Consider This from NPR - As Monkeypox Cases Climb, U.S. Officials Increase Testing and Order More Vaccine Doses

Episode Date: July 15, 2022

Public health experts know what it takes to get a disease outbreak under control - widespread testing and treatment, and vaccines made available to communities most at risk. But in the last two months of the Monkeypox outbreak, the response has not met the need. And there's been criticism that the missteps look a lot like the start of the coronavirus pandemic.Now, with more than 1,400 confirmed cases in the U.S., the Centers for Disease Control and Prevention says more help is on the way. Testing capacity is increasing along with vaccine doses.NPR's Ari Shapiro speaks to CDC Director Rochelle Walensky about the federal government's response to Monkeypox and whether it's enough to contain the outbreak.In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from Indiana University. Indiana University performs breakthrough research every year, making discoveries that improve human health, combat climate change, and move society forward. More at iu.edu forward. Another person in Virginia has a possible case of monkeypox. The state health department with breaking news. The first case of monkeypox is now being reported in Louisiana. That's according to... Monkeypox cases are on the rise in South Florida and the vaccine for it is scarce. The supply simply... The first monkeypox case in the U.S. was detected about two months ago. Now, the Centers for Disease Control and Prevention reports around 1,400 confirmed cases in the U.S. so far. Public health experts know what it takes to get a disease outbreak under control.

Widespread testing and treatment, vaccines made available to communities that are most at risk. But in the last two months of the monkeypox outbreak, the response has not met the need. I want to acknowledge that at this time, the demand for vaccines from jurisdictions is higher than our current available supply. And we know that this is frustrating. That's Dr. Rochelle Walensky talking at a press briefing this week. She said more help is on the way. Testing capacity will increase from 6,000 tests a week to 70,000. And by the middle of next year, the U.S. expects to have 7 million vaccine doses.

Now, the majority of monkeypox cases are showing up in men who have sex with men. And Walensky says the CDC is strategizing with the LGBTQ we continue to prioritize both jurisdictions seeing the greatest number of cases and communities at highest risk. Limited testing, not enough vaccines. These are some of the same problems the U.S. faced early in the coronavirus pandemic. The question is, can the U.S. stop the spread of the monkeypox virus before it becomes a bigger outbreak? Anne Ramoyne is a UCLA epidemiology professor who has studied monkeypox for years, and she says time is of the essence. Every day that we aren't throwing the kitchen sink at this outbreak is a lost opportunity, a missed opportunity. Whether or not we can contain this virus really depends upon how well we are able to get those vaccines out and making it as easy as possible for people to access care, to be able to get tested. And we're not there at this point.

Consider this. Monkeypox is not a new virus. It's been on the radar for decades. Still, the U.S. was unprepared to deal with it, and the virus continues to spread. From NPR, I'm Ari Shapiro. It's Friday, July 15th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com. T's and C's apply. This message comes from Indiana University. Indiana University drives discovery, innovation, and creative endeavors to solve some of society's greatest challenges.

Groundbreaking investments in neuroscience, climate change, Alzheimer's research, and cybersecurity mean IU sets new standards to move the world forward, unlocking cures and solutions that lead to a better future for all. More at iu.edu forward. It's Consider This from NPR. Let's head to the epicenter of this outbreak. New York has more confirmed monkeypox cases than anywhere else in the U.S. Right now, as we're recording this on Friday afternoon, the count is a little over 400. This week, the city got 14,500 doses of the vaccine. And when people went online to book their vaccination appointments, the website was overwhelmed. Kevin Hurd spent an hour and a half refreshing the page. He eventually got an appointment for himself and his partner,

and then the site completely crashed. They're not distributing this equitably. I guarantee you that the folks that actually got appointments will not be representative of the city of New York. Cody Dean owns a technology consulting business. He spent an hour and a half clicking through the website and never got an appointment. I have the privilege of sitting here for 90 minutes to get through every step here, and I was still unsuccessful. I seriously doubt that someone working, you know, in a retail job in another borough could do that. Obviously, there's been some technical and logistical glitches that we're working to iron out now. New York City Health Commissioner Ashwin Vosin apologized this week for the city's flawed response.

