How a new national emergency declaration could slow the spread of monkeypox

With more than 7,000 cases reported in the U.S, the Biden administration has declared monkeypox a public health emergency. The declaration announced Thursday comes after the administration endured weeks of criticism for its response to this outbreak. Dr. Jay Varma, director of the Cornell Center for Pandemic Prevention and Response at Weill Cornell Medicine, joins William Brangham to discuss.

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  • Judy Woodruff:

    With more than 7,000 cases already reported in the U.S., the Biden administration has declared monkeypox a public health emergency.

    William Brangham looks at the implications and whether it will help contain the virus.

  • William Brangham:

    Judy, that declaration announced yesterday by Secretary of Health and Human Services Xavier Becerra comes after the administration endured weeks of criticism for its response to this outbreak. And it's also been dinged at times for its public health messaging about who is most at risk.

    To provide some perspective on what this all means, I'm joined by Dr. Jay Varma. He's a professor of population health sciences and the director of the Cornell Center for Pandemic Prevention and Response at Weill Cornell Medicine.

    Dr. Varma, thank you so much for being here.

    So the administration has declared a public health emergency. Practically speaking, what does that mean?

  • Dr. Jay Varma, Weill Cornell Medicine:

    So the first and most important thing it does is, it allows the federal government to tap into emergency funding that's only available when a declaration like this is made.

    The second thing it does is, it allows that money to get to states or to community organizations faster. You basically are allowed to bypass sort of normal competitive procurement process and get money to people faster.

    The third thing it does, it allows the federal government to waive certain regulations and speed up processes like getting drugs or vaccines or tests approved faster. And the fourth thing, which may be in the long run one of the most important factors, is it raises the political awareness.

    When every part of the government is notified that this is a public health emergency, people just take this problem much more seriously.

  • William Brangham:

    Is it your sense that all of those elements you have just described will actually have a tangible impact on this outbreak?

  • Dr. Jay Varma:

    I am. I am quite convinced that this is going to make a difference.

    Now, will it make a difference tomorrow? No. And that really gets to kind of the main issue. The main issue is that these types of actions, whether you declare it an emergency, whether you act like an emergency, really should have happened in the middle of May. And it's taken quite some time to get to this point.

    So, absolutely, this is the right thing to do now. I think many of us just felt we wish it could have been done a little bit earlier.

  • William Brangham:

    Is that the bulk of the criticism of the administration, that it was just slow getting off the mark, slow with tests, slow in getting the word out?

  • Dr. Jay Varma:

    Yes, back in early May, many European cities were reporting these explosive outbreaks among gay, bi and men who have sex with men associated with monkeypox.

    And that really should have been the trigger for the U.S., at a minimum, to make testing more widely available. But it took many weeks to do that. And the challenge with that is, when you don't do enough testing, as we have seen during COVID, you don't know how big a problem is, and all the other aspects of the response get slowed down.

    So, really, what needs to happen is, you need to play catchup now. And that's really the biggest challenge with any disease. And people have learned that during COVID, and they're seeing it now. When you get caught because there's been a month or more of transmission without you knowing it, it just takes a lot more money and effort to catch up than it would otherwise.

  • William Brangham:

    You have said how essential it was to do much more testing early on.

    Were those tests available? We certainly saw with COVID that the initial CDC rollout of tests was a terribly bungled affair. Were those tests available and could have been deployed back in the — in spring?

  • Dr. Jay Varma:

    Yes, and I think that's what's most frustrating to me and to many others.

    If you are going to name a disease out there that — to test the U.S. pandemic preparedness, give it a stress test, this was a perfect test case. Unlike COVID, which is a brand-new disease, so people needed to invent everything from scratch, this was a disease that there were test kits available at over 70 public laboratories around the country, there was a stockpile of a drug to treat this that U.S. taxpayers paid to develop and stockpile, and there was even a vaccine available.

    And yet, even though the government was basically almost given the answers to the test, it had trouble passing it at the beginning. And that's kind of the challenge that I think a lot of us are facing.

    But I want to emphasize, the actions the government, the administration is taking right now are the right ones, and I'm hopeful all that these will help avert some of the problems that we have seen over the past two or three months.

  • William Brangham:

    I want to ask you about this issue of public messaging, because, as you indicated, we know that this virus is principally spreading amongst gay and bisexual men. I mean, anyone seems to be able to get it, but that's where it is concentrated heavily.

    And it seems like that, in an attempt to not stigmatize that population, certain messages were not issued appropriately. Do you think that that was a failing as well?

  • Dr. Jay Varma:

    You know, I think the bigger failing from the U.S. government was not sounding the alarm about the size of the problem and the risk it faced.

    I think the targeting of messaging has actually been, interestingly enough, one of the bright spots, if you specifically look at what CDC is saying.

    I think where the problem has gotten in is that there's a lot of voices out there. And there's a lot of people who, because of COVID, have sort of risen to prominence. And they think that they're doing people a favor by saying, well, look, we're all at risk, when the reality is, those of us who have worked on infectious diseases, particularly sexually transmitted infections, like I have, we know that you need to name the problem and you need to help the people who are most at risk address this problem.

    There's always going to be a problem of stigma and bad actors out there using that information. You're going to end up giving them ammunition. But the reality is, they're going to get that ammunition anyway. And so we really do need to target it to the people who are at highest risk right now, because — especially because our vaccines are in such short supply.

  • William Brangham:

    All right, that is Dr. Jay Varma at the Cornell Center for Pandemic Response and Prevention.

    Thank you so much for being here.

  • Dr. Jay Varma:

    Thank you very much for having me.

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