Reason Roundup

Monkeypox Is Giving Public Health Agencies a Chance To Prove They've Learned Nothing From COVID

Plus: Schools surveilling students online, Tim Wu leaving the White House, and more...

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woman with monkeypox vaccine | ANP/ZUMAPRESS/Newscom
(ANP/ZUMAPRESS/Newscom)

One might think that following several years of the COVID-19 pandemic, the federal government would be in fighting form when it comes to addressing a new public health threat. But here we are with another infectious disease outbreak on our hands and here are federal health agencies bungling the early response all over again.

In this case, we've got monkeypox spreading rapidly throughout the U.S.—cases have now been reported in every state but Wyoming and Montana—and, thankfully, a vaccine already in existence. However, federal authorities have been slow to ready the monkeypox vaccine for distribution—and even allowed a bunch of America's vaccine supply to be shipped to European countries.

This has led to a U.S. shortage of monkeypox vaccines that could be crippling attempts to slow or stop the disease's spread. "The government is now distributing about 1.1 million doses, less than a third of the 3.5 million that health officials now estimate are needed to fight the outbreak," The New York Times reported yesterday. "It does not expect the next delivery, of half a million doses, until October. Most of the other 5.5 million doses the United States has ordered are not scheduled to be delivered until next year, according to the federal health agency."

So, what went wrong? So, so much.

For one thing, "the Department of Health and Human Services failed early on to ask that bulk stocks of the vaccine it already owned be bottled for distribution," the Times reports:

By the time the federal government placed its orders, the vaccine's Denmark-based manufacturer, Bavarian Nordic, had booked other clients and was unable to do the work for months, officials said — even though the federal government had invested well over $1 billion in the vaccine's development.

In addition, we gave hundreds of thousands of doses away back in May:

Health and Human Services officials so miscalculated the need that on May 23, they allowed Bavarian Nordic to deliver about 215,000 fully finished doses that the federal government had already bought to European countries instead of holding them for the United States.

Besides, there was bureaucracy to respect! When the first U.S. monkeypox cases were being reported, the Department of Health and Human Services (HHS) could not yet distribute the vaccine because it was waiting on the Food and Drug Administration (FDA) to certify the plant where it was put into vials.

"Roughly 786,000 doses were held up by an F.D.A. inspection," the Times says.

Remember early in the COVID-19 pandemic when America's mask shortage was exacerbated by the FDA refusing to approve KN95 masks? It seems we're destined, with every new outbreak, to be thwarted by authorities "protecting us" to death, or at least to severe disease.

Monkeypox can be fatal, but so far no monkeypox deaths have been reported in the U.S.

The Centers for Disease Control and Prevention (CDC) says there have been 6,617 cases reported in this outbreak—but "the official case count is widely considered an underestimate," the Times suggests.

The disease has so far been spreading largely among gay and bisexual men.

As we saw with COVID-19, the CDC has been spreading incomplete or sometimes just plain wrong information about monkeypox. As Josh Barro points out:

Here is our federal government's official answer to the question "Am I at risk of getting monkeypox?" as contained in a CDC FAQ.

At this time, the risk of monkeypox in the United States is believed to be low. Monkeypox does not spread easily between people; however, anyone in close contact with a person with monkeypox can get it and should take steps to protect themselves. People who do not have monkeypox symptoms cannot spread the virus to others.

Not only does this fail to disclose that men who have sex with men face greatly disproportionate risk of monkeypox infection, it conveys an additional piece of misinformation: that we supposedly know monkeypox doesn't spread asymptomatically. As NYC DOH correctly notes, experts are concerned that asymptomatic spread may be a driver of the current epidemic. The CDC is wrong.

The CDC statement is also confusing: "Monkeypox does not spread easily between people" but also "anyone in close contact with a person with monkeypox can get it." Those statements aren't impossible to square, but to square them you need a piece of information the CDC leaves out — most (really, almost all) of the transmission seems to be happening through sexual contact, not other kinds of contact.

Barro blames this in part on a (misguided) fear of stigmatizing gay people and in part on the CDC (again) being slow to adapt to new information.

"The CDC is clinging to an understanding of how monkeypox spreads based on evidence from prior outbreaks, not the increasingly robust data about the current outbreak," he writes. "They seem to be waiting for more peer-reviewed research. I will remind you that the CDC failed to admit there was airborne COVID spread until October 2020."

