Gottlieb predicts monkeypox will become a public health failure

Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb wrote an op-ed in The New York Times published on Saturday, saying the United States lacked a federal infrastructure capable of dealing with emergencies. public health such as monkeypox and COVID-19.

“Our country’s response to monkeypox ‌‌has been plagued by the same shortcomings we had with Covid-19,” Gottlieb wrote in the op-ed.

“Now, if monkeypox gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures of modern times, not only because of the pain and peril of the disease, but also because it was so preventable,” he said. “Our failings extend beyond political decision-making to the agencies tasked with protecting us from these threat.”

Gottlieb said the country did not test enough people for monkeypox at the start of the outbreak, noting that the Centers for Disease Control and Prevention (CDC) only expanded testing to large commercial labs at the start of the outbreak. end of June.

“His cultural instinct is to take a deliberative approach, debating every decision,” he said of the CDC. “With the Covid, the virus ‌‌ quickly gained ground. With ‌‌monkeypox spreading more slowly, usually through very close contact, the shortcomings of the CDC’s cultural approach have not yet been so acute. But the shortcomings are the same.

The CDC reported nearly 5,200 cases on Sunday, and the outbreak has reached all but three states: Montana, Vermont and Wyoming.

Monkeypox is spread by close contact with an infected animal or person, usually through lesions, body fluids, contaminated materials, and respiratory droplets. These droplets can only travel a few feet and usually require prolonged contact to be transmitted.

The virus has been widely detected in men who have sex with men, leading some jurisdictions to prioritize these groups to receive the currently limited number of monkeypox vaccine doses available.

Gottlieb called on the CDC to continue to lead the nation’s response to the pandemic, but he argued it should shift some of its disease prevention work to other agencies.

He called on the FDA to manage smoking and the National Institutes of Health (NIH) to manage cancer and heart disease.

“Focus the CDC more on its core mission of responding to outbreaks,” Gottlieb wrote. “And imbue the agency with the national security mindset that it had at its origins. If the CDC’s mission were more narrowly focused on the elements needed to manage the contagion, Congress might be more willing to invest it with the solid authority to do that focused mission well.

But Gottlieb questioned the feasibility of reform to give the CDC and other public health agencies new tools and powers, citing his conversations with lawmakers and their staff that showed what he called a ” little appetite” for such a decision.

“After Covid, some believe public health agencies used faulty analysis and miscalculated their advice,” Gottlieb wrote. “Ensuring political consensus that the CDC needs to be given more power to carry out its mission ‌‌ — for example, vested with the power to compel states to report ‌‌ — is politically unobtainable.”

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