New York City’s Rapid Response to the 2022 Mpox Outbreak

Abstract

Human society is facing emerging infectious disease threats with increasing frequency, potentially with novel medical countermeasures available, but often with initial limited access and supply. Long-standing racial health inequities create barriers to accessing critical new treatments that can further exacerbate health disparities in an emergency. During the 2022 mpox outbreak, the antiviral tecovirimat was made available from federal stockpiles for the treatment of mpox disease. Here, the authors describe New York City’s multipronged approach to ensure access to mpox therapeutics, which built on related work during the Covid-19 pandemic. This approach can serve as a road map to addressing systemic barriers to treatment and care during emergency responses. It includes (1) targeting messaging and outreach to providers serving marginalized communities, (2) use of a centralized pharmacy process for medication access, (3) setting up a treatment evaluation and referral process, and (4) monitoring utilization through integration of data across multiple public health data sources. The result was tecovirimat treatment prescribed to 32% of all patients with mpox in New York City. This approach to tecovirimat access during the mpox outbreak in New York City illustrates a model for public health and health care delivery partnerships that could be implemented when novel medical countermeasures become available in the setting of an emerging infectious disease outbreak.