Epidemiologists warn of critical moment to contain monkeypox

Vaccinations against the monkeypox virus are picking up in the U.S., but access and speed of delivery remain issues as cases spread. This comes as the World Health Organization declared monkeypox a global health emergency. We spoke to Americans who’ve been exposed and have struggled to get the vaccine, and Gregg Gonsalves of the Yale School of Public Health joins Amna Nawaz to discuss.

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  • Judy Woodruff:

    The World Health Organization declared monkeypox a global health emergency this weekend.

    While the number of confirmed cases is very small, totaling under 20,000 so far, it has spread quickly to dozens of countries in less than three months. Some argue that the alert from the WHO is necessary, because the response in many countries has been too slow, including the U.S.

    Amna Nawaz focuses on that tonight.

  • Amna Nawaz:

    Judy, vaccinations against the monkeypox are picking up in the U.S., but access and speed of delivery remain issues.

    In some cases, people who've been exposed have struggled to get the vaccine. In others, patients with the virus can't get the drug TPOXX, which helps with symptoms, including painful lesions.

    We spoke to a few people from New York, Los Angeles and Baltimore about their issues getting the vaccine or treatment. Here's what they shared.

  • Joseph Pierce, New York:

    I noticed that there was a — kind of a blister on my finger that I thought was just an insect bite at first. Eventually, another blister showed up on my body. And then that was when I knew that it was not just an insect bite.

  • Brian Thomas, Maryland:

    I called my provider, and they asked me to send some pictures of the lesions, because I can say I was the third case diagnosed in Baltimore or in the state of Maryland.

  • Matt Ford, California:

    On Friday, June 17, I got a call from a friend I'd been hanging out with the weekend prior, informing me that I had likely been exposed to monkeypox.

  • Mordechai Zac Levovitz, New York:

    I was exposed to someone with monkeypox in the end of June. Unfortunately, I still haven't gotten the vaccine, and not — not without trying.

    I was lucky enough that I did not develop monkeypox, but I was scared out of my mind and really, really wanted this vaccine.

  • Joseph Pierce:

    And so then they sent a prescription for the antiviral for TPOXX to my regular pharmacy. And my pharmacy called me and said that they have no way to get that.

    And, finally, I got a call from a different pharmacy, saying that they did have it and that they were, in fact, the only pharmacy in New York that did. And so they were able to deliver it to my apartment, thankfully.

  • Brian Thomas:

    For about five to seven days, it just felt like I had crazy abdominal cramps constantly. I struggled to make — have bowel movements. I just — it was really, really, really horrible.

    And then taking care of these lesions all over my body, I probably had about 20 total on my body.

  • Matt Ford:

    It's really frustrating in hindsight to think that there is a drug I could have taken that's already somewhat clear that we used to treat smallpox, and could have made this experience much less painful and potentially a lot more — a lot quicker.

  • Joseph Pierce:

    I was worried. I was afraid. I was in pain. And I wasn't sure how I was going to get this medicine that was supposed to help.

  • Mordechai Zac Levovitz:

    I showed up to this public school. And I realized that there were lots of men hanging around outside the public school looking very frustrated. And when I came there, they said, it's closed. There's nobody there.

    We were all outside. We all lost our appointments.

  • Brian Thomas:

    Yes, I don't think our medical system was prepared for an outbreak of this nature.

    What is the best medically recommended way to get these lesions to heal as fast as possible? Should I keep them covered? Should I leave them open to air when I'm at home? So, yes, there's been no guidance. And that's really hard for people that have this infection. That's very scary.

  • Matt Ford:

    The vast majority of cases are in queer men or men who have sex with men. Our community is being hit the hardest right now. That does not mean that it is limited to us. And that certainly does not make it a gay disease or something that there should be shame or stigma around.

    But we should be realistic in who it is affecting, so that we can target treatment and preventative measures.

  • Amna Nawaz:

    So far, there are just under 3,000 confirmed cases here in the U.S., but many experts believe there are many other cases that have not been confirmed yet with testing.

    A lack of testing is just one part of the overall response from the Biden administration that's come under criticism.

    Gregg Gonsalves is a keep public health voice who has been making that case publicly. He's an epidemiologist at the Yale School of Public Health and a well-known global activist. He joins me now.

    Professor Gonsalves, welcome to the "NewsHour." Thanks for joining us.

    So, we just heard from those folks there. I want to get some context on this. They had trouble accessing treatment, accessing the vaccine. Others told us they were misdiagnosed in the first case. How rare are their stories?

  • Gregg Gonsalves, Yale School Of Public Health:

    Unfortunately, Amna, I think this is characteristic of what's happened over the past few months in the context of the monkeypox outbreak in the United States.

    I have heard very similar stories about people having trouble getting tested, trouble getting access to the vaccine, trouble finding access to treatment, even though we have all of these commodities that should be able to contain and — contain this outbreak and also treat the individuals who need help.

