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After a couple years of living with COVID-19, UC Santa Barbara student Alex Niles heard about the monkeypox outbreak. “Here we go again,” he thought.

Niles, who is president of the UC Student Association, knew monkeypox was transmitted very differently than COVID-19 and generally posed less risk. But he began to notice concern percolating within UC Santa Barbara’s student body.

“There’s a good share of folks who are definitely like ‘OK, I’m going to get vaccinated, I’m going to start taking precautions,’ ” Niles said.

With the monkeypox outbreak coming amid the ongoing COVID-19 pandemic, California colleges find themselves trying to control the spread of two infectious diseases at once. Vaccines for monkeypox are in short supply, and an infections can take students away from their studies for weeks. But some administrators and professors say their experience tackling COVID-19 has made them better prepared for the new threat.

“For the last two and a half years with COVID, we have, you know, more people in our public health teams. We have better connections with our local public health departments,” said University of Southern California chief health officer Sarah Van Orman. “That’s really the infrastructure that we’ll be able to leverage, whether it’s monkeypox, meningococcal disease or chickenpox or tuberculosis.”

Campuses across the Cal State system have launched awareness campaigns to educate students on how to prevent monkeypox infection. And the UC Office of the President has advised its campuses to provide treatment and academic support for those infected.

Not all campuses have vaccines, however, and those that do are limiting access to certain groups considered at high risk for the disease. To obtain larger supplies, they’ll have to work with local public health departments to acquire them when they are available. That date could be a few months away.

“It really is a system-level challenge that there just is not enough vaccine availability right now,” said David Souleles, the COVID-19 Response Team director at UC Irvine. “Health departments are having to really closely manage how it gets used and distributed so that it’s hitting the highest risk populations first.”

California has seen 4,453 cases of monkeypox as of September 13 — 6.8% of which were in people between the ages of 18 and 24. Several colleges around the country have confirmed the presence of monkeypox cases as students headed back to class nationwide. With vaccines in short supply, many California campuses are focusing on meeting the needs of students who test positive by setting aside isolation beds and providing academic accommodations.

While campuses should prepare to support students who test positive for monkeypox, there is no need for extreme measures like those previously taken against COVID, which is a global pandemic, Souleles said.

“The approach and the role that universities will play in a monkeypox response will be a little bit more along the lines of the traditional response we would have had whenever there was any other kind of communicable disease on campus,” he said.

Tailoring prevention efforts to the disease is critical, experts say, as the two are transmitted very differently.

Unlike COVID-19, monkeypox is only transmitted by close skin-to-skin contact, said Van Orman. Sitting next to somebody in class with the illness — or even living in the same dorm — is unlikely to lead to infection, she said.

Still, vaccines are the best way to curb the spread of monkeypox, whether at the campus or national level, experts say.

“Really promoting the availability of vaccination, both pre-exposure but also after someone’s exposed, that’s going to be our key in stopping this from spreading,” Van Orman said. USC has already seen cases on campus, she said, but the spike in cases nationally and locally has started to flatten.

UC San Francisco has already secured a vaccine supply, said campus spokesperson Laura Kurtzman. And everyone on the campus — including their 3,200 graduate students in the health sciences — can get the vaccine if they fall into one of several categories.

Those include laboratory workers who perform monkeypox testing, people who have been in close contact with a positive case and men or trans people who have sex with men, a group that has been disproportionately affected by the disease. Similar groups of students would likely be prioritized on other campuses throughout the state, as vaccines become available.

Beyond vaccination, most UC campuses have tests for students who want to take them. Other universities are still working to provide testing and treatment. Cal State San Marcos, for example, has applied to be a Centers for Disease Control Clinical Investigation Site, which would enable them to test students.

Unlike with COVID, campuses are not requiring students to test, and experts say there isn’t a need for widespread testing.

“If there’s somebody who has monkeypox in your dorm or in your classroom or in your workplace, you’re probably not going to know about it, and nor do you need to know about it,” said Van Orman. “That person does not pose a risk to you.”

While monkeypox poses far less of a health risk than COVID-19, experts say the symptoms can be painful and debilitating. And the isolation period for someone with the disease can be a lot longer than the five-day minimum for COVID — sometimes lasting as long as four weeks.

Prolonged isolation can mean longer time away from school, making academic accommodations important, Souleles said.

“That has a much more significant impact on a student’s academic progress and performance, particularly here at UCI, where we’re on a 10-week quarter system,” he said. “We want to make sure that we link our students with our disability services team to work out any accommodation needs…to allow them to manage their academic progress while they isolate.”

Some campuses are relying on public health measures they already took in response to COVID to help them control the spread of monkeypox. UC Irvine, for example, has 166 isolation beds set aside during the pandemic. A portion of those will now be available to monkeypox patients.

UC San Diego has added monkeypox to its wastewater surveillance program, which tests sewage in the area to spot early signs of COVID-19 surges. And UC Davis’s student health center has formed a public health unit – made up of a physician, a public health coordinator and a public health nurse – to combat infectious diseases, including monkeypox.

Communication between university administrators and students is critical, Niles said, especially as “campuses are an authoritative voice on health information.” Niles said he hoped his university would communicate more effectively about monkeypox than it did with COVID.

“Every aspect of the pandemic response, students had to engage so much and advocate for ourselves to ensure that things were handled in the right way,” Niles said. “It fell on students to make sure that academic responses were inclusive for all students, that personal protective equipment was available, that students had the basic needs, you know, attended to.”

The UC Office of the President says it has encouraged campuses to increase outreach and education, and USC has a monkeypox website it frequently updates.

“The other key role I think universities have is, you know, providing good information,” Van Orman said. Universities should avoid any messages that might create stigma around the disease, she said. “Anything that identifies people or kind of shames them based on the basis of identity is bad public health because it prevents us from getting good information and helping anyone who is impacted.”

Campuses on the quarter system still have time to prepare before students return later this month, Souleles said. In the meantime, they can keep an eye on what their counterparts on the semester system are doing.

“I don’t think we’re gonna see the thousands of cases we’ve seen with COVID-19,” he said. “I expect this to be a much smaller occurrence.”

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