By Emily Hoeven
Red tape, red tape, red tape.
That was the refrain that popped up repeatedly on Tuesday, when California lawmakers convened for two separate hearings on the two viruses for which Gov. Gavin Newsom has declared a public health state of emergency: COVID-19 and monkeypox.
The key takeaway from the two hearings — which, ironically, took place at the exact same time in the exact same building — was that although California’s monkeypox response has been aided and accelerated by lessons learned from the COVID pandemic, some frustrating problems continue to repeat themselves, CalMatters’ Kristen Hwang reports.
“We have shot ourselves in the foot,” state Sen. Scott Wiener, who leads the Senate Select Committee on Monkeypox, said at the start of the hearing, referring to “severe public health failures” at the federal level to procure doses of the vaccines used for monkeypox and to set up robust testing and treatment programs.
Officials ran through the ways in which red tape has hampered California’s monkeypox response, including:
- Difficulty in prescribing a drug known as TPOXX as an antiviral treatment for severe cases of monkeypox. Because the drug — federally approved to treat smallpox — hasn’t been cleared by the U.S. Food and Drug Administration to treat monkeypox, it requires hours of paperwork for each patient, along with an ethics review. (Anecdotally, monkeypox patients report TPOXX alleviates symptoms, which can include severe pain.) This “lengthy process has inhibited many medical centers and clinics from being able to offer the drug to many people,” said Dr. Vivek Jain, an associate professor of medicine at San Francisco General Hospital. To state Sen. John Laird, a Monterey Democrat, that signaled “another troubling parallel to the HIV crisis, where potentially life-saving drugs were being held up by the FDA because of bureaucratic red tape.”
- Difficulty in ramping up testing. “We know right now the only test that the FDA has approved is swabbing the lesions from monkeypox,” Wiener said. “So if someone doesn’t have lesions, or the test is done incorrectly, their tests may be falsely negative. There are new tests coming out, and we need a sense of urgency from the FDA in evaluating and approving those tests.” Dr. Erica Pan, California’s state epidemiologist, said the state is exploring with “academic partners” other methods of testing for monkeypox, including “antibody testing and testing for people who don’t have symptoms.”
- Difficulty in reallocating public health funds earmarked for COVID to monkeypox, a move that requires both state and federal approval. Some California lawmakers have already asked the feds to allow the state to authorize some of the $1.5 billion in COVID-19 response funds for monkeypox.
“What we learned from COVID is that speed is everything. When we look at the response of monkeypox later on, we’ll see speed is the main thing we take issue with,” Dr. Peter Chin-Hong, an infectious disease specialist at UC San Francisco and a member of the state’s scientific advisory committee for monkeypox, told Kristen.
A similar point was raised during the hearing on the state’s COVID response, led by state Sen. Josh Newman of Fullerton, CalMatters health reporter Ana B. Ibarra notes.
- Dr. Aimee Sisson, Yolo County’s health officer: “During a public health emergency the government needs to get out of its own way so we can act fast. … Our pandemic response went well when we suspended the usual rules and imported masks from overseas despite the high costs and without (federal) approval, and when we expanded the types of health care providers who could administer vaccines. Our response went poorly when we created a duplicative mechanism to allocate vaccines to providers and when we refused to allow labs to develop their own COVID tests.”
California’s monkeypox response may also take a page out of its coronavirus playbook when it comes to isolation and paid sick leave policies — which could signal a repeat of past legislative battles between business and labor groups.
- Wiener: “We need to make sure we are protecting people who have monkeypox and making sure that they do not lose their homes because of an inability to work. …You might have to isolate for three or four weeks if you get monkeypox, and for people who can’t work from home, they need to have paid sick leave.”
TELL YOUR FRIENDS ABOUT CITIZENS JOURNAL Help keep us publishing –PLEASE DONATE
Why are state and national leaders trying to convince everyone this is some sort of national health crisis? It’s exclusively a gay phenom that is easily preventable. I suppose a country that tries to teach children the details of adult sexual activities, we should not be surprised we are all suddenly responsible for monkey pox. Quit the nonsense. the vast majority of us know nothing of this pox, its a gay thing don’t you know.