Labcorp and Quest don’t dispute that in many cases, their phlebotomists are not taking blood from possible monkeypox patients. What remains unclear, after company statements and follow-ups from CNN, is whether the phlebotomists are refusing on their own to take blood or if it is the company policy that prevents them. The two testing giants say they’re reviewing their safety policies and procedures for their employees.
“This is absolutely inexcusable. It’s a grave dereliction of duty,” said David Harvey, executive director of the National Coalition of STD Directors, which represents 1,600 sexual health clinics in the US, some of which have phlebotomists from commercial labs including Labcorp and Quest in their offices. The commercial labs employ tens of thousands of phlebotomists — health care professionals who draw blood — in various types of clinics and doctors’ offices across the country, as well as in their own patient service centers.
Although monkeypox is diagnosed by swabbing lesions, blood tests are necessary to differentiate the virus from other types of infections, infectious disease experts say. Harvey said doctors at sexual health clinics have had to find workarounds when phlebotomists have refused to take blood from suspected monkeypox patients.
“We can’t afford a delay in diagnostic testing because commercial labs aren’t doing the right thing,” he said.
Harvey added that it feels like the refusals are “a modern-day example of discrimination” — a viewpoint shared by others.
“This reminds me of the olden days when people didn’t want to care for HIV patients,” said Arthur Caplan, a bioethicist at New York University.
Monkeypox cases in the US have been mainly among men who have sex with men, and when a technician does not draw blood, it “perpetuates more stigma and fear and anxiety” for a virus that’s already stigmatized, added Dr. Peter Chin-Hong, a member of the California Department of Public Health’s Monkeypox Virus Scientific Advisory Committee who is caring for monkeypox patients.
Chin-Hong, an infectious disease specialist at UCSF Health, said men are avoiding getting tested for the virus for fear of being stigmatized.
“The fact that phlebotomists are afraid of taking specimens makes it even more unappealing for someone to ask for a monkeypox test,” he said. “So this is going to make it even worse.”
‘Some of our phlebotomists have been scared’
Blood tests are necessary not only to differentiate between monkeypox and other infections but to test for other sexually transmitted infections, such as syphilis, since people with monkeypox sometimes have STIs.
If suspected monkeypox patients don’t have their blood drawn, “the standard of care is not being followed,” said Harvey, the director of the sexual health clinics association.
In an email to CNN on Monday morning, a Quest spokeswoman wrote that “we follow CDC guidelines that state that patients with confirmed or suspected monkeypox infection should be isolated. Once an individual is out of isolation, we will provide service for them.”