Authorities are also repeating COVID pandemic mistakes when it comes to testing for monkeypox. For way too long into the COVID-19 pandemic, it was incredibly difficult to get tested for it and home tests were hard to come by—due largely to government roadblocks.

With monkeypox, "the current testing system that the CDC has set up makes it very difficult for doctors to order tests," said NPR's Michaeleen Doucleff in June. "I was talking to Jennifer Nuzzo about this. She's an epidemiologist at Brown University. She says providers have to go out of their way to order a test. The process is cumbersome and time consuming, and sometimes they have to sit on the phone for hours."

The guidelines for how and when to test for monkeypox are also causing issues in detecting cases of monkeypox quickly enough to stop it from spreading.

"The CDC's official guidance recommends that labs test for monkeypox using only samples of a patient's skin, taken at the site of a visible rash. As a result, people…whose fever and swollen lymph nodes come on a few days before their lesions, must let the illness grow before it can be diagnosed," notes The Atlantic. "Others may develop hidden sores in their mouth or anus, and not realize that they can be tested. And many more without symptoms will be left to wait and wonder, after an exposure, whether they might have been infected."

FREE MINDS

Student surveillance reaches creepy new lows:

The Center for Democracy and Technology (CDT) has a new report on how schools are keeping tabs on what students do online. "We've found that nearly every school in the country is giving devices to students – and monitoring is hurting them," said CDT President and CEO Alexandra Reeve Givens in a statement. "Our data shows that nearly half of teachers say they know of at least one student who has been contacted by law enforcement as a result of student activity monitoring. When you combine the resurgence of violence in schools with the mental health crisis among kids, schools are surveilling students' activities more than ever. But these efforts to make students safer more often result in disciplining students instead."

FREE MARKETS

Tim Wu leaving the White House. President Joe Biden's antitrust adviser, Tim Wu, will soon be leaving his position on the National Economic Council. "Wu is expected to return to teaching at Columbia Law School after a roughly year-and-a-half as special assistant to the president for technology and competition policy," reports Politico. Reason noted last year how deeply wrong Wu has been about what makes the internet great.

FOLLOW-UP

How pro-choice activists won in Kansas. Kansas' messaging against the anti-abortion constitutional amendment—which voters resoundingly said no to on Tuesday—focused on medical privacy and religious freedom versus government mandates:

QUICK HITS

• Progressives want "to unleash what they call 'beast mode' executive power, and the Schumer-Manchin tax bill supplies the cash to turn the Internal Revenue Service into Wolverine," warns The Wall Street Journal. If they get their way, "IRS auditors will soon be coming after tens of millions of Americans."

• Reporter Molly Blackall rounds up her dispatches from the Ocean Viking, a search and rescue ship for migrants trying to cross the Mediterranean Sea.

• Elite Kenyans are no longer looking at American democracy as a good governance model, writes Farah Stockman in The New York Times. "Today, the United States has become more of a cautionary tale than an exemplar."

• "Kansas spent nearly five years trying to crush Rich Martinez's classic Corvette over a technicality," reports The Drive. "Five years later, Martinez's case is still pending, but a law passed earlier this year with Martinez's situation in mind looks to have finally saved his car."

• Alex Jones' lawyers accidentally sent the people suing him for defamation years' worth of Jones' text messages. (Jones now says he knows that the Sandy Hook Elementary School shooting was "100 percent real.")

•  The U.S. Department of Transportation wants to force airlines to give people refunds for travel delays, even when it's not the airlines' fault.

• Reason's Nick Gillespie talks to rapper and podcaster Zuby.

• "Americans who have watched too many PBS documentaries about the rise of the Third Reich no doubt will continue to fear demagogues in the European mold," but "a more plausible worry is the Latin Americanization of U.S politics," suggests Michael Lind at Persuasion, "with the left-right distinction replaced by a dichotomy of insider oligarchy and outsider populism, and with impeachment weaponized by the party that controls Congress to expel presidents of the other party from the White House."

• "Hungarian Prime Minister Viktor Orbán, a pariah in Europe and darling on the American right, is set to deliver an address Thursday titled 'How we fight' at the Conservative Political Action Conference (CPAC) in Dallas, Texas," notes Matt Welch.

• San Francisco's new district attorney is leaning back into the drug war.