Monkeypox forces a new public health test on local governments

As cases of monkeypox rise across the country, health officials are scrambling to tackle the infectious disease while also dealing with the ongoing fallout from the Covid-19 pandemic.

Back-to-back outbreaks present a unique set of challenges, especially for a public health workforce exhausted from more than two years of battling the coronavirus. But experts say there are some clear actions authorities can take to tackle the spread of monkeypox, particularly when it comes to communicating with the public and ensuring health professionals have the information they need.

The disease, which is rarely fatal, causes a rash that looks similar to pimples or blisters, and can also cause symptoms such as fever, headache, chills and exhaustion. On Saturday, the World Health Organization declared the spread of monkeypox a global health emergency after the disease appeared in several countries where it is not normally found, including the United States.

As of July 25, there were 3,487 cases of monkeypox reported in the United States, according to the Centers for Disease Control and Prevention.

But that doesn’t mean it’s time to panic, according to Brian Castrucci, president and chief executive officer of the de Beaumont Foundation, a public health nonprofit.

“The explosion, because of the way we use the term, always comes with fear and dread,” he said. “This should not be [the case]. We can have a measured and measured response that allows us to control the virus as much as possible and limit the damage it can do.”

Now is the time for a concerted effort to ensure that local health departments and providers have the information they need to recognize and treat monkeypox, Castrucci said.

“We need to meet this health care and public health workforce where they are and not rely on them going out and asking for this information,” Castrucci said. Fifty Street in an interview on Monday.

Communication is key now, Castrucci added. He pointed to communication errors during the Covid-19 response and said public health leaders can learn from those errors as they work to inform citizens about monkeypox.

“They have to be really thoughtful in their communication, be precise and consistent and embrace change. Sharing this with the public in a transparent way is really important,” he said.

Through the Covid-19 pandemic, many local health departments sought to improve public outreach by strengthening their communications staff, according to Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials.

“It’s so important that their community — and the decision makers in their communities — know what the situation is and what role they can play in stopping or slowing the spread,” Casalotti said.

Casalotti explained that, so far with monkeypox, municipalities generally fall into three categories.

The first are places like Los Angeles and New York, where there are many reported cases. In those cities, there are many activities with the public: vaccinations, community outreach, provider outreach, and case investigations to learn more about who is at risk of infection.

At the other end of the spectrum are communities that have no reported cases and are far from areas where infections are emerging. In those countries, much of the action is happening behind the scenes as health departments, community organizations and health care providers learn what to look for and, if there is a case, how to care for and monitor the infected person.

Then there are areas that fall somewhere in between. They have little to no cases, but expect to see more soon. These areas are also increasing their community and provider education efforts, as well as ensuring there are strong pathways to testing.

“It’s a wide range, but regardless of the community,” Casalotti said, “they have a role to play.”

Unlike in the early days of Covid-19, when little was known about the new and deadly coronavirus, public health officials are more up to speed on monkeypox and more accustomed to responding to outbreaks of this type, Casalotti said.

However, there are difficulties, including the lack of vaccines that can be used against monkeypox.

There is not enough of one type of vaccine — known as JYNNEOS — to meet demand, Casalotti explained, and another — ACAM2000 — can have severe side effects and is not suitable for many people, including those who are pregnant. who are immunocompromised and those with pre-existing health or skin conditions.

Burnout in the public health workforce is also a problem. After two and a half years of being hit by the Covid-19 health crisis, public health and health care professionals are exhausted, Castrucci said.

In a survey conducted late last year, more than a quarter of public health workers said they were considering leaving their organization, and 44% said they were planning to retire or leave for other reasons in the next five years. Of those, 76% said they started thinking about leaving after Covid-19 hit.

Now, health professionals once again find themselves in the position of having to guide Americans in responding to an unknown and infectious disease. Castrucci said he’s not sure what the pandemic-weary public’s tolerance will be for hearing them.

To avoid a worse outbreak, he said, health officials should follow “well-established” outbreak investigation and control steps. “We know how to do this. We have people trained to do that,” Castrucci added. “Now we just have to let them do their thing.”

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