Commentary: We aren’t prepared for monkeypox

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Early on in the COVID-19 pandemic, public health officials urged frequent testing to contain and monitor the virus’s spread. Yet numerous barriers, like the lack of tests and long turnaround times for results, made consistent, widespread testing extremely difficult.

It was only through public investment that communities across the country were able to expand testing access. Public testing sites — at libraries, in public school gyms and outside health department buildings — helped provide accurate data and speedy results, allowing communities to track the virus and act accordingly.

Now, more than two years after COVID first appeared on American shores — and during a surge in cases caused by the omicron BA.5 subvariant — public testing sites are disappearing. From Illinois to Alaska, Texas to New York, cities and states are shuttering sites and many have stopped collecting and releasing daily case data.

This is a mistake. Less public testing will likely lead to more cases and lives lost, leaving us less prepared for future variants. What we need is lasting, permanent public infrastructure to manage the emergence and spread of diseases. Instead of closing sites, we should be making them permanent and expanding their capabilities to test for other emerging diseases, like monkeypox.

Many believe that we are now in a phase of the coronavirus pandemic that no longer requires this level of vigilance. More and more people are accepting that COVID has just become a fact of life and they are abandoning precautions such as masking and regular testing. Congress has failed to provide additional relief funds after prior funding lapsed earlier this year. On both an individual and national level, we are approaching the pandemic with ambivalence bordering on disregard.

Public officials attribute the move away from public testing to a greater appetite for less reliable but more convenient at-home antigen tests. The thinking goes that the demand for public testing isn’t there, so there’s no need for the funding to keep the sites operating.

But infectious diseases do not follow the ups and downs of private markets driven by profit and consumer demand. Government officials, on the other hand, must make decisions based on public need. Testing is a public service that should be as common and accessible as our local post offices or libraries, especially since experts believe the risk of infectious disease outbreaks is increasing.

In the absence of free public testing, people must rely on private companies for a PCR test, the most accurate option. This is particularly difficult for people who are uninsured and can’t pay anywhere between $50 to $195 for a single test. That means they might not test as often or at all, which affects everyone.

We also need fail-safe options when rapid at-home tests are in short supply. When the omicron wave first began in December 2021, rapid tests flew off the shelves. People waited in line at testing sites for multiple hours and did not get results for multiple days.

Since the start of the monkeypox outbreak, people have struggled to get tests, treatments and vaccines. Vaccine appointment websites have crashed. Misdiagnoses have been common. Even New York City is just beginning to ramp up access to vital services, too long after community spread began.

Of course, adequate public testing will not solve limited supplies of vaccines and tests. Public testing sites must also be met with robust investment in public access to medical treatment and preventive care. Without the renewal of the federal COVID-19 relief package, there are limited funds for the government to be able to pre-purchase tests, treatments and vaccines.

It is naive to think that the pandemic is over, or that it is the only health crisis our communities will ever face. We have a choice: We can keep trying to rely on private markets that we know are incapable of meeting our essential needs, or we can fully fund our public health infrastructure for the long-term. Our well-being — and, as COVID-19 has shown, the economy — depends upon it.

Donald Cohen is executive director of In the Public Interest and the author, along with Allen Mikaelian, of “The Privatization of Everything.” This column was produced by Progressive Perspectives, which is run by The Progressive magazine and distributed by Tribune News Service.