As health authorities in the US warn that monkeypox must be taken more seriously, at-risk communities continue to face a limited supply of vaccines and lack of access to testing, while those contracting the virus in the US have struggled to receive treatment, according to reports.

“This is something we definitely need to take seriously. We don’t know the scope and the potential of it yet, but we have to act like it will have the capability of spreading much more widely than it’s spreading right now,” Anthony Fauci, Joe Biden’s top medical adviser, said on CNN this weekend.

Scott Gottlieb, the former US Food and Drug Administration commissioner, told CBS’s Face the Nation: “I think the window for getting control of this and containing it probably has closed. And, if it hasn’t closed, it’s certainly starting to close.”

There were 1,814 confirmed cases of monkeypox in the US as of Friday afternoon, according to the Centers for Disease Control and Prevention (CDC). Fauci and Gottlieb both expressed their belief that the actual numbers were higher – and stressed the need for testing.

Fauci said the data was “very likely an undercount”. He told CNN: “Whenever you have the emergence of something like this, you are always probably looking at what might be, might be, we don’t know, the tip of the iceberg, so that’s the reason why we’ve got to get the testing out there in a much, much more vigorous way.”

Gottlieb said that the authorities are probably detecting “just a fraction” of cases. “We had, for a long time, a very narrow case definition on who got tested and by and large, we’re looking in the community of men who have sex with men and at STD clinics… But it’s a fact that there’s cases outside that community right now. We’re not picking them up because we’re not looking there,” Gottlieb said.

Monkeypox is not a sexually transmitted virus; it spreads “through close, physical contact between individuals”, according to the New York state health department, which added: “This means anyone can get monkeypox. However, based on the current outbreak, certain populations are being affected by monkeypox more than others, including men who have sex with men.”

More than 132,000 doses of vaccine against monkeypox have been taken out of the US strategic stockpile and sent across the country, but health authorities estimate that more than 1.5 million US residents qualify for this two-dose vaccination, according to CNN.

The US has ordered almost 7 million doses, but the majority will not arrive for months, leaving many at risk, Forbes reported.

New York City, for example, “does not have sufficient vaccine supply to reach the number of people who need it [to] protect themselves”, health department officials said Friday. The city has now seen 461 cases of monkeypox, as the location of the greatest number of confirmed US cases.

Monkeypox patients have described numerous barriers in accessing care. Gabriel Morales told the New York Times that it took him nine hours of inquiries just to secure a test.

After Morales returned home, he never received a phone call with his results and worked to obtain antiviral treatment and pain medication.

“It was just the worst pain I’ve experienced in my life,” Morales told the newspaper.