As Monkeypox Spreads, US Vaccine Access Is Pitifully Inadequate

AMY GOODMAN: There have now been more than 17,000 cases of monkeypox infections in at least 75 countries, including the United States. Monkeypox isn’t fatal, but it can cause fever, rashes and extremely painful lesions. It’s most often spread through close, intimate physical contact. On Saturday, for the second time in two years, the World Health Organization declared a global emergency to address the spread. The last time, it was for COVID-19; this time, for monkeypox. This is WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

TEDROS ADHANOM GHEBREYESUS: WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region, where we assess the risk is high. There is also a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment. So, in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations. For all of these reasons, I have decided that the global monkeypox outbreak represents a public health emergency of international concern. …

Stigma and discrimination can be as dangerous as any virus. In addition to our recommendations to countries, I’m also calling on civil society organizations, including those with experience in working with people living with HIV, to work with us on fighting stigma and discrimination. But with the tools we have right now, we can stop transmission and bring this outbreak under control.

AMY GOODMAN: Here in the United States, the Centers for Disease Control and Prevention has reported more than 2,800 cases of monkeypox so far across 44 states, with the largest outbreaks in New York, California, Illinois, Florida, D.C. and Georgia. The White House has not declared a public health emergency, that could bolster the U.S. response to the monkeypox outbreak. White House COVID response coordinator Dr. Ashish Jha said, quote, “It’s an ongoing, but a very active conversation at HHS.” That’s the Department of Health and Human Services.

For more, we’re joined by Joe Osmundson, professor of microbiology at New York University, scientist, activist, author of the new book Virology: Essays for the Living, the Dead, and the Small Things in Between. He’s featured in a new piece in The New Yorker headlined “The Agony of an Early Case of Monkeypox.”

The piece begins, quote, “On the evening before Juneteenth, Joseph Osmundson, one of my best friends and a microbiologist at N.Y.U., texted me: ‘We think Andy has monkeypox.’ Two nights earlier, our friend Andy, as I’ll call him, had spent hours hunched over in an emergency room with excruciating rectal pain, only to be refused testing. It was his third try in five days. Andy’s anal sores were internal; for patients to qualify for testing, C.D.C. guidelines required the appearance of lesions on the skin. Osmundson needed help.”

Well, Professor Joe Osmundson, that’s the opening paragraph of the piece in The New Yorker. Tell us where you went from there. And in the process, explain what monkeypox is.

JOE OSMUNDSON: Yeah. I’ll actually start with the second part. Monkeypox is not a new virus. And this is sort of why our community has been so frustrated by the lack of urgency to get us the tools we need to care for ourselves and each other and to prevent this virus. It was discovered in 1958 in animals and was shown in 1970 to exist in humans. It’s a virus that’s related to smallpox. You mentioned earlier that it’s not deadly. It’s not very often deadly, but in this outbreak so far this year, there have been five deaths, all of them in the endemic region between Congo and Nigeria. It’s a virus that is similar to smallpox but less dangerous. But it causes pockmarks all over the body, high fever. The lesions can be in the throat or on the mouth, inside the anus and rectum. They are excruciatingly painful. And the course of infection typically lasts two to four weeks. And during this time, patients are asked to fully isolate.

So, again, it’s a pretty miserable virus, although it’s not very often deadly. The frustration has been that because it’s so closely related to smallpox, we actually, prior to this sort of explosion of monkeypox outside of the endemic region — we have FDA-approved tests, we have FDA-approved medications that are likely to help ease suffering, and, most importantly, we have vaccinations that can prevent infection. So we have all of the tools, and yet all of these tools have been exceedingly difficult to access, even for someone like Andy, who has a Ph.D., has friends who are working on the response. I mean, it took direct phone calls to contacts in the New York City Department of Health and in the federal government to get him tested. And then, once he was tested and presumed positive, it took another few days to get him access to TPOXX, which is, again, an FDA-approved medication that we thought would help. Once he did get TPOXX, he went, in 24 hours, from being in the most pain of his life to the pain easing. And within five or six days, all of his lesions had healed, and he was cleared to leave isolation.

So, the good news is we have the tools both to prevent infections and to ease suffering. The immense frustration in our community has been watching hundreds of people get sick, not because they’re having sex, not because of their queer identity, but because they’ve wanted to get vaccinated and those vaccines have not been available.

AMY GOODMAN: I mean, we’re here in Chelsea, New York, and this is where people lined up around the block to get vaccines, but there simply weren’t enough.

JOE OSMUNDSON: That’s right. And that, you know, the rollout in New York, has gotten a lot of criticism. And, you know, the New York City Department of Health didn’t reach out to community partners prior to that. They just wanted to get shots into arms prior to Pride weekend. They’ve been listening to us about how that didn’t go well, and they are trying to do better. They are reaching out to more community-based organizations. They’re trying to have more vaccine equity in nonwhite, less affluent communities than the Chelsea community. But, you know, they are incredibly limited. You cannot have equity when vaccine is so scarce. It’s just not possible.

AMY GOODMAN: I wanted to turn to the protest that occurred last Thursday here in New York. ACT UP New York organized an emergency march against monkeypox and government failure in New York City. This is Cecilia Gentili, founder of Transgender Equity Consulting, speaking at the rally.

