Monkeypox again exposes U.S. yawning racial gaps
* With the number of infections surpassing 20,000, the United States now leads the world in monkeypox cases.
* Black and Hispanic Americans in the country make up the majority of monkeypox cases but are underrepresented in vaccine distribution.
* Experts urged the U.S. administration to alter its slow pattern of responding to pandemics.
by Xinhua writers Yang Shilong, Liu Yanan
Following the disastrous handling of COVID-19, the spread of monkeypox is another microcosm of the racial disparities and health inequity in the United States.
With the number of infections surpassing 20,000, the United States now leads the world in monkeypox cases. Like a replay of the COVID-19 outbreak, Black and Hispanic Americans in the country still bear a disproportionate burden in the public health emergency. They make up the majority of monkeypox cases but are underrepresented in vaccine distribution.
WORSENING RACIAL DISPARITIES
Signs show the number of infections in the country is slowing, but racial divides are worsening in monkeypox cases and vaccine access.
Over 38 percent of the monkeypox infections are among Black people, who represent only 13.6 percent of the country's population of 335 million. Similarly, Hispanic or Latino people account for 28.3 percent of the total cases as of Sept. 3 but are only 19 percent of the U.S. population.
By contrast, the share of White people in the total contracted cases slumped from 75 percent as of May 20 to 27.5 percent, according to the U.S. Centers for Disease Control and Prevention.
Similar trends in racial disparities can be seen among U.S. states and cities with the most monkeypox cases.
Black or African American residents make up 55 percent of all monkeypox cases but just 24 percent of vaccinations in Philadelphia, city data showed. White Philadelphians make up 24 percent of cases but have received 56 percent of first doses.
White and non-Hispanic people received 67.2 percent of monkeypox vaccines and only account for 35.2 percent of cases as of Sept. 4 in New York State, excluding New York City, the state's health department said.
Up to 39.2 percent of cases are among Hispanic people, while they only got 15 percent of vaccines in the state. Black and non-Hispanic people accounted for 18.5 percent of the total cases while receiving 9.3 percent of vaccines.
"IT'S NOT THAT SURPRISING"
"Unfortunately, it's not that surprising," said Mark Abdelmalek, a dermatologist who has treated monkeypox patients. "History kind of repeats itself. We see health disparities across many aspects of medicine, and to think that this wouldn't be one of them is a little naive."
The associate professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania added, "I mean we saw it with COVID. It speaks to the fact that we have a lot of work to do to meet people where they are."
Total cumulative data show that Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander people have experienced higher rates of COVID-19 cases and deaths than White people when data are adjusted to account for differences in age by race and ethnicity, according to a recent report by Kaiser Family Foundation.
The foundation noted in an earlier report that "underlying structural inequities place people of color at increased risk for public health threats, as was seen in COVID-19 and as is beginning to be observed amid the monkeypox outbreak.
Robert Fullilove, a professor of clinical socio-medical sciences at Columbia University's Mailman School of Public Health, said that the lack of trust and communication between the health department and the Black community resulted in the racial disparities, which were exacerbated by stigma and the long history of medical neglect and abuse of Black patients.
"What's happening with monkeypox is just yet another chapter of 150 years of medical mistrust," Fullilove said.
The U.N. Committee on the Elimination of Racial Discrimination raised significant concerns regarding the United States implementing the International Convention on the Elimination of All Forms of Racial Discrimination, according to Lisa Borden, the Southern Poverty Law Center's senior policy counsel for international advocacy.
Although the United States has signed and ratified the treaty, Congress has never taken any step to incorporate its requirements into U.S. legislation. No administration has made an effort to do the same when developing and implementing domestic policy, said Borden in an article on Friday.
She said that the treaty is in force on paper, but any instance of compliance with its requirements is merely coincidental.
The committee said the United States has failed to create a national human rights institution or any similar coordinating mechanism to monitor the treaty's implementation. Additionally, it lamented the continued absence of a comprehensive federal action plan to combat systemic racism and structural discrimination, urging the United States to proceed on both fronts.
SLOW, MUTED RESPONSE
Experts urged the U.S. administration to alter its slow pattern of responding to pandemics that has worsened the spread of COVID-19 and is dragging on the current fight against monkeypox.
"If monkeypox gains 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 not only because of the pain and peril of the disease but also because it was so avoidable," former FDA commissioner Scott Gottlieb wrote in a July 30 essay, citing a slow ramp-up of testing, inadequate vaccine supply and "an absence of coordination among federal agencies."
The first cases confirmed or suspected in Europe in May "should have been a code red for federal infectious disease response" here in the United States, Gottlieb said, criticizing the timeline for expanding testing to commercial labs, which didn't start until late June.
"In the end, monkeypox was a soft stress test for our public health system that we should have passed reasonably well after our jarring and humbling bout with COVID-19. The results, especially with more virulent bugs surely looming, are discomfiting," Jalal Baig, an oncologist, opined in an article on NBC last month.