NIH is launching a new clinical trial to study the efficacy of TPOXX in monkeypox patients, a study finds two doses of a vaccine may reduce your risk of long Covid by up to 81%, and more in this week's roundup of monkeypox and Covid-19 news.

Monkeypox:

• The Los Angeles Department of Public Health (LADPH) on Monday confirmed the first death due to monkeypox in the United States. According to the LADPH, the patient who died was "severely immunocompromised and had been hospitalized." Previously, health authorities in Texas reported the death of an individual with monkeypox, but officials are still investigating whether monkeypox was the cause of death. Overall, deaths due to monkeypox are relatively rare, with the World Health Organization (WHO) citing a 3% to 6% fatality rate. Individuals who are immunocompromised are more likely to experience severe illness with monkeypox, which may in turn increase their risk of death. (Chen, Axios, 9/12; Choi, The Hill, 9/13; Payne/Mahr, Politico, 9/13; AHA News, 9/13)

• Brain inflammation and spinal cord lesions were reported in two men with monkeypox, according to a new report published by CDC. In the study, researchers detailed the experience of two previously healthy young gay men who had confirmed monkeypox infections. One patient was in Colorado, and the other was in Washington, D.C. In both patients, encephalomyelitis developed within days of illness onset. The pathology of the condition was unclear, but researchers posited that it could be due to either the virus invading the central nervous system or triggering a para-infectious autoimmune process. According to Daniel Pastula, one of the study's authors from the University of Colorado School of Medicine, encephalomyelitis may be a rare effect of viruses like monkeypox. In a recent review of monkeypox and other similar viruses, Pastula and his colleagues "found evidence of smallpox infections being described with similar things from centuries ago." (George, MedPage Today, 9/14)

• NIH is launching a Phase 3 clinical trial to evaluate the efficacy of TPOXX, a smallpox antiviral, in monkeypox patients. "We currently lack efficacy data that would help us understand how well this drug may mitigate painful monkeypox symptoms and prevent serious outcomes," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "This clinical trial was designed to answer those important questions." Currently, the study is enrolling adults and children who have been infected with monkeypox as participants. The study will follow participants for at least eight weeks. Participants will perform daily skin checks and take photographs during this time period. According to federal data, more than 21,000 monkeypox cases have been reported in the United States, and almost 2,000 patients have been treated with TPOXX so far. (Choi, The Hill, 9/9)

Covid-19:

• WHO Director-General Tedros Adhanom Ghebreyesus on Wednesday said that while the world has not yet gotten past the Covid-19 pandemic, we have "never been in a better position" and "the end is in sight." According to WHO, the number of weekly Covid-19 deaths worldwide has now reached its lowest point since March 2020, when the coronavirus was first declared a global pandemic. "We can see the finish line. We're in a winning position. But now is the worst time to stop running. Now is the time to run harder and make sure we cross the line and reap the rewards of all our hard work," Tedros said. "If we don't take this opportunity now, we run the risk of more variants, more deaths, more disruption and more uncertainty." Going forward, Tedros said governments should "take a hard look" at their policies and "strengthen them for COVID-19 and future pathogens with pandemic potential." (Doherty, Axios, 9/14; Choi, The Hill, 9/14)

• People who have had at least two doses of a Covid-19 vaccine are 50% to 81% less likely to develop symptoms of long Covid, according to an ongoing study from Israel published in npj Vaccines. In total, there were 951 patients who tested positive for Covid-19. Of this group, 36% had received one vaccine dose, and 31% had received at least two. After adjusting for age, time from symptom onset to questionnaire completion, and baseline symptoms, researchers found that patients with at least two doses were less likely to report fatigue, headache, limb weakness, muscle pain, and shortness of breath in the months after their initial infection. "It is becoming increasingly clear that vaccines protect not just against disease but, as the results of this study suggest, against long-term, sometimes life-changing, effects of COVID-19," said Michael Edelstein, one of the study's authors from Bar-Ilan University. (Van Beusekom, CIDRAP News, 9/12; Twenter, Becker's Hospital Review, 9/13)

• Individuals who are at high risk should get an updated Covid-19 booster immediately, while healthy individuals should get a booster by Halloween, according to Ashish Jha, the White House Covid-19 response coordinator. "Why Halloween? Because three weeks after Halloween is Thanksgiving, and there's a lot of travel, and you're seeing family, and you're seeing friends," Jha said. "And [a] few weeks later, it's the holidays." In addition, Jha noted that even if you are not worried about catching the virus yourself, you can still potentially transmit it to your loved ones who are at a higher risk of severe illness. "[E]ven if you yourself are on the low-risk side, you're going to have family and friends you're going to see. You don't want to be the person who gives it to your grandma," Jha said. "… You don't want to be the person who gives it to your vulnerable friend who's immunocompromised. Lots of good reasons for people to go get it [a booster] this fall." (Gleeson, Becker's Hospital Review, 9/13; Constantino, CNBC, 9/14)