CECILIA GENTILI: Sex workers are again being forced to the impossible situation of choosing between prioritizing their health or having enough money to survive. Sounds familiar. Yes. The same [beep] happened a couple of months ago with COVID. What did the government do? Almost nothing. What is the government doing now? Almost nothing. I am so tired of getting almost nothing from the federal government.

AMY GOODMAN: Professor Joe Osmundson, if you can say what needs to happen? I mean, this weekend, you have Congressman Adam Schiff demanding that more be done. You have Ashish Jha on the weekend news shows saying they haven’t decided whether to make the — call this a national emergency in the U.S. And if it were called an emergency, what would that unleash?

JOE OSMUNDSON: Yeah, it would just increase the amount of funding and tools available. There’s a couple of things going on here. One is the scientific response, the biomedical response, that is absolutely lacking. There is no urgency. This should have been an easy virus to contain. Unlike COVID, unlike many other emerging threats, we have all of the tools. They are in a stockpile. The point of that stockpile is that it’s meant to be there to respond to an emergency. Here we have an emergency, and the stockpile has not been activated. We found out that vaccine sits in the stockpile in such a way that it can’t actually get into people’s bodies. And vaccine in a freezer is useless. So, we need resources to mobilize the national stockpile that we have to help us, to keep us safe, to treat us when we’re ill.

But we also know — look, COVID is — you know, a lot of us, by now, have done COVID isolation, 10 days, even five days. It is incredibly difficult. It is costly. Sometimes you miss out on work. Sometimes you have to get a hotel to isolate in. It is really difficult to do. Here we have an isolation with monkeypox that is two to six weeks. That is incredibly disruptive for people’s lives. We’ve been having to crowdfund to get people the money that they need to take time off work. We need emergency funds and hotel rooms so people can properly isolate to prevent the spread. And none of that, none of those funds and resources have been coming from any level of government.

In addition, there are essential scientific questions: Is the virus present in semen? Can we develop new tests that don’t require a skin lesion? Can we test saliva during the early-on flu-like illness? These are obvious questions. And without the proper funding, it will take too long to answer them. The ideal is we get these scientific questions answered as rapidly as possible; instead of skin lesion tests, we have really good saliva tests; if you think you have monkeypox, you can go in, get a saliva test in your flu-like illness, get TPOXX immediately, and maybe you don’t even get an outbreak of skin lesions, or if you do, you suffer much less, and you’re much less likely to spread the virus. And just, I mean, the vaccine is the most ridiculous thing. There are people who wanted to get vaccine, and now instead of getting vaccine, they have monkeypox.

AMY GOODMAN: Professor Osmundson, this whole controversy over whether to call this a sexually transmitted disease — you can also get it just in close breathing contact, isn’t that right?

JOE OSMUNDSON: That’s right. It’s a very tricky, you know, question. And there are obviously STIs that don’t require sex to transmit them, like herpes. But I’m really worried. We’re already seeing this pushback of, “Oh, if monkeypox is an STI, why are we seeing it in children?” — sort of, again, doing the groomer thing, implying that queer people are having sex with children. This is incredibly, incredibly dangerous.

This is a virus that commonly spreads throughout households when it’s in households. It is on sheets. It’s on towels. It’s on clothes. And we need to be aware of those nonsexual modes of transmission, so that if it pops up in a wrestling team or a massage parlor or a Broadway show where someone is handling costumes all the time, we actually — that’s on our radar, and we can diagnose it in those places and prevent spread there. I think it’s a little bit myopic to be so focused on sex and the queer community. WeAs Monkeypox Spreads, US Vaccine Access Is Pitifully Inadequate need to be curious and open to the many places this virus may spread.

AMY GOODMAN: Finally, Professor Osmundson, let’s talk about the issue of global equity. There is a severe lack of vaccine here in the United States, but multiply that many times over. Talk about the rest of the world.

JOE OSMUNDSON: This was a choice. This international outbreak was a choice. The United States government let 28 million doses of the modern smallpox vaccine, JYNNEOS, expire and get binned from the national stockpile, as opposed to being used in the endemic regions, from Congo to Nigeria, where people commonly are getting monkeypox. I was on a webinar with the head of the Nigerian CDC, who laughed when I asked, “What countermeasures do you have? Do you have vaccine? Do you have treatment?” They have nothing. If in Nigeria, where there’s been an ongoing outbreak of human-to-human spread of monkeypox since 2017, if they had countermeasures there to care for this painful infection there, it’s likely that we may have prevented the international spread of this virus.

Infectious diseases show us that borders are meaningless. Viruses will spread because people interact around the world. It is our obligation to care for human suffering everywhere, not just because it will prevent us from potentially getting sick, but because human suffering is human suffering. So there is absolutely an issue with countermeasures, including vaccine and treatment globally. And capitalism does not set us up well to care for everybody. It is not a way to make a profit. But in our increasingly warming and increasingly interconnected world, we are going to see more of these crises. This is not a viral crisis; this is a crisis of late capitalism.
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AMY GOODMAN: Joe Osmundson, I want to thank you for being with us, professor of microbiology at New York University, scientist, activist, author of the new book Virology: Essays for the Living, the Dead, and the Small Things in Between. We’ll also link to that piece in The New Yorker that features Professor Osmundson.

When we come back, we speak with California Congressmember Ro Khanna about his efforts to address the ongoing infant formula crisis impacting working-class families and parents of color, to stop the price gouging. Stay with us.