The Role of a Tertiary Level Safety Net Hospital in New York City's 2022 Mpox Outbreak

Anthony J Lo Piccolo¹, Andrew Wallach², Tristan D McPherson³, Ofole Mgbako⁴, Ian Fagan⁵, Robert A Pitts⁶, Amanda Klinger⁷, Mary Foote⁸, Elizabeth A Garcia⁹, Jason E Zucker¹⁰, Justin Chan¹¹, Douglas B Bails¹², Gabriel M Cohen¹³, Patricia Ann Tennill¹⁴, Marcia Wong¹⁵, Vikramjit Mukherjee¹⁶

Affiliations

¹ Anthony J. Lo Piccolo, MS, is a Research Coordinator, Division of Infectious Diseases & Immunology, NYU Langone Health, and a Research Coordinator, NYC Health + Hospitals (NYC H+H)/Bellevue, New York, NY.
² Andrew Wallach, MD, is Clinical Director and Chief Medical Officer of Ambulatory Care, NYC H+H/Bellevue, and an Associate Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
³ Tristan D. McPherson, MD, is Medical Director, Viral Hepatitis Program, New York City Department of Health and Mental Hygiene (NYC DOHMH), and a Clinical Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁴ Ofole Mgbako, MD, is Section Chief of Infectious Diseases, NYC H+H/Bellevue, and an Assistant Professor, Department of Population Health and Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁵ Ian Fagan, MD, is Medical Director of Inpatient Medicine Units, Division of Hospital Medicine, NYC H+H/Bellevue, and a Clinical Associate Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁶ Robert A. Pitts, MD, is an Infectious Disease Specialist, Department of Internal Medicine and Infectious Diseases, NYC H+H/Bellevue, and a Clinical Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁷ Amanda Klinger, MD, is Associate Medical Director of Special Pathogens Program, Division of Hospital Medicine, NYC H+H/Bellevue, and a Clinical Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁸ Mary Foote, MD, MPH, is Medical Director, Bureau of Healthcare and Community Readiness, NYC DOHMH, New York, NY.
⁹ Elizabeth A. Garcia, PharmD, is Deputy Director of HIV Clinical Technical Assistance, NYC DOHMH, New York, NY.
¹⁰ Jason E. Zucker, MD, is an Assistant Professor, Department of Medicine, Columbia University, New York, NY.
¹¹ Justin Chan, MD, MPH, is Director of Infection Prevention and Control, NYC H+H/Bellevue, and an Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
¹² Douglas B. Bails, MD, is Chief of Medical Service, Associate Director of Bedside Skills Team, Division of Hospital Medicine, NYC H+H/Bellevue, and a Clinical Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
¹³ Gabriel M. Cohen, MD, is Chief Medical Informatics Officer, Population Health, Infectious Disease Informatics Liaison, NYC H+H/Bellevue, and an Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
¹⁴ Patricia Ann Tennill, BSN, is Associate Director of Nursing, NYC H+H/Bellevue, New York, NY.
¹⁵ Marcia Wong, MD, is a Medical Epidemiologist, Bureau of Communicable Diseases, NYC DOHMH, New York, NY.
¹⁶ Vikramjit Mukherjee, MD, is Medical Director of Special Pathogens Program, Co-Principal Investigator, National Emerging Special Pathogen Treatment and Education Center, and Director of Medical Intensive Care Unit, NYC H+H/Bellevue, and an Assistant Professor, NYU Grossman School of Medicine, New York, NY.

PMID: 36862506
DOI: 10.1089/hs.2022.0120

Free article

The Role of a Tertiary Level Safety Net Hospital in New York City's 2022 Mpox Outbreak

Anthony J Lo Piccolo et al. Health Secur. 2023 Mar-Apr.

Free article

. 2023 Mar-Apr;21(2):146-155.

doi: 10.1089/hs.2022.0120. Epub 2023 Mar 1.

