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tv   New York City Health Commissioner on Monkeypox  CSPAN  August 13, 2022 1:09pm-1:43pm EDT

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♪ >> c-span is your unfiltered view of government. we are funded by these television companies and more, including buckeye broadband. ♪ buckeye broadband supports c-span as a public service, along with these other television providers, giving you a front row seat to democracy. >>, new york city health commissioner dr. ashwin boston talks about the monkeypox outbreak and how to confront the spread of the virus. to date new york city has one of the highest numbers of reported epoxy cases. this conversation with "the washington post" is half an
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hour. ♪ subvariants like b five. we do not know when the vaccine will be ready. -- ba.5. we do not know when the vaccine will be ready. -- if you are not up-to-date with your vaccination schedule trying to get up today. >> you can watch this program in its entirety on our website we take you to the washington post new york city's health commissioner discusses
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the monkeypox outbreak and the spread of that disease. live coverage here on c-span. ♪ >> new york as ever was leading the way with the first in the country to start vaccinating people against monkeypox. people at risk of getting or transmitting buggy box -- monkeypox -- we need to do our best to get ahead of it and it has been a strain on vaccination -- that is limited the number of vaccines we can deliver to slow this down. hello and welcome to washington post live. i am dan dimon at the post. i am joined by new york city health commissioner dr. ashwin vasan to discuss the monkeypox outbreak.
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dr. vasan welcome. guest: thank you. host: we want to hear from viewers. you can share your thoughts by tweeting at post live. many americans still have questions about monkeypox. briefly, what is this virus and how is it spreading? guest: you are absolutely right. there is a lot of lack of information or confusion around this virus. so it is important to start with the basics. mpv or what is being known as monkeypox is a poxvirus that is related to smallpox but not as severe traditionally. it is a virus that has passed primarily through contact of lesions that develop around the body and transmit to someone who does not have the disease. it is -- it requires close skin
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to skin contact for a relatively long period of time. so brushing against someone or shaking hands should not be, and we are not seeing it as, a prime rate of transmission. monkeypox has existed since the 1970's mostly endemic to west and central africa. and that strain of the virus has circulated without a whole lot of intervention in that area. from the global north and west point of view, we have not treated it as a concern for us. until now. starting in may, we saw cases enter in western europe and enter a new population which is men who have six with -- sex with men.
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gay men whose social and sexual networks have become the primary root for transmission of outbreak in western europe and here in north america. for the general public though, this is not about identities, it is about behaviors. as i said, it is prolonged skin to skin contact that drives the transmission of this virus. for the vast majority of americans, they are not at risk of this virus. that is why as public health officials we are targeting our approaches and messaging to the behaviors and communities that are most impacted at this time. host: as you talk about risk and transmission i would like to ask a question we got from twitter. they ask how long a time is there between touching a surface infected with monkeypox virus and contracting get? i do housekeeping and i like to
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know if i need to disinfect my arms after handling soil linens. can you speak to that at all? guest: yes monkeypox can transmit brute linens and clothing who has been warned by someone with active lesions. so the question from the reader is a good one. what we ask is that exposure to infected linens and clothing be minimized largely through wearing gloves if possible. and creating a barrier to exposure. what we will also say is that, in general, on surfaces, hard surfaces like desks and keyboards and so forth, this is not a primary mode of transmission. sitting at the same desk as someone and sharing a keyboard or working in the same office environment is not really a
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primary mode of transmission and is not represent a high risk environment. which is what we are similar to what we are dealing with in the early days of covid because we were not sure how transmission was occurring. we were washing our groceries and cleaning services thinking these are primary ways of transmission. in this case, we know that these are not primary root of -- routes of transmission. i would like to let the listener know that as long as you're wearing gloves and have protection you are protected. the other issue that comes up in her question is incubation. the thing with monkeypox is not a short incubation. with covid it is up to 21 days or a month before someone who has been exposed develops symptoms. that can also lead to difficulties in tracing contact
