A local epidemiologist says we shouldn’t ‘wait and see’ with monkeypox

A local immunologist and epidemiologist is urging aggressive action to address the monkeypox virus outbreak, which has infected more than 400 people worldwide.

Dr. Michael Mina, a former Brigham and Women’s epidemiologist and Chief Science Officer of eMed, warned Friday against a “wait and see” approach when it comes to monkeypox. 

“If we wait and see … then by the time we are seeing, it’s too late,” Mina said on Twitter. 

The virus, which has symptoms similar to but milder than smallpox, has been diagnosed in 12 cases in eight states, including Massachusetts. A man suffering from the virus was treated at Massachusetts General Hospital from May 12 to May 20, according to The Boston Globe. He was the first person in the nation known to have the virus in this recent outbreak.  

The pox-like virus has also been found in New York, California, Colorado, Florida, Utah, Virginia, and Washington.

A prominent advocate for the widespread use of at-home COVID-19 antigen tests, Mina warned against being “timid” in the face of pandemics, and urged health officials to be proactive with monkeypox testing. Otherwise, the nation could find itself in a situation similar to that of early 2020. 

“For one — let’s make sure that people can be diagnosed ON TIME. Sure, send a specimen to CDC. But if it’s going to take weeks to return, do not limit testing to CDC or DPHs,” said Mina. “Trust academic / hospital / clinical labs w deep experience in molecular virology to set up PCR assays.”

He warned against limiting who gets tested for monkeypox based on “arbitrary decisions,” such as people who may constitute a high-risk exposure. 

“Don’t limit it to ‘Have you been to Africa?’ that would be idiotic, but we are already seeing it happen,” he said. “Don’t limit it to ‘Do you have a known contact.’ Also unwise.”

According to the Centers for Disease Control (CDC), monkeypox was discovered in 1958, in African monkey colonies. The first human case was recorded in 1970, in the Democratic Republic of Congo. Since then, the virus has been diagnosed in humans in central and various western African countries.

To get ahead of the spread, Mina recommended that public health officials focus on where cases currently are, or may be, and adjust the response accordingly. 

“In COVID, we made remarkably bad decisions about who warranted a work up for COVID. That was deadly. Let’s be more efficient and data driven this time around,” said Mina. “To facilitate timely diagnosis and reporting, we absolutely cannot limit testing to CDC, like we did in 2020, and Must NOT require every hospital lab to go through the FDA before testing their patient like we did in COVID.” 

Mina said that scenario “would be disastrous.”

The key to protecting the nation from a COVID-19-like situation with monkeypox is to diagnose it quickly, according to Mina.

“…With fast moving viruses… speed trumps perfection,” he said. “It’s true w COVID. It’s true with Monkeypox.”