Category Archives: Infectious diseases

“Many Tuskegees” occur daily in the U.S. 

Epidemiologist Dara Mendez, Ph.D., M.P.H., pediatrician Diane Rowley, M.D., epidemiologist Theresa Chapple-McGruder, Ph.D., and epidemiologist Bill Jenkins, Ph.D., who blew the whistle on the experiment at Tuskegee while working at the U.S. Public Health Service, gather at the 2017 meeting of the American Public Health Association. (Photo courtesy of Theresa Chapple)

When writing about the 50th anniversary of the revelation of the U.S. Public Health Service study at Tuskegee, I reached out to several Black health care professionals to ask for their perspectives on the study’s legacy a half-century later. Five women — an epidemiologist, two psychiatrists, a surgeon, and an HIV primary care physician — offered their insight. This post shares two of those perspectives, one focused on the man who blew the whistle on the experiment and the other on how the legacy of the experiment at Tuskegee is playing out with monkeypox.

Key takeaways

  • The whistleblower who ensured the world found out about the U.S. Public Health Service study at Tuskegee, Bill Jenkins, Ph.D., has also been a role model to Black epidemiologists in showing how to stand up to racism within the system.
  • Although the “Tuskegee study” is a convenient shorthand, it’s more appropriate and accurate to refer to the experiment as the ”U.S. Public Health Service study at Tuskegee” to keep the blame on the perpetrators rather than the victims.
  • The experiment at Tuskegee lives on in a collective memory of those in the Black community even when they don’t necessarily know the details of the specific study.
  • The distrust many in the Black community have toward the health care system is less about this one experiment than is “the everyday interactions” they have today, as “many Tuskegees” are occurring all the time.
  • The rollout of the monkeypox vaccine demonstrates how treatment is being denied to Black communities that need it.

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Monkeypox experts to follow on social media

The monkeypox story has been evolving quickly this year, moving from a pathogen that wasn’t on the radar for most people to a global outbreak that led the World Health Organization to declare a global health emergency on July 23.

To boost your reporting on this topic, use social media and create a Twitter list to help focus your coverage. Use the platform to contact experts for comment, a lesson I learned from covering COVID-19. 

In March 2020, I created a Twitter list of COVID-19 experts to help me cut through the clutter of voices on social media and shared it with AHCJ members. At that time (and frankly, this continues to be the case), there were many people on Twitter without training in infectious diseases, virology and immunology opining on what was happening. (See Tara Haelle’s post on how important it is to seek out people who specialize in infectious diseases, not just any physician)

Over the past two and a half years, I have added and removed names from the list depending upon the person’s social media presence. Overall, I have found it a helpful lens for understanding what is going on as the pandemic has evolved.

This week, I created another Twitter list for covering monkeypox. There is a crossover of experts between the COVID-19 and monkeypox list, as the world of trusted infectious disease experts who are also helpful on social media isn’t huge. I also may have missed people that should be on the list, so please send a note (Email me at bara@healthjournalism.org) if I have missed someone. 

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How to use health equity data to cover access to COVID‑19 rapid tests

Victoria Knight

When the Biden Administration rolled out two COVID-19 rapid tests programs in mid-January, Kaiser Health News reporters Victoria Knight and Hannah Recht were separately researching the initiatives, including one that allowed Americans to get free tests through the U.S. Postal Service. Their reporting included interviewing experts and gathering U.S. Census Bureau data about health equity measures such as home-based internet subscription rates. 

The behind-the-scenes reporting illustrates how some stories are rooted in social media serendipity and collaboration. In this “How I Did It,” Knight and Recht explain how the article came together and why the data they compiled suggested that millions of Americans — mainly Black, Hispanic and Native American, and Alaska Native people — could face significant challenges in getting the rapid tests. (The following conversation was edited for clarity and brevity.)

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Omicron subvariants “of concern” drive surge in cases and reinfection rates

Photo courtesy of the National Institute of Infectious Diseases.

The COVID-19 story of the summer is omicron subvariants.

As of mid-July, two subvariants are “of concern,” according to the CDC: BA.4 and BA.5, which make up about 80% all COVID-19 cases in the U.S. Another variant, though it has yet to reach the status of “concern,” is BA.2.75, which is rapidly spreading in India and could become a threat in the U.S., according to virologists. (Omicron is the SARS-CoV-2 variant that emerged and swept the globe beginning November 2021, causing a big wave in cases, hospitalizations and deaths globally.)

How much the public should worry about these variants is a matter of debate among public health experts. See this July 13 story in Business Insider, quoting four infectious disease experts I have contacted frequently over the past two and half years. Three of the four experts (Amesh Adalja, M.D., Celine Gounder, M.D., Katelyn Jetelina, Ph.D., M.P.H., and Preeti Malani, M.D.) ranked the risks — on a scale of 1 to 10 — of between 0 and 7 depending upon age, health status and geographic location. One wouldn’t rank the risk because the data isn’t clear.

Some researchers, including Eric Topol, M.D., are extremely concerned because the variant is so contagious.

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The latest on monkeypox: rates, preparedness

On June 30, Texas’s department of health reported multiple cases of monkeypox in people who hadn’t traveled outside the United States, suggesting the outbreak of the disease is expanding to different parts of the country.

So how worried should Americans be? Most are currently at low risk for the disease, but that could change, Celine Grounder, M.D., an infectious disease specialist at New York University’s Grossman School of Medicine told CBS News on June 28.

Monkeypox is spreading predominantly among men who have sex with men, but it could spread to other communities, Dr. Grounder said. The World Health Organization said on June 25, that monkeypox wasn’t a public health emergency of international concern, but the WHO said that may change if more cases emerge globally in the coming weeks.

As of June 30, the CDC said there have been 396 confirmed cases in the U.S. in 30 states and the District of Columbia. There were 4,177 cases reported in Europe, with the majority of cases reported in the past two months.

Monkeypox is caused by an orthopoxvirus and is a cousin of smallpox. Until recently, monkeypox has rarely been detected outside of west and central Africa. Though in most cases it is mild, the disease can be serious and even deadly for the immunocompromised, pregnant women and children. U.S. health officials have stepped up calls to clinicians and the public to know what the signs and symptoms are of the disease. They include fever, headache, muscle aches, swollen lymph nodes and a rash that can look like blisters. Transmission occurs through direct contact with the rash or bodily fluids like saliva and prolonged face-to-face contact through respiratory droplets.

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