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and figuring out when exposure happened versus disease. and it is something to be aware of. if you think you have been exposed without protection, the best thing to do is be aware and call your provider and get tested or evaluated. host: i want to think more broadly about where we are in this spread. the first confirmed case of monkeypox in the u.s. was detected less than three months ago and now there's more than 3000 cases one in five is in new york so that makes new york the epicenter. is this the beginning, middle, or the end of his outbreak? guest: it's an interesting question because from the beginning we did not have enough testing at hand. -- it is an extraordinarily hard position to be in to wrap your arms around then and condemn it -- an epidemic without knowing
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what causes transmission. we see testing ramping up in the last month so we are doing a significant amount of testing. in the last week, we've seen a velocity of case increase. the day on day numbers have started to have a little bit. it is too early to tell if we are reaching or if we are near a peak but i would say we are somewhere in the middle. he still have a chance to slow this down. that is why we been so aggressive on vaccination and prevention. and targeted at the most at risk communities. i think we are still weeks if not months away from seeing sustained decline in case transmission. so we still have a lot of work to do. host: the accompanying fear is not about cases spreading but this virus coming -- becoming
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permanent in the united states. others have said that we are on the verge of that potentially happening. are you tracking indicators, commissioner, is there a number or signal that you are looking at to know whether monkeypox has become permanently entrenched in your city in the u.s.? guest: we have to follow the data and epidemiology and right now the vast majority of the cases in the city and country are contained within a subset of populations that is large -- largely men that have sex with men and trans people that have similar sexual networks and some gender nonconforming people who are in sin -- similar exposures. that means that they have multiple or anonymous partners in the last several weeks that put them at risk. that is where we see the bulk of transmission happening. i know we are talking about individual cases where children
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or other people of -- that are members -- are not members of those populations. the good news is, given the transmission -- it is a harder virus to transmit and we have a test and treatment, the fact is we can interrupt the chains of transmission in a way that is much harder for something like covid which is airborne respiratory and fast-moving. -- virus where contract -- contracting it is challenging. so we have an opportunity to slow this down. i do not think we are here the end yet. and i think the choices we make and the aggression in which we attacked this in the next weeks and months will play a big part in determining whether that becomes an issue or not. the king at where cases are outs the primary at risk -- looking at cases -- whether a virus is
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becoming more widely spread. host: in terms of attacking that outbreak you mentioned there was challenges in testing -- and i've spoken with health officials in your city but talked about barriers of getting treatment -- your boss city mayor eric adams wrote to president biden a month ago laying out his concerns about the response and ask for more vaccines. what do you need now? what does your city need now from the biden administration to make your response stronger? guest: it's a great question and number one i want to start with how the situation has -- how difficult the situation has been and how grateful we are to the federal government for their support. i understand the frustration of the american public -- with the fact we had a vaccine in hand and a test we knew of and treatment available to us and it
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became harder and harder to rule those things out. -- roll those things out. we are grateful for the support and partnership of federal partners but the frustration among the public in terms of the speed is warranted and we have been there as well it is something we experience every day. that is part of the reason we got ahead and started vaccinating people in june because we knew we had to start interrupting these chains of transmission. and reducing risk. i think as a country i am proud to say new york is pushing the envelope and leading the way in stimulating the robust national response we are seeing come to light. that said, we are running a response against covid, currently, as you know in new york city, we have polio cases.
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or we have a polio case in upstate new york and some evidence of wastewater sampling here in new york city and beyond. and we have mpv -- monkeypox to deal with. that requires federal resources to mount the scale and team and equitable response that new yorkers and people demand and expect of us. we are grateful to president biden for declaring a public health emergency because it allows us to talk about remote reimbursement funds to build temporary public health infrastructure to allow us to vaccinate the hundreds of thousands of people who might be at risk to get people tested and treated at scale. more concretely, we are encouraged by increasing vaccine supply. we would love reduced barriers to accessing treatment.
