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Comment by scythe | Hacker News Reader

>someone who couldn’t get a monkeypox test because she is not a gay man.

This is bad, of course. But I feel like you buried the lede. Did she have monkeypox?

>it’s possible that it is only considered rare because they’re not testing.

Unlike COVID-19, monkeypox has frank symptoms (welts) that clearly distinguish it from other diseases. It cannot be mistaken for much else. Therefore, only a certain fraction of cases (the least severe) are even candidates to be missed, since I find it hard to believe that even the "medically reluctant" would not visit a doctor when they find themselves developing a monkeypox rash.

EDIT: to another poster's comparison with AIDS, it's my understanding that the incubation period for monkeypox is not months long as happens with HIV, either.

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There was a story on NPR a couple days ago where they were talking to a man that had Monkey Pox. He went to the doctor and told him he was pretty certain he had it. The doctor wouldn't even order the test. There was a fair amount more to the story but, if I recall correctly, he had to go to like 4 different doctors to even get one to order the test; and it came back positive.

They then went on to discuss it with (someone related to the medical / testing field in some way) who explained that it's very hard to order a test for; something about there being a limited number of labs that can test for it or some such. And doctors needed to justify the test and would likely be on the phone for an hour just to get it ordered. As such, a lot of doctors just... won't, because it's such a commitment of time/effort to do so.

Edit: I think this is the story (it was the radio when I encountered it) https://www.npr.org/sections/health-shots/2022/06/25/1107416...

> Providers have to go out of their way to order a test. They have to receive permission and instructions from local or state labs, Nuzzo says. The process is cumbersome and often time-consuming. Sometimes a doctor has to sit on the phone for hours.

> explained that it's very hard to order a test for; something about there being a limited number of labs that can test for it or some such. And doctors needed to justify the test and would likely be on the phone for an hour just to get it ordered

This was also a significant concern early in the COVID outbreak, and tests are ubiquitous now. (And a head-in-the-sand attitude coming from top policy-makers didn't exactly help, either.) So hopefully it can be addressed down the line, just as COVID was.

> They then went on to discuss it with (someone related to the medical / testing field in some way) who explained that it's very hard to order a test for; something about there being a limited number of labs that can test for it or some such. And doctors needed to justify the test and would likely be on the phone for an hour just to get it ordered. As such, a lot of doctors just... won't, because it's such a commitment of time/effort to do so.

The doctors need to explain this to the patients then, but that's probably also too much effort for them.

On the contrary, it could be easily mistaken for herpes, molluscum, warts, syphilis, acne, insect bites... This outbreak doesn't usually have the severe rash that's characteristic of classic monkeypox.

Here is the tweet I saw; https://twitter.com/ahandvanish/status/1541214341558636547

It's stated that their whole family has symptoms. I agree, anyone who has symptoms should be able to get a test if available. In the case where not enough tests are available I would prefer a probabilistic approach (e.g. multi-armed bandit).

Also unlike HIV/AIDS we already have a pretty effective vaccine in the form of the Smallpox vaccine:

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/smallpox...

People in high risk groups should look to get vaccinated.

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