Virus takes root in a chaotic system that has been underfunded, bureaucratically confused and coronavirus-ridden for years

Proponents say the "slow and bureaucratic" response to monkeypox spread rapidly across the United States - more than 1,000 cases in New York City alone - suggesting that local health agencies have been overwhelmed since the Covid pandemic. Since the Covid epidemic, local health agencies have been hit hard.

Once a rare African virus, monkeypox now dominates the uneven mix of city, county, state and federal agencies that make up the U.S. public health infrastructure.

Unfortunately, the delay in taking action means that monkeypox has spread among the gay community and other men who have sex with men," said David Harvey, executive director of the National Coalition of Sexually Transmitted Disease Directors.

As an explanation for this confusion, many observers point to how Covid has reshaped the landscape of public health officials. Many health officials, once considered neutral arbiters of information, have come under political attack in the wake of unpopular masks and vaccination policies.

Across the country, public health officials were harassed, threatened, fired, or simply felt exhausted and resigned. The situation did not improve as resources once used to track infectious diseases like tuberculosis or run routine vaccination clinics were suddenly shifted to Covid-19.

The result has been a deterioration in the health status of many essential public health services: routine childhood vaccinations have declined; drug overdose deaths have spiked; and the rate of sexually transmitted infections in the U.S. is at a record high for the sixth year in a row.

The World Health Organization declared monkeypox a global health emergency this week, and the U.S. could follow suit by declaring monkeypox a national public health emergency, which would free up more resources for local agencies.

"Together with monkeypox and other diseases, we also have staff documenting mental health trauma in the aftermath of a pandemic."

Public health advocates want the president and Congress to allocate more money to respond to the outbreak, as well as to sexual health clinics in general. Public facilities have proven to be the first line of defense against monkeypox, although federal funding for such efforts for prevention has declined 41 percent since 2003.

Although anyone can contract monkeypox, the virus primarily infects men who have sex with men. Sexual health clinics are often the first responders to outbreaks, as symptoms of monkeypox manifest around the genitals and anus, although sexual intercourse is only one way in which monkeypox is transmitted. Any close contact with an infected person can spread the disease, including touching, kissing and hugging, as well as sharing glasses, utensils, bedding and towels.

Although the virus, which is in the same family as smallpox, is rarely fatal, symptoms can be very painful, with painful lesions and flu-like symptoms, according to the U.S. Centers for Disease Control and Prevention (Centers for Disease Control and Prevention). Freeman said up to 10 percent of people reportedly require hospitalization, with many presenting to emergency rooms for severe pain.

The situation is worsened by limited testing for monkeypox. There is no home testing, and results can take days. However, there is a vaccine that people at risk may be eligible for; they may also be eligible for treatment with the drug tecovirrimat, known as TPOXX. But the hurdles are significant, access to it can be tricky, and the viral agent usually reserved for people with severe symptoms must be requested by a physician from the government's Strategic National Stockpile, which involves a lot of paperwork.

In addition, people without insurance may not be able to get vaccines and medications, Freeman said; about 12.7 percent of the LGBTQ+ community lacks health insurance, compared with 11.4 percent of the general population, according to an analysis by federal officials. Even if you do have insurance, there are barriers to the U.S. health care system, such as navigating between urgent care clinics, primary care providers and state health departments.