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it is not a question of supply but it is a question of safety and regulation. we are talking with federal partners at the fda around what we can do to make the application process for teapots to be -- monkeypox to be simplified. -- we are seeing the response ramp up but we need those resources to maintain it. and let alone the idea of creating something more consistent. host: you mentioned vaccine several times. the u.s. has hundreds of thousands of doses stuck in denmark and the city was clamoring for vaccines across the month of june. pride month. could the have a faster way to get you vaccines when you need them? guest: we all could have moved faster. this is a collective effort.
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host: could the city of new york city move faster? guest: -- yes maybe we could have gotten more maybe we could have pushed for more. host: you were saying you could've needed more vaccines from the biden administration or -- guest: we did what we could at the time and we needed to collectively turn on this response. i am glad -- grateful it is turned on now. back in june we saw the same things you are describing. we saw pride month and increasing anxiety and worry and an uptick in cases in an environment of low testing. -- i think because of that, we are here talking about this is a national response now. host: the washington post broke the news last night that very gornick's the manufacturer of
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the vaccine for monkeypox has safety concerns about the biden administration plan to start splitting up doses and injecting them in a different way. do you have any concerns about the new biden administration land? are you going to tell your own health workers to follow this plan? guest: yes i think we are in an emergency we've declared it in new york city and it has been declared in multiple states around the country. and obviously the biden administration has done so at -- as well. so we are in a position where we have to make tough choices. in this particular situation what we have is encouraging data that suggests that a revised dosing and administration procedure can extend the supply we currently have. so i am encouraged by the data i have seen, but it doesn't, like anything, any midcourse
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correction it requires real thought from this with respect to the technical issues around it and safety issues around it. -- the training and staffing needed to dose vaccine, storage conditions, supply chain management issues around it -- those are all real things that we are wrestling with as we speak and trying to find a best way to roll this out. the top line is that it extends supply dramatically to potentially reach demand. to reach much more than the demand that we may be seeing in the country. that is a good thing and it is coming from a good place. now, like any sort of new protocol -- clinical protocol we need to test it. we need to study it and we are doing as much as we did with covid vaccines. we must do actsing f exceed --
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vaccine efficacy trials. and we have talked about how new york city can contribute to those trials and making sure that we do so safely and responsibly during are looking at the media -- immediate effects but also the etienne and long-term. we are and long-term. we are in a difficult situation but i think the effort to do intradermal dosing is trying to make the best of the situation using a strong basis of data. as limited as it might be. host: shifting from vaccine strategy to messaging around the outbreak, city health official dog light -- don white said he is devoted after raising concerns about your department's communication -- the department failed to warn men about the risk of anonymous sex. -- i wanted to address his specific complaint that your department should have warned gay man to cut back on anonymous
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sex. and that is how the virus is spread. the health department have been or direct or explicit on this response? guest: i think one has to take a historical view when giving out any sort of behavioral especially sexual behavioral advice to a community that has had their sexual behaviors and social behaviors dissected, discriminated, and judged for decades. and there has to be legal and social implications for them as well. so we are exceedingly mindful of that. we take every sort of caution and precaution to make sure that we -- when we are working on messaging we do so in a responsible way in a way that meets the needs of the community. -- the presence of monkeypox
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virus in sexual fluids is it a formal sti versus something that is transmitted through close skin to skin contact of sexual and intimate contact. you start opening clinical debates that are happening -- at the cdc and health departments all across the country. so we've been having that debate -- i think it is always a balance. it is always a balance to say these are the behaviors that are pitting people most at risk -- putting people most at risk without calling people out and judging and stigmatizing the that might be associated with those behaviors. that is what we have been trying to strike from the beginning and we are seeing some success. host: you called for changing the name of the virus saying that monkeypox is intentionally stigmatizing wind is changing the name of monkeypox a priority in the midst of this operation? guest: we can all walk and chew
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gum in the same time. i wrote a letter that she does not take that long and as we are doing our operational work and rollout of the vaccine we raise an issue because language matters. choice of language matters. we know that this is not an issue of politics and jargon this is an issue of public health. we know the stigmatizing language and demonizing language can push people further into the shadows and they will delay seeking care and we will have worse outcomes. we can look at the hiv epidemic which was not called hob in its early days it was called gay related immune deficiency causing a great deal of stigma in the greek -- gay community. -- the asian flu and the impact that had on asian american communities and the rise of asian american hate in this country.