I asked him what went wrong. You know, we have a vaccine appointment infrastructure that we built for COVID, and it's being used basically to its maximum bandwidth. And we had to create a new build, and that wasn't available fast enough to meet the supply that we were getting in. And so we relied on vendors to use their technology, and it wasn't sufficient. And so we own that, and we apologize to New Yorkers who had a bad experience here. I will say this, though. We are trying to balance the public-facing appointments with pretty strong partnerships with community-based organizations and providers with whom we're giving direct access so that we are ensuring that we're centering

equity as well in the process. So while there are a lot of glitches, or there have been glitches with the public-facing side of things, we are partnering with community organizations to ensure that this is being rolled out in a more equitable way. Vossen says responding to monkeypox on top of the coronavirus pandemic is a real challenge. We also have to diagnose the problem accurately, which is to say, did we have the resources to do what we needed to do? Did we have the time to do what we needed to do? And I think in this case with monkeypox, and while we're continuing to fight COVID, I think that what you found was a public health system that has been shorn of workforce with incredible rates of burnout and mental health issues amongst healthcare workers

and public health workers. And I think that what we need to do is support that infrastructure, support those workers so that we can manage multiple crises at once, which is what we're in the midst of doing. I want to start by reminding listeners that while monkeypox symptoms can be extremely painful, this disease is not fatal and does not typically lead to hospitalization. It's spread through close, intimate physical contact. When the head of the CDC finished announcing the strategy to get more tests and vaccines out to the public, Dr. Rochelle Walensky got on the line with us. And I asked her why the U.S. wasn't able to get this disease in check two months ago when the case count was still small. Well, I think there are several things that go into that. First is that this was seeded in numerous places around the country. And so by the time clinicians who had never seen it before

detected it, by the time patients came forward, and in fact, some of these presentations mimic other infections, and so patients may or may not have come forward. And so by the time we had real provider and patient education, much of this had spread already. And then also right now, we are starting to see the results of exposures that happened two or three weeks ago. And so with all of that coming together, we anticipate that we'll have more cases. You've said that the U.S. expects to have 2.5 million vaccine doses by late this year and 7 million by the middle of next year if the goal is to contain the outbreak and keep it from becoming endemic in the U.S. Is that a fast enough pace to meet the goal? Well, I do want to just convey that that is not

the only way that we can sort of help mitigate this. First is education, making sure patients and providers understand what they can do to prevent and protect themselves. The second is to test so that patients have access to these tests and that providers use these tests. And then finally, we have the vaccine. And then we also have treatment available, the TPOX treatment that is available. So while we are working up to scale a vaccine, we have other tools that we can use to try and prevent the spread. So far, the known spread in this outbreak has mostly been men who have sex with men. And you've talked about outreach to the LGBTQ community and to health care providers. Many people with suspected monkeypox cases have reported encountering ignorance and hostility, homophobia, providers who are just downplaying or denying symptoms. What needs to be done to fix that problem? First, let me just give a shout out of gratitude to the LGBTQ advocacy community

whose voice has been essential as we have worked at the federal government and our local governments and providers across the country to get the word out. And that community has been essential through this. But what we are doing right now is trying to reach all patients and all providers so that people understand what this disease is, how to test for it, how to prevent it. We have several calls a week with our public health providers. We've done listening sessions with many in the LGBTQ community, as well as doing a lot on social media to try and get the word out. And what we're asking of community providers, as well as public health officials, is to continue

to extend that word with us. As you answer questions about shortage of testing and lack of vaccine doses, I guess, you know, I see so many headlines that say things like monkeypox response mirrors early coronavirus missteps. Do you think that's fair? You know, I think in the world of infectious diseases, not all infectious diseases are the same, and monkeypox is very different than coronavirus. And so I think we have to understand the implications of each of the challenges that we are facing in each of the individual periods of time. There certainly have been, you know, less vaccine than we wanted immediately through this. But it's also the

case that this has been, in my view, a very different response than the early days of the COVID response for many different reasons. Given that you've said you expect the numbers to keep climbing for the next couple months at least, when do you expect the numbers to start going down? Well, of course, I don't have a crystal ball. What I'd really love to be the state is that we start really doing a broad understanding education across the country for both patients and providers alike so that they know when to come for testing, what to do to prevent disease in themselves and to prevent spreading it to others. And then as we have more and more vaccine available and more going out just in the next few days, that patients come forward who are at risk of disease and get that vaccine

so that we can, you know, encircle this and not have this be a lasting challenge. So you're hoping by the fall, is that the takeaway? You know, I have learned that in public health, never to predict the future. But what I will say is that we do have the tools here. We know how to prevent the spread. We know how to test. We have massive testing available right now. And as we scale a vaccine, we also really want to encourage those who are in the high-risk communities to access those vaccines and to do so equitably across the country. That's Director of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky. It's Consider This from NPR. I'm Ari Shapiro.