When about 100 cases of monkeypox had been confirmed or suspected in Europe in May, it was clear the virus was spreading outside the areas where it was previously seen. Some on social media suggested it might already be spreading rapidly in communities in Europe and the United States. These reports should have been a code red for federal infectious disease response.
But it wasn’t until late June that the Centers for Disease Control and Prevention expanded testing for monkeypox to large commercial labs like Quest Diagnostics and Labcorp for more capacity and access. The C.D.C. had gone through its standard playbook, ticking through its protracted checklist.
Compared with the agency’s botched rollout of a test for the coronavirus, the monkeypox test came at warp speed. But the virus spread even faster. If American leaders wanted to quash the outbreak, the United States should have been testing all people who presented with what was presumed to be atypical cases of diseases like genital herpes and zoster infection; both can cause rashes that sometimes resemble monkeypox. That might have required 15,000 tests a week, by my rough estimate. From mid-May to the end of June, the United States tested only about 2,000 samples.
Our country’s response to monkeypox has been plagued by the same shortcomings we had with Covid-19. Now if monkeypox gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times not only because of the pain and peril of the disease but also because it was so avoidable. Our lapses extend beyond political decision making to the agencies tasked with protecting us from these threats. We don’t have a federal infrastructure capable of dealing with these emergencies. [Continue reading…]