Slow response to monkeypox exposes ‘tired and exhausted’ US health agencies | monkeypox

Advocates said the “slow and bureaucratic” response that has seen monkeypox spread rapidly across the United States – with more than a thousand cases in New York City alone – reveals just how hard local health agencies have been hit since the Covid pandemic.

Once a rare African virus, monkeypox spread through the coarse patchwork of cities, counties, states and federal agencies that make up the public health infrastructure in the United States.

“Unfortunately, the delayed action means monkeypox is spreading within the gay community and among other men who have sex with men,” said David Harvey, executive director of the National Alliance of Sexually Transmitted Diseases Managers.

This outbreak has grown into a public health crisis in America. We are still in a very chaotic situation at the state and local level with an organized response.”

As an explanation for the chaos, many observers point to how Covid has reshaped the landscape for public health officials. Considered as impartial arbiters of information, many health officials have come under political attack by following unpopular vaccination and mask policies.

Across the country, public health officials have been harassed, threatened, fired or simply overwhelmed and quit smoking. The situation is not helped as resources previously dedicated to things like tracking infectious diseases, such as tuberculosis, or running routine vaccination clinics, have suddenly been diverted to Covid-19.

Sexual health clinics have also suffered, as testing and staffing resources have been allocated to Covid-19, to the detriment of organizations already suffering years of underfunding.

The result was worse health outcomes for many essential public health services: routine vaccinations for children were reduced; Overdose deaths exploded; The United States recorded a record increase in the incidence of sexually transmitted diseases for the sixth year in a row.

With the spread of monkeypox, the Biden administration attempted to respond by releasing about 1.1 million vaccines and increasing testing capacity, which has grown from about 6,000 to 80,000 per week. The World Health Organization declared monkeypox a global health emergency this week, and the United States could follow suit by declaring monkeypox a national public health emergency, which will provide more resources for local agencies.

“The system is tired, overworked, underpaid, and understaffed,” said Laurie Tremmel Freeman, chief executive of the National Association of County and City Health Officials. “All the same issues that have plagued us during the pandemic are still with us and have not gone away yet.

“What’s added to that, with monkeypox and beyond, is that we also have a workforce that has documented post-epidemic mental health traumas.”

Public health advocates want the president and Congress to allocate more money to the outbreak response, and to sexual health clinics in general. Public utilities have proven to be the first line of defense against monkeypox, even as federal prevention funding for such work has declined 41% since 2003.

“Local sexual health providers are being asked to respond to monkeypox in addition to the already out-of-control epidemic of STI in America,” Harvey said. “We are on the verge of collapse: We need the Biden administration and Congress to fund public health programs and clinical services for STDs immediately.”

Although anyone can get monkeypox, the virus has primarily affected men who have sex with men. Sexual health clinics have often been very responsive on the front lines of outbreaks due to how monkeypox symptoms appear, with lesions around the genitals and anus—although sex is just one way monkeypox can spread. Any close contact with an infected person can spread the disease, including touching, kissing and hugging, as well as sharing glasses, utensils, bedding, and towels.

Although the virus, which is in the same family as smallpox, is rarely fatal, symptoms can be excruciating with painful lesions and flu-like symptoms, according to the Centers for Disease Control and Prevention. Up to 10% of people require hospitalization, Freeman said, and many go to emergency departments because of the severe pain.

The situation is exacerbated because testing for monkeypox is limited. There is no home test and results can take days. However, there is a vaccine, for which people at increased risk may be eligible; They may also be eligible for treatment with the drug tecovirimat, sold as TPOXX. But the drawbacks are significant, obtaining it can be tricky, and clinicians must order tecovirimat — usually meant for people with severe symptoms — from the government’s Strategic National Stockpile, which includes significant paperwork.

On top of that, people without insurance may lack access to both a vaccine and medication, Freeman said. About 12.7% of the LGBTQ+ community lacks health insurance compared to 11.4% of the general population, according to an analysis by federal officials. Even if you have insurance, there are hurdles hidden in the US health care system, such as trying to navigate urgent care clinics, primary care providers, and state health departments.

Freeman told a story about a local health department that asked her state for information on an outbreak of monkeypox. The state responded to the CDC’s verification; Then the CDC redirected local officials to the state.

“There’s a lot of finger pointing here,” she said. “We had to learn. We should know more now than we did three years ago when we responded to Covid [about] What we need to do here.”

Leave a Reply

%d bloggers like this: