the date at the end of the chart is incomplete and with incomplete data. HOWEVER, the seven day running average is still being plotted into it which tends to imply it is still data that is valid for indicating a trend. Not everyone reads graphs that well. Avoiding monkeypox will partly depend on people understand the real risk.
Also, the status of vaccine availability and whether there is a shortage is clearly stated and also that it is the reason for having criteria for who can get the vaccine.
I had a discussion with Dr. Huang that some people who are MSM (Men who have Sex with Men) might not want to have on record their sex lives and that if someone shows up for a vaccination they likely need it. I said that if there isn’t a shortage of vaccine then walk-ins should be accepted. However, there is a shortage.
But I was pleased to see that the criteria has been expanded. Likely since the rate of monkeypox is trending down they don’t have as many cases of where people had, quoting the first criteria on their website, “close, intimate, skin-to-skin contact with someone who has tested positive for monkeypox.” Also, they have had a fair number of people who have been vaccinated, though we don’t have numbers on the Dallas County Health page. So there has been an expansion. This was not part of my request, but I do want to make sure I do acknowledge improvements as well as criticize.
What I requested and wasn’t done.
There still isn’t any indication of how many vaccinations have been done cumulatively. At least we could have a running count of the doses of vaccines that were allocated to Dallas County.
How many were given in the last week.
Whether Dallas is getting all the vaccines doses they are requested.
So only one of the requests of the four, (No. 4 in my list, “The justification for current restrictions needs to be posted.”
I also asked why was the number of African American monkeypox cases greatly in excess relative to the racial demographics of MSM. Reviewing the data, it does NOT appear that the racial disparity has improved. African Americans between 10/1/2022 to 10/11/2022 had half of the new cases.
However, lets look at the numbers from 10/1/2022 versus 10/11/2022.
Screen captured 10/11/2022.
Again, half the cases are African American. The numbers are small so the statistical significance is low, but it is concerning that half of the new cases are African American. African Americans don’t represent half of the MSM in the county. (% rounded off to one decimal.) These are screen capture dates.
This should be concerning to everyone regardless of race, since if monkeypox isn’t being adequately addressed in the African American MSM community, then we have the potential for a persistent reservoir of monkeypox waiting to infect the entire community after it evolves around the vaccines. I reported earlier that monkeypox was mutating.
Conclusion
Very limited improvement in reporting and vital information still isn’t being given. The issue of racial disparity involved with the program hasn’t been addressed yet, though it might be.
CURRRENT STATUS.
It might be improving, but we don’t definitively know yet. You might wonder why my graph doesn’t show the rate of improvement shown in the Dallas County Health. My chart is showing improvement, the points are below the yellow line, but my plotting the cumulative numbers tends to not show progress until and additional point is added. The report of 721 cases was on 9/30/2022 and the 745 was reported on 10/7/2022, so it is 8 days which is 3.0 cases per day. But this is just two data points. It is encouraging, but we need to wait for one or two more data points to be sure.
Without the vaccination numbers we can’t even guestimate what percentage of of the MSM population is vaccinated. We have no idea as to what is contributing to this declining rate. Having the sexual life of the Gay community shutdown isn’t a victory.
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