Opinion: Monkeypox: It's not a matter of whether it will spread widely. We need to focus on when.

Monkeypox is spreading. We must move quickly, avoid past mistakes to protect LGBTQ people.

  Monkeypox is spreading. We must move quickly, avoid past mistakes to protect LGBTQ people. Officials are largely vaccinating individuals and close contacts among men who have sex with men. This could shift if the outbreak drags on.If we do not contain this outbreak, the risk of the persistence of monkeypox among gay, bisexual and transgender people is likely. That is, it will dig its roots into these communities, making this a disease LGBTQ communities will have to live with for a long time.

As monkeypox continues to spread across the globe and in America, experts are starting to warn that the country is not prepared to respond.

The Center for Disease Control and Prevention shows that we are past 6,600 cases as of Thursday and that just about every state is dealing with the virus. The World Health Organization declared monkeypox a global emergency in late July.

USA TODAY Opinion has posted several columns on the topic that includes experts warning about what happens next and offering advice on how we need to respond. What can we learn from our response to HIV and COVID-19? Will monkeypox spread more widely across the country?

2 more children in US test positive for monkeypox

  2 more children in US test positive for monkeypox At least four children in the U.S. have now tested positive for monkeypox, officials have confirmed. Your browser does not support this video Amidst a growing emergence of cases across the country, state officials in Indiana confirmed late last week that two children had tested positive for monkeypox. At this time, no additional information has been made available due to patient privacy concerns, the Indiana Department of Health wrote in a statement. “Like many other states, Indiana has seen an increase in monkeypox cases over the past month,” State Health Commissioner Dr. Kris Box said in a statement.

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These columns addressed those questions as the virus started to take hold.

Monkeypox now a 'global emergency.' US needs to step up.

Dr. Jerome Adams, a former U.S. surgeon general, spent time with USA TODAY Opinion to talk about monkeypox being named a global emergency by the WHO and how America has responded.

As the country neared 3,000 cases, we asked Adams whether the United States has the capacity to vaccinate, treat and test.

World Health Organization Director-General Tedros Adhanom Ghebreyesus declares monkeypox a global health emergency in July 2022. © WHO World Health Organization Director-General Tedros Adhanom Ghebreyesus declares monkeypox a global health emergency in July 2022.

"Right now we do not have the capacity to properly treat and vaccinate people for monkeypox. And, it's an important distinction here for monkeypox: You can vaccinate people who are at risk before they're exposed, but you can also use vaccines as post-exposure prophylaxis – which is why it's important that people who are at risk know that if you've been exposed and if you are early in the symptomatology, you can actually get vaccinated at that point, and that can prevent progression of the disease. But we don't have enough vaccines available in this country."

More than 780K doses of monkeypox vaccine available Friday; San Francisco declares state of emergency

  More than 780K doses of monkeypox vaccine available Friday; San Francisco declares state of emergency The government distributed 300,000 doses this month and announced Wednesday another 786,000 are available – bringing the total to over 1.1 million.Those doses will add to the 300,000 doses distributed this month, bringing the total to 1.1 million.

Treating HIV taught us about inclusive care

Dr. Siegel wrote a second column for us as monkeypox cases in America went past 2,000. This column examined the response to HIV and how different the monkeypox response needs to be.

"Back in 1985, as a reliable blood test for HIV was first becoming available, I plunged headlong into medical residency at Bellevue Hospital in New York. Half of my patients had AIDS, and the challenge quickly became managing opportunistic infections with multi-organ involvement.

Lining up to get the monkeypox vaccine on July 17, 2022, in New York City. © KENA BETANCUR, AFP via Getty Images Lining up to get the monkeypox vaccine on July 17, 2022, in New York City.

"Stigmatization of men who have sex with men and intravenous drug users was more of a political than medical issue. It didn’t reach into the hospital trenches, as we learned to treat diseases and show compassion for the patients who have them. The diagnostic test for HIV helped us enormously in those days, though it took another decade before we had truly effective treatments – and we still don't have a vaccine.

Spain reports 2nd death from monkeypox

  Spain reports 2nd death from monkeypox BARCELONA, Spain (AP) — Spain reported Saturday a second death in as many days from monkeypox. These are believed to be the first confirmed fatalities from the disease in Europe since its recent spread beyond Africa. The ministry based in Madrid said both fatalities were young men. It reported its first death on Friday, the same day that Brazil also reported its first death from monkeypox. The global monkeypox outbreak has seen more than 22,000 cases in nearly 80 countries since May. There have been 75 suspected deaths in Africa, mostly in Nigeria and Congo, where a more lethal form of monkeypox is spreading than in the West.In the U.S.

"Now we are facing another growing outbreak largely impacting men who have sex with men. This time we have tests, treatments and vaccines, though not enough of them."

We must avoid past mistakes to protect LGBTQ people

In early July, we posted a column from Zain Rizvi, a research director in the Access to Medicines Program at Public Citizen, and Gregg Gonsalves, an associate professor of epidemiology at the Yale School of Public Health. Their focus was on stopping the spread by protecting the LGBTQ community.

Mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. © AP Mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak.

"More than 7,200 cases of monkeypox have been reported this year in dozens of countries, including over 600 cases in the United States, largely but not exclusively in men who have sex with men. While it is not as contagious as COVID-19, monkeypox could easily gain a foothold in communities now suffering from the latest spread of the disease.

"If we do not contain this outbreak, the risk of the persistence of monkeypox among gay, bisexual and transgender people is likely. That is, it will dig its roots into these communities, making this a disease LGBTQ communities will have to live with for a long time."

Under fire, US officials say monkeypox can still be stopped

  Under fire, US officials say monkeypox can still be stopped WASHINGTON (AP) — The country’s monkeypox outbreak can still be stopped, U.S. health officials said Thursday, despite rising case numbers and so far limited vaccine supplies. The Biden administration’s top health official pushed back against criticism about the pace of the response and worries that the U.S. has missed the window to contain the virus, which has been declared a global emergency. “We believe we have done everything we can at the federal level to work with our state and local partners and communities affected to make sure we can stay ahead of this and end this outbreak,” Xavier Becerra, head of the Department of Health and Human Services, told reporters on a ca

Is the US prepared to handle the monkeypox threat?

Dr. Marc Siegel wrote a column in May as the virus was approaching 100 cases. He focused on COVID-19 testing lessons that can be applied now.

"What we can learn from COVID’s PCR and rapid testing delays is the great importance of decentralized, widely available testing. Public health requires an accurate assessment of the number of cases, the ease of spread and the severity of illness before we can accurately identify and fight any infectious disease.

"We have a PCR test now to identify monkeypox; it needs to be made widely available without delay."

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This article originally appeared on USA TODAY: Monkeypox: It's not a matter of whether it will spread widely. We need to focus on when.

California not ready to declare emergency over monkeypox .
SACRAMENTO, Calif. (AP) — California officials are pressing for more vaccine and acting with “utmost urgency” to slow the spread of the monkeypox virus, but they have not decided whether to declare a statewide emergency as the city of San Francisco announced on Thursday, the state's public health officer said Friday. Dr. Tomás Aragón, director of the California Department of Public Health, said they are focused on getting accurate information to the public and expand testing. He said they are taking advantage of the ties forged with local health offices and clinics during the coronavirus pandemic to distribute vaccines quickly.

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