For example, Mayo Clinic laboratories have the capacity to process 1,000 monkeypox samples a week but have received only 45 samples from doctors since monkeypox testing began on July 11. Another laboratory, Aegis Sciences Corp., can perform 5,000 tests per week. Zero samples were received in the last two weeks. At LabCorp, one of the largest commercial laboratories in the US, uptake is high but still “very low,” Dr. Brian Caveney, the lab’s president of diagnostics.
A member of the California Department of Public Health’s Monkeypox Virus Scientific Advisory Committee, Dr. Peter Chin-hong said the numbers were “shocking.”
“It’s really, really concerning. It’s like Covid PTSD,” he said, referring to the early stages of the pandemic when coronavirus testing was extremely limited. While the concerns are similar, the reasons are different as testing capacity for Covid-19 was low and for monkeypox there is plenty of capacity but low demand.
Chief Medical Advisor to President Biden Dr. Anthony Fauci on CNN on Tuesday described the test as a “pillar” of the government’s monkeypox response. He and other health officials have repeatedly assured Americans that testing capacity is high, with labs capable of processing 80,000 samples per week. Most of that capacity — 70,000 samples — is in private laboratories.
The CDC engaged five laboratories to handle the growing number of cases. Two of them, Quest Diagnostics and Sonic Healthcare, declined to tell CNN how many monkeypox samples they received, but “at this point the capacity in the five commercial laboratories is far greater than what we’re seeing in demand,” according to Susan Van Meter, president of the American Clinical Laboratory Association.
Testing is a key part of monkeypox prevention efforts for two reasons: It is the first step in identifying and isolating patients, and it gives public health officials an idea of the extent of an outbreak and which geographic areas need the most resources.
Chairman of the Board of Directors of the American Clinical Laboratory Association and Chairman of the Mayo Laboratory, Dr. William Morris said, “Without testing, you are flying blind.” “The biggest concern is that we will not identify cases and [monkeypox] Endemic disease can occur in this country. We really need to worry.”
Chin-Hong compared the low lab number to “walking around with Vaseline in your eye: You’re not seeing the whole picture.”
Dr. Matthew Hardison, senior vice president of Aegis, cautions that “if you don’t test enough, you won’t find it, and it will continue to spread, and we’re already seeing significant increases in numbers. Right now in various states across the country.”
A steep learning curve
“The message is definitely getting out,” said a federal health adviser who requested anonymity because he is not a government employee and does not speak for any federal agency. “Our hope is that every clinical provider in this country now knows monkeypox and when to test.”
But even with that education, finding a case of monkeypox can be difficult, because the rash isn’t always specific, Cavani said.
“It just looks like a pimple or something,” he said.
Because monkeypox is spread through prolonged skin-to-skin contact, doctors also need to obtain a detailed and thorough history from their patients.
“Getting an accurate history of someone’s exposure to maybe a week or two ago and then looking at a wound and saying, ‘Oh, it’s not just, you know, it’s a normal thing that’s going to be in your skin. That’s something I tested. Should,” he said.
Cavani added that as doctors learn more about monkeypox, they expect the number of tests to increase.
Other barriers to testing
Experts say education is the only reason behind the slow adoption of the test.
For another, some people who have symptoms of monkeypox do not seek care for fear of stigmatization.
“They might think, ‘I’m going to identify as someone who’s socially stigmatized: I have sex with men, I’ve had multiple sexual partners, or I haven’t used protection.’ That’s what having monkeypox means now, and you can imagine people don’t want to say all that,” said Chin-Hong, an infectious disease specialist at the UCSF School of Medicine who has treated people with monkeypox.
Also, many members of the LGBTQ community are used to receiving care from sexual health clinics, which are now overwhelmed treating monkeypox patients as well as their regular caseloads, according to David Harvey, executive director of the National Coalition of STD Directors, which represents the public. and private sexual health clinics and programs.
He said about half of the clinics in his organization don’t send samples to private labs because it’s too expensive to hire staff to manage the paperwork, which may help explain why the rate of monkeypox tests in private labs is so low.
“It’s very frustrating for us in the (sexually transmitted infection) field to hear information from the White House and the CDC about testing capacity and access to vaccines when all the implementation issues in your day-to-day clinic are not being discussed.” Harvey said.
On Monday, more than 100 members of Congress wrote to the Biden administration calling for additional funding for sexual health clinics to improve monkeypox response efforts.
CNN’s Brenda Goodman, Jamie Gumbrecht and Daniel Herman contributed to this report.