Our country’s response to monkeypox ‌‌has been plagued by the same shortcomings we had with Covid-19. Now 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. Our lapses extend beyond political decision making to the agencies tasked with protecting us from these threats. We don’t have a federal infrastructure capable of dealing with these emergencies.

The failures that got us here fit a now familiar pattern.

Early on, similar to the early days of Covid, testing access for monkeypox was limited, despite ample evidence that monkeypox was spreading in the United States. The Strategic National Stockpile was meant as a hedge against viral contingencies, but when the coronavirus struck, it lacked adequate supplies of testing equipment, ventilators and masks. With monkeypox, the government hadn’t stockpiled enough of the only vaccine, Jynneos, that was indicated for prevention of the disease and considered safe for use. The United States had on hand fewer than 2,400 doses in mid-May, mostly as a hedge against the risk of smallpox, which was the vaccine’s other indication.