CDC Says Monkeypox Virus Transmission Unlikely To Be Eliminated

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After botching the Covid-19 response, the U.S. hasn’t exactly done a great job containing the monkeypox outbreak. In fact, reviews of the U.S. monkeypox response published in The Washington Post, The Hill, The New York Times, and other places have ranged from bad to very bad. And the U.S. could end up paying for such public health missteps for years and years. That’s because the slow and disorganized monkeypox response may have allowed the monkeypox virus, which was practically non-existent in the U.S. prior to 2022, establish a new foothold in this country, as a new Centers for Disease Control and Prevention (CDC) technical report has indicated.

Make that a brickhold, since the monkeypox virus doesn’t have feet. This brick or oval-shaped virus with large double-stranded DNA has already caused 26,049 and counting reported monkeypox cases in the U.S. so far this year, according to the CDC. This number was about 26,047 more than the number of reported monkeypox cases in the U.S. in 2021. It was also 26,049 more than the number of reported monkeypox cases in 2020. And 2019. And 2018. And well you get the picture. In fact, take away the 2003 monkeypox outbreak that left 47 confirmed and probable cases in six states, Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, and monkeypox hadn’t really been in the U.S. much ever before 2022.

Now, according to the new CDC technical report, “domestic transmission in the United States is unlikely to be eliminated in the near future.” That’s a polite way of saying that the virus could continue to circulate in the U.S. for many years, meaning that the already underfunded and understaffed public health system will have to deal with yet another pathogen indefinitely. It’s yet another brick in the wall or perhaps brick-shaped virus in the wall that’s keeping the U.S. population from achieving better health.

That being said, in the coming weeks, the number of new reported cases per day in the U.S. may not remain in the hundreds as it has throughout much of the Summer of 2022. This number has been trending downwards since peaks of 678 on August 15 and 736 on August 22. September 28 had 107 reported cases. Of course, such reporting numbers aren’t exact to the day like the number of toilet paper rolls in your closet since there may be delays in cases getting reported to the local, state, and national authorities. Nevertheless, the CDC technical report stated that “daily cases in the United States will most likely continue to decline or plateau over the next two to four weeks.” Well, the report itself didn’t say that because reports don’t have mouths. It’s the members of CDC’s 2022 Multi-National Monkeypox Outbreak Response who wrote the report and thus have said those things.

The problem is as long as the virus remains in adequate amounts somewhere in the U.S. new cases may continue to emerge at any time and the risk of another surge will always be there. It will be very difficult to predict when such surges may occur and how big these surges may be. For example, the CDC report mentioned that “the monkeypox outbreak could accelerate in the United States over the next several months and affect an increasingly wider segment of the United States population.” Or it may not. It all depends on who infected with the virus interacts with whom, how quickly those infected recognize and report their infections and get isolated, and what precautions people in general do and don’t take. Meanwhile, the Covid-19 pandemic has shown just how difficult it is to get many Americans to take proper precautions and actually, you know, care about one another.

All of this shows the big bleeping impact of the U.S. messing up the monkeypox response in 2022. There’s a very, very big difference between the virus being virtually non-existent in the country to being present and actively transmitting from human-to-human regardless of how low the daily reported case count may be. Before 2022, public health authorities in the U.S. didn’t really have to worry about monkeypox spreading and had assumed that the number of new cases would be zero aside from an occasional getting infected while abroad. What happened in 2022, or more importantly what didn’t happen, has changed all that. Going forward, there’s a whole lot of uncertainty as to the trajectory and impact of monkeypox in the U.S.

The U.S. screwed up the monkeypox response in many ways. First, there was delays in recognizing and fully acknowledging the problem. In the days following the May 18 identification of the first U.S. case of the current outbreak how many political leaders emphasized the importance of keeping this virus from spreading further in the country? On May 22, U.S. President Joe Biden did say in a speech at Osan Air Base in South Korea that monkeypox was “something that everybody should be concerned about.” But that was not the same as articulating a clear, organized, and comprehensive plan on how authorities would urgently try to contain the virus such as a multi-layered approach with coordinated testing, vaccination, and communications strategies. After all, you can tell your significant other that you are really concerned about the garbage. But until you actually take out the trash, you are not going to earn any brownie point.

Some actions were taken in May 2022. Very soon after the first case in the U.S. was reported, the U.S. Department of Health and Human Services (HHS) did exercise an option to purchase thousands of doses of the JYNNEOS vaccine, a smallpox vaccine that can protect against monkeypox. However, buying vaccines ain’t the same as getting them on hand and then distributed and into the arms of people. For example, you can tell your significant other that you bought all these flowers, an elegant dinner, a man-purse, cheese, or condoms for Valentine’s Day. But if none of these are actually present and available to your significant other on Valentine’s Day, you could end up having problems. Similarly, as of June 14, the U.S. government had only about 70,000 doses of the JYNNEOS vaccine in its stockpile and had to order 500,000 more several days earlier. Waiting nearly a month to order more vaccines didn’t exactly scream the words “urgent response.” Additionally, a series of missteps, such as federal officials taking too much time to inspect a key manufacturing facility in Denmark, kept the ordered doses from actually reaching the national stockpile, as was described by Benjamin Ryan and Aria Bendix for NBC News.

Once vaccines started becoming available, and you can put the word “available” in quotes, people had trouble making appointments to get the vaccine, reminiscent of what happened in late 2020 and 2021 with the Covid-19 vaccine. To say that the roll-out of the monkeypox vaccine was disorganized would be, well, pretty darn accurate. Federal and many state and local authorities didn’t really make it clear who should get the vaccine either. At the same time, the testing strategy was unclear, and for a while, many people had trouble getting appropriately tested. Meanwhile, many authorities didn’t clearly communicate early enough who exactly should get tested and when. In fact, there were a number of WTH moments when it came to monkeypox communications strategies or relative lack thereof. For example, recall the CDC sex guidance that emerged in mid-June, which I covered for Forbes back then. This guidance included some “interesting” advice such as having sex while wearing your clothes and masturbating with (or perhaps against) each other while standing at least six feet apart. This latter suggestion may have conjured up images of some kind of Western showdown at the O.K. Corral. But public health experts expressed on social media that they were not OK with such guidance.

It’s not clear either what the U.S. has been doing to prevent the virus from getting established in non-human animal populations, which would make the virus even more difficult to control. After all, rodents, dogs, and other non-human animals who have shown that they can get infected can be even worse than humans at revealing that they are infected and taking precautions. You don’t see too many prairie dogs or dogs that don’t live on prairies saying, “dude, don’t feel too well today. You’d better keep your distance.” If the virus begins circulating among certain animal populations in the U.S., it will be even harder to predict when human infections and outbreaks will result.

Ultimately, the U.S. will continue to pay steep price for monkeypoxing around in 2022. The U.S. response to the monkeypox outbreak was in many ways a case study on how not to respond to an infectious disease outbreak. Maybe the U.S. will get it right the next time a new infectious disease threat emerges, which in high likelihood will be sometime over the next several years. After all, the U.S. has learned its lessons from prior botched responses, right?

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Source Information (if available)

This article originally appeared on www.forbes.com by Bruce Y. Lee – sharing via newswires in the public domain, repeatedly. News articles have become eerily similar to manufacturer descriptions.

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