Wide Variation in Protocols, Testing Delays Reported During the 2022 Mpox Outbreak
March 2, 2026
The 2022 mpox outbreak exposed uneven readiness across U.S. health systems. Survey data presented at IDWeek reveal that testing access, delayed results, and inconsistent communication were the most significant institutional challenges. Even large academic centers struggled when turnaround times stretched to a week, undermining contact tracing and containment. While many hospitals adapted lessons from COVID-19 to mobilize faster, experts such as Boghuma Titanji warn that continued erosion of public health infrastructure may leave systems more vulnerable today. Preparedness gains are real but fragile.
The institutional response to the 2022 mpox outbreak offers a mixed portrait of progress and vulnerability. Survey findings presented at IDWeek indicate that U.S. hospitals faced significant obstacles in testing access, result turnaround time, and internal communication during the first large-scale mpox outbreak in nonendemic countries.
Respondents from predominantly large academic medical centers reported that delayed diagnostic results, often stretching several days to a week, hindered timely isolation, contact tracing, and clinical decision-making. In the early phases of the outbreak, many institutions lacked in-house testing and relied on state laboratories or the Centers for Disease Control and Prevention, compounding delays. Rapidly evolving guidance created additional communication challenges, forcing institutions to continually update frontline teams while maintaining coordination with public health departments.
To their credit, many health systems leveraged lessons learned from COVID-19. Faster mobilization of infection prevention teams, adaptable outbreak protocols, and strengthened relationships with local health authorities reflected institutional learning under pressure. Yet the survey also revealed regional disparities. Institutions in parts of the southern United States were more likely to report staffing and material shortages, highlighting persistent structural inequities in preparedness capacity.
External observers have raised a cautionary note. Boghuma Titanji of Emory University School of Medicine has warned that reductions in federal and state public health infrastructure since 2022 could further weaken outbreak response capabilities. Gains achieved during the pandemic era may erode without sustained investment.
The mpox experience underscores a central tension in U.S. preparedness. Health systems demonstrated resilience and adaptive capacity, but these strengths rest on funding, laboratory infrastructure, and workforce stability. Recognizing both effective strategies and persistent weaknesses is essential. Without continuous investment, preparedness risks becoming episodic, improving after each crisis only to recede before the next.