DOYLE: Even as COVID continues to present a risk to healthcare professionals and those working in congregant care settings, they face a new workplace risk from the monkeypox virus. The New York Times described Monkeypox as being similar to smallpox but with symptoms that are less severe. While several thousands cases have been documented nationally, no deaths have yet been reported. With us now is WBGO’s Bob Hennelly to discuss what essential workers need to know about the latest occupational health risk and what officials are doing to address this quickly emerging health crisis.
Thanks for joining Bob. So what do we know about Monkeypox?
HENNELLY: It was first seen in Africa in the late 1950s, and is primarily spread through close physical contact, like sex, but can be transmitted by less intimate contact like through towels or sheets used by someone infected. Initially, the hardest hit population has been gay men, but potential pathways of exposures include locker rooms and any congregant residential facility like a hospital or prison. The first case in New York City was flagged back on May 20. According to an internal occupational health guidance from the New York City Fire Department Bureau of Emergency Medical Services issued back in May, the strain of monkeypox that’s hit our region is "not capable of causing permanent disability of life threatening/fatal disease in healthy humans" but manifest in lesions as well as other pretty nasty symptoms.
"Incubation periods after potential contact with an infected person is 5-21 days and a patient is considered infectious from 5 days prior to the onset of rash until the lesions have crusted over with new skin," according to the FDNY's EMS 911 fact sheet. "Symptoms usually start within 5 days of exposure and can include fever/chills, headache, muscle aches, fatigue, and swollen lymph nodes in the neck, jaw, genital area and usually start before a rash appears. The distinct rash which may appear 1-3 days after initial symptoms, usually begins on the face then spreads to the palms, soles, extremities, and trunk of the body. Usually, they appear as puss filled blisters but not all patients with monkeypox develop this signature rash.
DOYLE: What’s been the public health response so far?
HENNELLY: Back on July 23, the World Health Organization (WHO) declared a global public health emergency due to the proliferation of the monkeypox virus. When WHO's panel met a month earlier to evaluate the status of the contagious virus there were 3,040 cases in 47 countries. In just a month it had exponentially expanded to 75 countries and was observed in more than 16,000 people. Now, it’s over 30,000 in countries that don’t have a history of the virus. Here in the U.S. there’s been several thousand documented and it's spreading pretty rapidly. New York is considered the epicenter of the outbreak and earlier this month Mayor Adams and Gov. Hockul declared a public health emergency.
City officials initially reported 1,300 confirmed cases and said that potentially as many as 150,000 New Yorkers had been exposed to the virus. President Biden followed suit and declared a national public health emergency. Back on July 28, Gov. Murphy wrote the federal government to complain that New Jersey was not getting its fair share of the Monkeypox vaccine which has been in short supply everywhere.
In a New York Times op-ed on Aug. 1 Scott Gottlieb, a former FDA Commissioner, wrote that "our country's response to monkeypox has been plagued by the same shortcomings we had with COVID-19," Gottlieb said. He also warned that if monkeypox gained a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times.
DOYLE: Have there been any occupational related infections? What can workers do to protect themselves?
HENNELLY: As for prevention, it’s pretty much common sense. If you have to move laundry or towels and turnover hotel or hospital rooms masking, gloves, and regular washing of your hands is essential. You have to avoid skin contact with the virus. As for exposures, there were two New York City Department of Corrections officers that got infected. In Illinois a daycare worker came down with it and there were an unknown number of preschoolers that all had to be screened for Monkeypox and were all administered the vaccine which required all kinds of waivers.
DOYLE: What’s been the response of the unions that represent essential workers who are at risk of contracting this?
HENNELLY: What I have been hearing from union leaders is that the response from management has been kind of plodding like it was with COVID. And as we saw with COVID, the government was playing catch-up with ramping up sufficient testing capacity and then vaccine availability has been a real problem which produced long lines and frustration in New York City. The day after the Biden administration declared a national health emergency, Dr. Ashish Jha, the White House's point person on COVID, said that the shortfall in vaccines was because there was only one small Danish company that makes all the vaccines for the world and that the US had procured more vaccines than the rest of the world combined.
Vincent Variale, the president of the union that represents the FDNY EMS officers told me he was glad the city had declared an emergency but said that there was a lot of work to be done to help recover from the impact of COVID which killed a dozen members of EMS He said that because EMS is so short-handed, there's constant pressure to get a rig back into service after a call even though the city's monkeypox outbreak requires ambulances go through a thorough cleaning they are so short staffed the Chiefs will yell at crews who go off service to properly clean their vehicles.
DOYLE: Has this additional challenge helped to revive the call for hazard payfor some of these frontline occupations?
HENNELLY: Well here in New Jersey, the HPAE, the state’s largest healthcare union and 32BJ SEIU, which represent essential workers have continued to press the case for $100 million in hazard pay going back to COVID which we know killed thousands of workers and left many more with long term health issues.
Dr. Edward Zuroweste, the founding director of the Migrant Clinicians Network, an international non-profit that serves migrant and immigrant worker told me that while monkeypox had yet to yield a death in the U.S., it's likely a bellwether of things to come as the climate continues to heat up and tropical infectious diseases migrate, Zuroweste believes. "There's no question that we have to find a way to protect essential workers from these infectious diseases because it's going to continue to be an issue so that people have to be aware of the new viruses coming down the pike and what to look out for,'' he told me.
Zuroweste says that in the current risk climate, union representation for essential workers is more vital than ever and that the best countermeasure to the proliferation of pandemics and public health emergencies is the establishment of universal health care that would promote "rapid public health investigations of infectious diseases and contact tracing.
DOYLE: Thanks Bob
HENNELLY: Thanks for caring so much about essential workers Doug.