Advocacy Update

• CDC Announces Monkeypox Specimen Guidelines, PCR Test
• CAP Lead Pathology Delegation to Address Upcoming Pathology Shortages at AMA 2022 Annual Meeting
• Schooling Pathology Residents on PathPAC
• New Month, New Advocacy Quiz 

The Centers for Disease Control and Prevention (CDC) released specimen collection guidelines and PCR test procedures for monkeypox virus on May 31. The CDC recommended that laboratories with suspected monkeypox virus specimens contact their state or territorial public health department (contact list) or the CDC Emergency Operations Center (EOC) at 770-488-7100 for guidance. Additionally, the CDC published a Real-Time PCR test procedure to detect non-variola orthopoxvirus.

The CDC provided the following guidelines for clinical laboratories when collecting specimens for suspected monkeypox virus:

• Collect at least two dry swabs from the same lesion.
• Swab or brush lesion vigorously with two separate sterile dry swabs. Use a sterile nylon, polyester, or Dacron swab with plastic, wood, or thin aluminum shaft. Do not use other types of swabs.
• Place swabs in individual sterile containers. Do not add any transport media.
• Refrigerate (2–8°C) or freeze (-20°C or lower) specimens within an hour after collection. Store refrigerated specimens for up to 7 days and frozen specimens for up to 60 days.
• Send refrigerated specimens within seven days of collection, and ship frozen specimens within 60 days of collection. Specimens that are greater than 8°C upon receipt will be rejected. Ship on dry ice as category B.
• Send both swabs to the state or territorial public health laboratory. All specimens should be sent through the state or territorial public health department unless authorized to send them directly to CDC.
• A state public health laboratory may test one of the paired dry swabs for presumptive results. In addition, CDC can provide monkeypox virus-specific testing on the second dry swab specimen if the first dry swab is non-variola orthopoxvirus positive at the state or territorial public health laboratory.

After consultation, laboratories can send appropriately collected specimens to their state or territorial public health laboratory for real-time polymerase chain reaction (PCR) testing. For more information, see the CDC Laboratory Process for Monkeypox Virus Testing.

Public health laboratories have the capacity for the current testing demand; but released their testing procedures in the event additional testing is needed.

The CDC real-time PCR test procedure to detect non-variola orthopoxvirus is intended for international partners and any laboratories interested in pursuing a laboratory-developed test (LDT). This procedure includes sequence information for primer and probe development and cycling conditions.

This assay is designed to detect non-variola orthopoxviruses, including the monkeypox virus. It is not intended to specifically detect monkeypox virus or differentiate monkeypox virus from the other orthopoxviruses this assay detects. Clinical presentation and positive test results from a non-variola orthopoxvirus assay are adequate for treatment, and laboratories should notify the appropriate state or territorial public health authorities of positive results.

The CAP will lead a delegation of pathologists at the annual 2022 American Medical Association (AMA) Special House of Delegates (HOD) Meeting to set policy affecting the practice of medicine from June 10-15 in Chicago, IL. The CAP-led Pathology Section Council will discuss clinical applications of pathology for medical students, residents, and fellows during the meeting, as the vast majority of GME funding comes from the federal Medicare program. Recently CAP members encouraged legislators to increase Graduate Medical Education (GME) funding to increase residency slots, which is key to addressing critical shortages of pathologists in the coming years.

Additionally, the AMA, the CAP, and other medical professional groups also developed a set of principles to guide advocacy efforts on Medicare physician payment reform. The group wants to create substantial changes to the payment system to improve the financial viability of physician practices and reduce its administrative burdens. The AMA and the group asked Congress to work with physician stakeholders to put the payment system on a sustainable path.

Sang Wu, MD, FCAP, Chair of the PathPAC Board of Directors, is personally invested in educating pathology residents on the important role of the CAP’s political action committee (PAC), early in their careers.

One of Dr. Wu’s main focuses for the year is increasing PathPAC engagement levels among pathology residents. He has given “PathPAC 101” presentations to the residency programs at Baylor College of Medicine, McGovern Medical School, and Beth Israel Deaconess/Harvard Medical School and has several more presentations planned this summer. At these informational gatherings, Dr. Wu provides a general overview of the CAP’s Advocacy approach, and where exactly the PAC fits.

In a recent presentation to Beth Israel Deaconess/Harvard Medical School residents, Dr. Wu shared that PathPAC serves as an integral tool in cultivating strong relationships on Capitol Hill. These relationships with members of Congress allow pathologists to give first-hand accounts of a policy’s impact on their patients and their practices.

Several health care issues, from Graduate Medical Education slots to the physician fee schedule, fall under Congressional jurisdiction. PathPAC facilitates opportunities for CAP members to educate key Congressional players on the unique value of the pathology profession. These interactions, and PathNET’s robust grassroots efforts, have helped secure many legislative victories for the CAP over the years.

Dr. Wu, who also serves as an advisor for the CAP Residents Forum Executive Committee (RFEC), plans to continue leveraging this network to educate and activate the next generation of pathology advocates and PAC supporters.

It’s a new month and here’s your chance to take an all-new June advocacy news quiz! Last month over 130 members took the quiz. See how you compare against your fellow CAP members and brag about your top scores on social!

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