Health Testing is crucial to bringing monkeypox under control, but...

Testing is crucial to bringing monkeypox under control, but there is a ‘shocking’ lack of demand


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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.

The First The US monkeypox case in this outbreak was reported on May 17, and the virus spread rapidly 4,639 probable or confirmed cases, in almost all men who have sex with men. Bringing the outbreak under control has been a challenge for the US Centers for Disease Control and Prevention and the Biden administration, which is expected to be named. Monkey Pox Coordinator and considering whether to declare the virus a public health emergency.

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

Before this year, there were only a few dozen cases Monkeypox in the United States. As with any newly emerging pathogen, the CDC has educated health care providers on how to detect the disease, order tests for it, and how to treat it.
Doctors say the search for monkeypox cases needs to look beyond men who have sex with men
The agency has sent emails through them Health Notification NetworkHosted two Call More than 17,000 doctors and other practitioners attended and set up a phone line to ask questions to doctors. The CDC also sent emails to doctors announcing the availability of the test at five private labs.
Jama And other medical journals also provide information on how to diagnose, test, and treat monkeypox.

“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.

WHO advises men who have sex with men to reduce their partners to limit transmission of monkeypox

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.

'You don't want this' virus: California man with monkeypox urges others to get vaccinated

“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.

“As cases of monkeypox continue to rise, states and communities are relying heavily on health clinic specialists for disease detection, contact tracing, symptom monitoring, and community education, as well as their community connections, to help reduce the spread of the virus.” The letter said

CNN’s Brenda Goodman, Jamie Gumbrecht and Daniel Herman contributed to this report.

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