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Public health experts, including in the Biden administration, are increasingly concerned that the federal government’s response to the largest monkeypox epidemic to date in the United States reflects his clumsy response to the coronavirus pandemic 2 and a half years ago, with potentially dire consequences.
As a result, they said, community transmission occurs largely undetected, and the critical window to control the outbreak quickly closes.
“It was an incredible challenge,” said Lauren Sauer, director of the Special Pathogen Research Network within a government-funded consortium of medical centers focused on pathogen training and education. “I felt like January 2020 again.”
More than 150 Cases of monkeypox have been identified in the United States since May 19, federal officials said this week, and more than 3,300 cases have been found in 42 countries around the world.
The rapidly growing number of cases worldwide prompted the World Health Organization to convene an emergency commission on Thursday to assess whether the monkeypox epidemic is a public health emergency of international concern. – the Agency’s highest level warning, which currently only applies to coronavirus and polio.
But as other nations stepped up efforts to track and prevent the spread of the infection, experts say the United States has moved too slowly to expand access to monkeypox tests and vaccinate people at highest risk. The government’s failure to communicate clearly and urgently the symptoms and risks associated with monkeypox, a disease spread through close contact that can lead to fever, pain and a visible rash, has made gay and bisexual men who become disproportionately particularly vulnerable to the virus. , public health experts say.
The difficult US response so far raises doubts about the country’s readiness for the next pandemic, some administration officials say.
Communication about who to test, when to test, and what monkeypox symptoms look like is grim, Sauer said. public health expert at the University of Nebraska Medical Center.
The disappointment is particularly great because, unlike the coronavirus, apes is studied for decades by global and American experts who know the tools, strategies and protocols for vaccines that can limit the spread.
Biden administration officials said Wednesday they were well prepared for a outbreak of monkeypox, publicity of government efforts to obtain more doses of vaccine, warn the public of the emerging epidemic and begin distributing tests in commercial laboratories across the country this week. They also insisted that their response reflected the lessons learned from fighting coronavirus, such as waiting for the “correct test that works” to spread in laboratories after federal officials circulated defective coronavirus tests in early 2020.
“All this work takes weeks to get done right,” said Raj Punjabi, who is leading the White House’s global health security effort. reflective for the “humility” which he said officials tried to apply for monkeypox after struggling to control the coronavirus and other outbreaks.
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Clinicians, patients and some administration officials blame the Centers for Disease Control and Prevention for the testing criteria, which they say are too narrow and have led to a long wait – sometimes several days – in identifying positive cases. Under the current framework, physicians seeking a test for a person suspected of having monkeypox should first consult a state epidemiologist. Public health officials say the protocol helps identify people at highest risk so doctors can recommend isolation and take other steps to prevent it from spreading to the community.
And just like in early 2020, when the coronavirus first threatened the United States, federal officials initially limited monkey measles tests to a network of several dozen public health labs – and did not authorize thousands of commercial labs and hospitals to run their own. tests.
Testing for monkeypox is performed by 86 mostly state and local public health laboratories, with a capacity for more than 8,000 tests a week, according to the CDC. But an employee of a large city health department who works directly on the reaction of monkeypox said the figure was misleading as laboratories were not concentrated around large urban areas, where most infections are found.
Without better access to tests, which involves tamponade of the lesion, it is impossible for public health officials to know the true spread of the disease.
Smallpox has recurred in Central and West Africa for decades, but the current outbreak has occurred in countries that have not previously reported infections, raising concerns about how and why the disease appears to be spreading in countries, including Great Britain, Germany, Portugal and Spain.
The reaction was also hampered by the lack of knowledge of American doctors with the rare disease. The CDC initially published photos from decades of heavier outbreaks in Africa, instead of the finer rashes found in the recent global outbreak. The United States has been much slower than the UK and Canada in distributing updated educational materials, only recently sharing photos showing what fair skin rashes look like, said David Harvey, executive director of the National Coalition of Directors of STD.
“One of the things that worries me right now is that we are seeing cases that are happening in many countries, and we are also seeing numbers being reported in places that are much more aggressive in their observation than what we have seen. here, ”said Jennifer Nuzo, an epidemiologist at Brown University School of Public Health.
While smallpox is spread mainly among men who have sex with men, the disease is not specific to any group. “If a woman does not have a specific known risk factor and a woman comes to the emergency room, what is the probability that she will be found?” Nutso said.
In most cases, the symptoms of monkeypox go away on their own within a few weeks. But for pregnant women, children and people with weak immune systems, the disease can lead to medical complications, including death, according to the WHO.
Chasing a Killer: At a time when a deadly disease could cross the globe, scientists need to understand the mysterious ape pattern.
Two federal officials involved in the monkeypox response said there were “significantly” more cases in the United States that were missed because monkeypox tests had not been expanded outside the network of public health laboratories.
“If we don’t act aggressively now, monkeypox will be so much harder to eradicate later – or it may even become endemic,” in the United States, said one administration official, who is among more than two dozen across the country. The Ministry of Health and Human Services and the White House in charge of fighting the outbreak and who have spoken on condition of anonymity because they are not authorized to speak to the press. Many of the same teams are working on the coronavirus response.
On Wednesday, administration officials said they were allowing five large commercial labs to test for monkeypox, starting in early July, which is a dramatic expansion of capacity. This could allow laboratories to conduct tens of thousands more tests a week. Healthcare providers will be able to send samples directly to commercial testing laboratories without having to first consult with public health officials to determine if the testing criteria are met. Activists say the move is overdue.
concerning 10 Tests for monkeypox a day were conducted across the country in early June, although other countries such as Britain performed much better, a senior administration official said on Wednesday. While laboratory tests increased last week, only about 700 tests were conducted as of June 17, the official said.
Before the CDC made its test widely available to commercial laboratories, the agency had to update test protocols, establish agreements with the five laboratories and ensure that staff had personal protective equipment and vaccines to protect against infection, according to a senior public health official. who speaks according to the basic rules of the Biden administration, they should not be named.
A man who asked for a test on June 13 in New York for potential symptoms of monkeypox – flu-like illness and swollen lymph nodes – was initially advised by a doctor that he did not have the disease and did not need a test, said Joseph Osmundson, a virologist at New York University. who spent several days trying to help the individual get a test. The man recently returned to New York from Portugal, where he said he had casual sex with other men. Health officials have advised clinicians to watch out for travel-related cases in Europe and in situations where men have had sex with men.
But the man told The Post that his efforts to get a test had been repeatedly rejected – even after he was found to have “abnormal HPV-like lesions”. which were not easily seen.
“The pain was like someone stabbing me inside – I couldn’t sit, I couldn’t sleep,” said the man, who spoke on condition of anonymity to protect his privacy. He said he went to four different providers, including a large hospital in New York, before an emergency clinic took a sample on Monday. He said he finally got his results on Thursday afternoon, 10 days after he first asked for a test. The results: positive.
Osmundson said he was aware of a dozen similar cases in which people with possible symptoms of monkeypox had been repulsed.
“The CDC sets very narrow criteria for testing and [New York] The Ministry of Health does not go beyond these criteria. So if you don’t check each …
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