ARI SHAPIRO, HOST:
Public health experts know what it takes to get a disease outbreak under control - widespread testing and treatment, vaccines made available to those most at risk. In the last two months of the monkeypox outbreak, the response in the U.S. has not met the need. Today, the CDC and other agencies responding to the outbreak said more help is on the way. Testing capacity will increase from 6,000 tests a week to 70,000. And by the middle of next year, the U.S. expects to have 7 million vaccine doses.
Dr. Rochelle Walensky is the director of the Centers for Disease Control and Prevention. Welcome back to ALL THINGS CONSIDERED.
ROCHELLE WALENSKY: Thanks so much for having me, Ari.
SHAPIRO: I want to start by reminding listeners that while monkeypox symptoms can be extremely painful, this disease is not fatal and does not typically lead to hospitalization. It's spread through close, intimate physical contact. And there are public health experts who say for those and other reasons, this outbreak should have been easy to get under control, yet case numbers keep growing. Why?
WALENSKY: Well, first, maybe I'll just sort of say right now we are tracking about 11,000 cases that have been detected globally in 65 countries. Here in the United States, we have about 1,470 cases that have been seen in 44 jurisdictions. And what we're doing right now is working to do a lot of provider and patient communication to know what they're looking for, to know how to test for it and to know what behaviors put people at high risk and what they can do to prevent it.
SHAPIRO: And you've said that in the next two months, you expect these numbers to keep climbing because there is an incubation period, and testing is going to increase. But it would have been much easier to get this under control in the first month, the first two months. And with every month that goes by and the numbers increase, it gets more difficult. So I guess the question is, why couldn't the public health community nip this in the bud right out of the gate given that this was a disease that was well known?
WALENSKY: Well, I think there are several things that go into that. First is that this was seated in numerous places around the country. And so by the time clinicians who had never seen it before detected it, by the time patients came forward - and in fact, some of these presentations mimic other infections, and so patients may or may not have come forward. And so by the time we had real provider and patient education, much of this had spread already. And then also right now, we are starting to see the results of exposures that happened two or three weeks ago. And so with all of that coming together, we anticipate that we'll have more cases.
SHAPIRO: You've said that the U.S. expects to have 2.5 million vaccine doses by late this year and 7 million by the middle of next year. If the goal is to contain the outbreak and keep it from becoming endemic in the U.S., is that a fast enough pace to meet the goal?
WALENSKY: Well, I do want to just convey that that is not the only way that we can sort of help mitigate this. First is education, making sure patients and providers understand what they can do to prevent and protect themselves. The second is to test so that patients have access to these tests and that providers use these tests. And then finally, we have the vaccine. And then we also have treatment available, the TPOXX treatment that is available. So while we are working up to scale a vaccine, we have other tools that we can use to try and prevent the spread.
SHAPIRO: So far, the known spread in this outbreak has mostly been men who have sex with men. And you've talked about outreach to the LGBTQ community and to health care providers. Many people with suspected monkeypox cases have reported encountering ignorance and hostility, homophobia, providers who are just downplaying or denying symptoms. What needs to be done to fix that problem?
WALENSKY: First, let me just give a shoutout with - of gratitude to the LGBTQ advocacy community that - whose voice has been essential as we have worked at the federal government and our local governments and providers across the country to get the word out. And that community has been essential through this.
We have several calls a week with our public health providers. We've done listening sessions with many in the LGBTQ community, as well as doing a lot on social media to try and get the word out. And what we're asking of community providers as well as public health officials is to continue to extend that word with us.
SHAPIRO: As you answer questions about shortage of testing and lack of vaccine doses - I guess, you know, I see so many headlines that say things like monkeypox response mirrors early coronavirus missteps. Do you think that's fair?
WALENSKY: You know, I think in the world of infectious diseases, not all infectious diseases are the same. And monkeypox is very different than coronavirus. There certainly have been, you know, less vaccine than we wanted immediately through this. But it's also the case that this has been, in my view, a very different response than the early days of the COVID response for many different reasons.
SHAPIRO: Given that you've said you expect the numbers to keep climbing for the next couple months at least, when do you expect the numbers to start going down?
WALENSKY: Well, of course I don't have a crystal ball, but what I really love to be the state is that we start really doing a broad understanding education across the country for both patients and providers alike, so that patients come forward who are at risk of disease and get that vaccine so that we can, you know, encircle this and not have this be a lasting challenge.
SHAPIRO: So you're hoping by the fall, is that (laughter) the takeaway?
WALENSKY: (Laughter) You know, I have learned that in public health never to predict the future. But what I will say is that we do have the tools here. We also really want to encourage those who are in the high-risk communities to access those vaccines and to do so equitably across the country.
SHAPIRO: Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, thank you, as always.
WALENSKY: Thank you so much, Ari. Transcript provided by NPR, Copyright NPR.