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so why, when we have a name that has no accuracy or descriptive benefit and it does not accurately describe anything about the virus or in symptoms why not try to choose a name that is more neutral that can be widely understood and does not call out or a feeling a racist or stigmatizing language with a particular community. host: a quick follow your health department -- you said the term monkeypox several times during this interview, if it is potentially stigmatizing i keep easing the term? guest: internally at the health department we are using mpv as much as possible. we are also mindful of not trying to correct multiple times. that's why i wrote the letter to the who they can change the nomenclature for the globe.
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they created the nomenclature covid-19 which was adopted around the globe. we hope to cup decide on something sued -- soon that we can all adopt. and we want something that has the least amount of confusion. >> you mentioned polio earlier or the threats beyond monkeypox, i would like to spend a moment on that now. in new york several weeks ago someone pest -- people tested positive for polio. the department has had potentially hundreds of people have been infected. what are you doing in new york city to defect -- to detect polio and do you have any indication on his potential spread? guest: i think is very pass it -- mary mentioned in her press routes -- press release -- there
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are certain areas of our city and our state that have low rates of polio vaccination coverage in children. that is three doses that most of us get in order to go to school. there are subcommunities and neighborhoods that have chosen to not emphasize vaccination in the same way and now is our chance to target messaging and support and distribute vaccines to provide -- to providers in the most affected communities. we have some communities in our city with polio coverage rates as low as 56% and we need at least 80% to achieve immunity for polio. so we must redouble our efforts. we are tracking this through wastewater surveillance.
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and as others have said, a case for paralytic polio, it is usually assigned that there is community transmission going on. and that has been earned by our wastewater sample. we are doubling our efforts. the cdc has sent resources to the county to help. and we are redoubling our efforts in the city to get ahead of this. this is a personal issue for me. my at my dad's sister died of polio when she was in school. and my -- is disabled as a result of polio. it is discouraging that we are talking about diseases that were mostly eradicated in recent memory and i think this is a call to action for all of us around immunization. the governor 19 pandemic and the misinformation and
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disinformation that has been circulating around vaccines has impacted certain communities more than others. it is leading to an overall vaccine hesitancy that we have not seen in decades and it is leading across a host of other vaccine as well area now is the time to get kids back to school in the fall and up-to-date on all vaccines. host: you mentioned kids going to school in the fall and you mention covid i would like to put that together. covid continues to circulate there's about 4000 new cases in new york city i understand that is higher than the caseload of last school year. and the numbers are above them. because many tests are not being reported. are you thinking about ringing back mass mandates in schools for this year? guest: we have to reassess where we are today from where we have been. the case of covid and its impact
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on human health is different today and july 22 versus january 2022 certainly from march 2020 we recognize there has been a high wall of immunity that has been built up through vaccination. in new york city we've given out more than 18 billion vaccines. a significant -- 18 million vaccines. -- advances in treatment and care. that enables us to treat people early and keep them out of the hospital. even if they are hospitalized, it prevents severe illness and death. over the last several months, in the spring and the summer, we are seeing a break in the pandemic between case transmission and severe illness.
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so we have to take that into account and decide when is the right time on the basis of what data to re-implement population prevention strategies. it was inappropriate in march and april of 2020 two introduce the guidance whether it was mass mandates or population vaccine and aids. those are the right things to do in a time of an emergency. i do not think we are in an emergency but i think we are somewhere between emergency and -- the fact that severe illness and hospitalizations and the fact that the impact overall on human health and society is lessening is a good thing. it causes us to reassess where we are in terms of the data and when to allow policies.
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