As of yesterday, the U.S. has 2,108 confirmed cases of monkeypox in 45 states. On Sunday, former FDA commissioner Scott Gottlieb offered a grim assessment on Face the Nation:
I think, at this point, we’ve failed to contain this. We’re now at the cusp of this becoming an endemic virus, where this now becomes something that’s persistent that we need to continue to deal with. I think the window for getting control of this and containing it probably has closed. And, if it hasn’t closed, it’s certainly starting to close, 11,000 cases across the world right now, 1,800 cases, as you said, in the U.S.
We’re probably detecting just a fraction of the actual cases, because we have a very — we had for a long time a very narrow case definition on who got tested. And, by and large, we’re looking in the community of men who have sex with men and at STD clinics.
So we’re looking there, we’re finding cases there. But it’s a fact that there’s cases outside that community right now. We’re not picking them up because we’re not looking there. This has spread more broadly in the community. I wouldn’t be surprised if there’s thousands of cases right now.
As ominous as that sounds, you’ve probably not thought much about monkeypox that much over the past two months, and your risk of contracting monkeypox is significantly smaller than the risk of catching Covid; later in the interview, Gottleib adds, “this isn’t going to explode like COVID. This is a slower-moving virus, which is why we could have gotten control of this if we had been more aggressive up front.”
Back in May, I wrote, “rest assured that this monkeypox outbreak is not likely to shake out like the Covid-19 pandemic.” The first case of monkeypox in the U.S. was hospitalized May 12, meaning we’re a bit more than two months after the first case.
And a little more than two months after the first case of Covid-19 in the U.S. was announced January 20, the U.S. had more than 159,000 cases. Covid-19 was and is much, much more contagious than monkeypox.
But the sight of federal health officials struggling to slow the monkeypox spread is a useful corrective for the narrative that took hold during the hellacious first year of Covid-19. A lot of the coverage of the Covid pandemic in 2020 and into 2021 treated the health crisis as primarily a matter of Trump administration bumbling, and callous, ignorant and reckless Republicans being in charge. Recall The Atlantic magazine’s panicked response to Georgia allowing barbershops and stores to reopen: “Georgia’s Experiment in Human Sacrifice.”
In fall 2020, when the U.S. had recorded 220,000 Covid deaths, Joe Biden declared, “anyone who is responsible for that many deaths should not remain as president of the United States of America.”
About 437,000 Americans died with Covid during the Trump presidency; about 612,000 have died with Covid since Joe Biden took the oath of office. The monkeybox outbreak is occurring entirely on Biden’s watch, and we’re seeing the same mistakes and problems: a slow-footed, faltering response with insufficient testing, insufficient vaccinations, software glitches, and poor communication with the public. The virus moves at the speed of human interaction; the U.S. response moves at the speed of the federal bureaucracy.
The San Francisco Department of Public Health asked the federal government for 35,000 doses of the Jynneos vaccine; they received just 4,000 doses. Some members of the San Francisco gay and lesbian community accuse the Department of Health and Human Services of dragging their feet on their response to monkeypox.
Notice the response to monkeypox does not require sudden society-wide changes in behavior; no one needs everyone to stay inside their homes, or shut down businesses, or wear a mask everywhere they go. No, we just needed to get an existing smallpox vaccine, which the government already had in significant quantities, into the populations most at risk of encountering monkeybox. And we couldn’t do it. The only silver lining is that so far, the monkeypox infections aren’t fatal.
As Allahpundit put it a few days ago, “that makes Biden 0 for 2 on his 2020 campaign pledge to shut down the virus.”
The lesson is that containing a communicable disease in a free society is difficult, and our public health bureaucracy is not particularly agile, speedy, or adaptable. If there is a president who is capable of turning the Department of Health and Human Services, the Centers for Disease Control and Prevention, the Food and Drug Administration, and other branches of the federal public health bureaucracy into an effective, quick-moving, fast-responding unified team, we have yet to elect that president. No doubt many people found it cathartic to blame President Trump for all the troubles of Covid-19, but the world was and is much more complicated than that.