Good morning. Welcome, Nexios today. It's Thursday, August 4th. I'm Nailibutu. Here's

what we're covering today. Back to school could mean disease outbreaks beyond COVID. Plus,

credit card balances are soaring. But first, is it too late to fix our response to monkey

box? That's today's one big thing. California is the latest state to declare a state of emergency

over the monkey box outbreak. Earlier this week, the Biden administration named a White House

coordinator to manage the federal response. The CDC says more than 6,600 U.S. cases of monkey

box have been reported since May. And as that number grows, so does pressure for more government

action. Tina Reed is a health care editor for Axios. Hey, Tina. Hi, Nailibutu. Tina, monkey

box is rarely fatal in the U.S. But we know it can cause terrible pain for patients who contract

this. Why are some people saying the government response still has been inadequate so far? In many

ways, it felt like deja vu from the beginning of COVID. But what we saw was really a slow response

in the lack of clear communication. It was very difficult to find testing and treatment. Data

has been piecemeal. And then there's been this very poor coordination between local state and

federal governments on this. In what's the situation with vaccines? This story has been very different

geographically. Some cities, there's been very high demand for vaccines. For instance, in San Francisco,

the San Francisco AIDS Foundation clinic has a 10,000 person waiting list for vaccines as of Tuesday

this week. However, our Axios locals team has also found that in some states, they really haven't

asked for their entire allocation of vaccines and demand has been much lower. So it's been very

different depending on where you are in the U.S. Tina, your team's also reporting that people are

having trouble finding treatment when they do test positive for monkey box? Yes. So there's still a lot

of confusion among the provider community and a lack of clarity about where to get treatments.

And so meeting the patient demand for treatment has led some clinics simply to just not offer

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