Authors

Affiliations

¹ Anthony J. Lo Piccolo, MS, is a Research Coordinator, Division of Infectious Diseases & Immunology, NYU Langone Health, and a Research Coordinator, NYC Health + Hospitals (NYC H+H)/Bellevue, New York, NY.
² Andrew Wallach, MD, is Clinical Director and Chief Medical Officer of Ambulatory Care, NYC H+H/Bellevue, and an Associate Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
³ Tristan D. McPherson, MD, is Medical Director, Viral Hepatitis Program, New York City Department of Health and Mental Hygiene (NYC DOHMH), and a Clinical Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁴ Ofole Mgbako, MD, is Section Chief of Infectious Diseases, NYC H+H/Bellevue, and an Assistant Professor, Department of Population Health and Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁵ Ian Fagan, MD, is Medical Director of Inpatient Medicine Units, Division of Hospital Medicine, NYC H+H/Bellevue, and a Clinical Associate Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁶ Robert A. Pitts, MD, is an Infectious Disease Specialist, Department of Internal Medicine and Infectious Diseases, NYC H+H/Bellevue, and a Clinical Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁷ Amanda Klinger, MD, is Associate Medical Director of Special Pathogens Program, Division of Hospital Medicine, NYC H+H/Bellevue, and a Clinical Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
⁸ Mary Foote, MD, MPH, is Medical Director, Bureau of Healthcare and Community Readiness, NYC DOHMH, New York, NY.
⁹ Elizabeth A. Garcia, PharmD, is Deputy Director of HIV Clinical Technical Assistance, NYC DOHMH, New York, NY.
¹⁰ Jason E. Zucker, MD, is an Assistant Professor, Department of Medicine, Columbia University, New York, NY.
¹¹ Justin Chan, MD, MPH, is Director of Infection Prevention and Control, NYC H+H/Bellevue, and an Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
¹² Douglas B. Bails, MD, is Chief of Medical Service, Associate Director of Bedside Skills Team, Division of Hospital Medicine, NYC H+H/Bellevue, and a Clinical Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
¹³ Gabriel M. Cohen, MD, is Chief Medical Informatics Officer, Population Health, Infectious Disease Informatics Liaison, NYC H+H/Bellevue, and an Assistant Professor, Department of Medicine, NYU Grossman School of Medicine, New York, NY.
¹⁴ Patricia Ann Tennill, BSN, is Associate Director of Nursing, NYC H+H/Bellevue, New York, NY.
¹⁵ Marcia Wong, MD, is a Medical Epidemiologist, Bureau of Communicable Diseases, NYC DOHMH, New York, NY.
¹⁶ Vikramjit Mukherjee, MD, is Medical Director of Special Pathogens Program, Co-Principal Investigator, National Emerging Special Pathogen Treatment and Education Center, and Director of Medical Intensive Care Unit, NYC H+H/Bellevue, and an Assistant Professor, NYU Grossman School of Medicine, New York, NY.

PMID: 36862506
DOI: 10.1089/hs.2022.0120

Abstract

Similar to the early phases of the COVID-19 pandemic, New York City was the national epicenter of the ongoing 2022 mpox (formerly monkeypox) outbreak. Cases quickly began to rise in July 2022, primarily in gay, bisexual, or other men who have sex with men. Tools in the form of a reliable diagnostic test, an effective vaccine, and a viable treatment option have been available from the onset, although logistically complex to roll out. The special pathogens program at NYC Health + Hospitals/Bellevue, the flagship facility for the largest public hospital system in the United States, collaborated with multiple departments within Bellevue, the hospital system, and the NYC Department of Health and Mental Hygiene, to swiftly establish ambulatory testing, immunizations, patient-centered inpatient care, and outpatient therapeutics. With the ongoing mpox outbreak, hospitals and local health departments must prepare a systemwide response to identify and isolate patients and provide high-quality care. Findings from our experience can help guide institutions in developing a multipronged, comprehensive response to the ongoing mpox outbreak.

Keywords: Diagnostic testing; Hospital preparedness/response; Monkeypox; Mpox; Patient-centered care; Special pathogen preparedness; Tecovirimat.

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The Role of a Tertiary Level Safety Net Hospital in New York City's 2022 Mpox Outbreak

Affiliations

The Role of a Tertiary Level Safety Net Hospital in New York City's 2022 Mpox Outbreak

Authors

Affiliations

Abstract

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Medical