Will we prepare now, so we don’t panic later? Hopefully, not (boldface mine):
Testing for monkeypox in the United States remains cumbersome. Currently, if a person is suspected to have monkeypox, their physician must contact a state or local public health department to test for the disease. Then, a C.D.C. laboratory partner runs a generic orthopoxvirus test on the sample. If that test is positive, the sample is sent to the C.D.C. headquarters in Atlanta so a monkeypox-specific test can be performed to confirm.
There are 66 public health labs that can test for orthopoxvirus. The C.D.C. estimates the partner labs have the capacity to test 6,500 orthopoxvirus tests per week, which the C.D.C. says is more than current demand. Between May 17 and 24, the labs were sent fewer than 60 samples for orthopoxvirus testing. Given that some of the cases detected so far appear to not be linked to travel, we remain concerned about efforts to identify and test ongoing community spread.
We worry the centralization of testing wastes precious time and would limit capacity if more testing is needed. Monkeypox tests, like Covid-19 tests, are based on P.C.R. technology that is available in hospitals and clinical labs across the country. Many labs at major hospitals, commercial sites, and city and state health departments have capacity to develop, manufacture and run tests for monkeypox rapidly if they are given guidance and samples to use to validate their tests.
Even if widespread testing is ultimately not needed, the cost of being prepared is low and the risk of being caught off guard is high. Increasing the nation’s monkeypox testing capacity will allow health leaders to intervene and slow the possible spread of the outbreak.
The C.D.C. should widely release the details of its monkeypox testing protocols so that more labs around the country can develop and run their own tests for monkeypox. The F.D.A. should also issue guidance to all labs with credentials to perform complex laboratory tests and clarify what regulatory authority, if any, they will exercise over monkeypox tests developed elsewhere.
This time, we can’t let FDA dither over PCR tests, which as the authors note, are routinely conducted by many institutions. There needs to be a much quicker approval process, and it needs to start now.
I don’t think monkeypox will be ‘the next COVID’, but if we prepare now, it will be something we don’t have to worry about. Public health preparation is like insurance: it’s a waste of money until you need it, and then you’re damn glad you have it.
And when monkeypox first made the news, a friend started singing this and I can’t get it out of my head, so I’m now going to share it with you: