San Francisco, California - As the threat of monkeypox grows, controversies keep arising about how best to try to bring it under control with disagreements even among the experts.
"We need better testing. We need more vaccines. We need better treatment, And, part of the straightforwardness of that message unlike the early days of COVID, here we do have the tools we need for a robust response. They're just not being utilized," said Akash Singh a Monkeypox Volunteer Response Group activist.
There is a clear lack of enough vaccine to get ahead of the infection rate. The government does not pay for monkeypox. What is available is slow in coming. Testing result turnarounds are very slow and sometimes unreliable. Clinicians are not adequately trained or overly fearful of testing. And medical treatment is hard to get if one can find it at all. Singh calls it a catastrophe.
On top of that, public health officials in San Francisco are at odds about whether it's better to do contact tracing, when a case arises, or to have intense interaction with the group where it is found most often right now; among men who have sex with men, gay and bisexual males.
"The people involved in San Francisco, in the public health department are outstanding and they know what they're doing," said infectious disease expert Dr. John Swartzberg. He said testing has its problems. "A lot of people either don't know who their contacts were or are reluctant to reveal the names of those folks," said Dr. Swartzberg. The alternative to testing may actually be better. "Try to identify particular groups that are at high risk," he said.
Either way, if you don't have enough vaccine, it's hard to get monkeypox under control.
There's not enough vaccine. So it doesn't do you much good to find out who somebody had contact with if you can't do something to help them.
Until we get what protesters demand, one thing is critical. "The worst thing we can do during an epidemic, is to stigmatize people," said Swartzberg.
The San Francisco Department of Public Health expects thousands of more vaccine doses Tuesday, but it's still a game of catch up with suffering and stigma in control right now. With more epidemics around the world, the chance of a pandemic is more risky than if we attack a small outbreak with overwhelming responses.
San Francisco's health department reports 472 probable and confirmed cases of monkeypox as of Monday. The Zuckerberg San Francisco General Hospital monkeypox vaccine walk-in clinic resumes Tuesday through Friday from 8 a.m. to noon. The clinic will also hold Saturday hours from 8 a.m. to 3:30 p.m.
More information on monkeypox from the San Francisco Department of Public Health: https://sf.gov/information/monkeypox