  • Amna Nawaz:

    So, the numbers right now, as we just reported, about nearly 3,000 cases. A lot of people look at that and say, that doesn't sound like that much, right?

    But you have called this a crisis. Tell me why.

  • Gregg Gonsalves:

    Well, let's talk about May 2022. There were no cases in the United States.

    And we have gone from that to over 3,000 in the U.S. We went from zero to close to 17,000, 18,000 around the world in a matter of time, going from a small series of countries in West and Central Africa, where the disease has been endemic. It's now over 70 countries around the world in which this outbreak is coming to pass.

  • Amna Nawaz:

    So the Biden administration has said here, here's what we're doing. We have shipped over 300,000 vaccine doses across the country.

    They're working on a new, faster, streamlined process for doctors to get that treatment into patients' hands. They say they're actually weighing declaring a public health emergency as well. But you have called the response a mess.

    What do you think they could be doing already or could do today that they haven't been doing?

  • Gregg Gonsalves:

    The point is, is that they have moved incredibly slowly.

    There were early criticisms that the testing for monkeypox was being too tightly controlled by state health departments and the CDC, leading to a bottleneck in people getting access to testing. A couple of weeks ago, the federal government gave permission to large commercial diagnostic providers to ramp up testing, but, still, it's creating a bottleneck in the entire system by the slowness of the movement at the White House and the administration.

    TPOXX, the drug that can treat the infection, it's available under very strict scrutiny by FDA and the federal government, in which doctors have to do several hours of paperwork to get the drug for one patient. And then there's the vaccine, right?

    We have one vaccine, JYNNEOS, or JYNNEOS, which is available to prevent this infection. We have the largest stockpile of this vaccine in the world, but yet we have been able to really distribute more than about 140,000 doses over the past couple of months.

    And there's about 200,000 doses sitting in a warehouse in Denmark. It's not very clear that the administration knows what it's doing in terms of coordination. The TPOXX treatment is one kind of medical care that people need.

    As your interviewees spoke in the segment before this, there's enormous physical pain that many of these men who have monkeypox are experiencing, and they're going into the hospital to get treated for this, coming out with hospital bills that strain their own finances, they can't pay for.

    This should have been set up and staged six weeks ago, eight weeks ago, in the beginning of June. Now we're hearing we will have enough vaccine by Thanksgiving. By Thanksgiving? Really? After we have, what, 10,000, 20,000 cases in the U.S.?

    The big thing here is that we could have contained this outbreak. We could have stopped it in its tracks. Now the chance of it becoming endemic, of it sticking its roots into the country is quite imminent, right? And we may be looking at living with monkeypox for a long time to come, not just in the gay community, but it spills over into other communities, in which close physical contact is common, homeless shelters, prisons, potentially other kinds of settings, health clubs.

    We may be dealing with this on a much larger societal scale.

  • Amna Nawaz:

    Well, let me ask you about that point exactly, because what we have seen so far is that it has been mostly limited to the gay, bisexual and transgender communities, right, men who have sex with men, in other words.

    And there are a number of folks who are basically saying it's like HIV all over again. It's not getting the attention it deserves. It's being ignored because it's largely impacting only certain communities.

    Is that what you see here?

  • Gregg Gonsalves:

    It's very, very hard not to have gone through the AIDS epidemic and to see the federal government's response to it 40 years ago, and not see what's happening now and think, here we go again. It's deja vu.

    It's absolutely unacceptable that a disease that could have been stopped in its tracks, when we knew about it in May and early June, is now heading towards several thousand more cases, which were totally preventable.

  • Amna Nawaz:

    Professor, a lot of your criticism sounds like you could also be talking about COVID and the government's response early in the pandemic.

    Are those lessons we should have learned?

  • Gregg Gonsalves:

    Indeed, we should have.

    But it's pretty clear that there were fundamental weaknesses in the American public health system before COVID, right? We have a weak public health infrastructure. We spend 1 to 2 to maybe 3 cents on every health care dollar on public health. And we expect the system debt to act like a Ferrari out of the showroom, rather than a 30-year-old used car.

    We have a fractured health care system. And, again, people are having to stay home for 21 days under quarantine. What about paid sick leave? We have a very sort of fractured, tattered social safety net in this country.

    So we came into the COVID pandemic unprepared for what befell us. You would have thought we would have fixed all these things or been on our way to it by 2022. Now we see a new pandemic, a new outbreak happening in the U.S., and all the mistakes that happened in 2020, all the sort of deficiencies in our public health, our health care system, our social protection systems are out on full display once again.

    And one has to wonder when we're going to learn our lesson.

  • Amna Nawaz:

    That is Gregg Gonsalves. He is associate professor of epidemiology at Yale School of Public Health, joining us tonight.

    Professor, thank you so much for your time.

  • Gregg Gonsalves:

    Thank you.

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