AIDS, COVID-19 cast shadow over state response to monkeypox

LILO H. STAINTON, HEALTH CARE WRITER | JULY 18, 2022

NJ Spotlight News

Electron microscope image from Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right.

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Monkeypox cases may still be limited in New Jersey, where just over two dozen people have been diagnosed with the disease, but some health advocates in the gay community — which has borne the brunt of the national outbreak — would like to see a more robust state response.

Fueling this frustration is their knowledge of history, several advocates said, and how public health professionals were slow to address the HIV/AIDS epidemic as it emerged in the 1980s. Some argue state and federal officials could also have done more to control COVID-19 early on.

“We’re not responding adequately” to monkeypox, said Rutgers School of Public Health Dean Perry N. Halkitis, who is gay. “Exposure rates are up and it’s just a matter of time until this reaches the general population.”

New Jersey was reporting 27 monkeypox cases as of Thursday, five more than Wednesday, according to the state Department of Health. The monkeypox virus — which is similar to smallpox and cowpox — is spread through contact with skin or bodily fluids and can cause rashes, blisters, fever and other flu-like symptoms, but is rarely fatal. Smallpox vaccines provide some protection and are recommended for those who have been exposed or are particularly at risk for infection.

State health officials — who announced the first case in New Jersey on June 20 — have alerted providers about the outbreak and sent guidance to local health departments, the department’s deputy communications director Nancy Kearney said Friday. They have also posted warnings and fact sheets on social media, with more information and resource links on the department website.

Kearney said the state has smallpox vaccines available for those who are exposed and consult a clinician, who will work with the local health department to arrange for the two-dose immunization. Additional doses are expected from the Centers for Disease Control and Prevention, she said, adding that state officials are working with local health departments to share information about vaccine use, testing and treatment for those who are positive.

“We will continue engaging key partners to amplify awareness of the virus and the availability of the vaccine,” Kearney said. “As we get additional supply we will continue to expand access to the vaccine.”

Lack of critical information

But Halkitis and others said the message is not getting through. “Every gay man I’ve spoken with — friends, acquaintances, colleagues — feel like they have no information on where they are supposed to go to get a vaccine for monkeypox in the state of New Jersey,” said Halkitis, who published a Q&A online about the virus and shared it with colleagues and students at the Rutgers School of Public Health.

While monkeypox may be primarily spreading among gay and bisexual men this time — America’s only previous outbreak, in 2003, involved 47 cases in six states — experts stress it is not restricted to this population. It is also not a sexual disease, in the sense that it can be spread by any skin-to-skin contact with an infected person. The virus is believed to be initially passed from infected animals — small primates, like monkeys, and rodents — to humans that handle them, according to the CDC.

“It could have been a straight wedding” that sparked the current outbreak here, Halkitis said. “We have to stop thinking about this as a gay disease. Let’s just get the vaccine out to everyone. That’s how you avoid stigma.” “And we have to stop all the sex talk,” he added. “It’s about being close to someone. You could get monkeypox sitting on the ferry next to someone.”

New York City has been criticized for its efforts to distribute vaccines, but Halkitis said at least the city has made a public push to protect people who are more at risk. Those born before 1972, when smallpox vaccines were standard, may have some protection, he added.

“Is this a deadly virus? No,” Halkitis said, although some immunocompromised people might die. “Nonetheless, you don’t want it spreading. Get it done, get rid of it now,” he said. “We shouldn’t get into the pattern of letting these pathogens emerge in our country.”

Case numbers double nationwide

The outbreak has not struck widespread public fear like in the early days of the coronavirus pandemic, but monkeypox cases have nearly doubled nationwide in the past week to 1,469 as of Thursday, according to the CDC. The agency recommends the use of smallpox vaccines for those who are at risk or live with someone who has contracted the disease, and the Biden administration pledged in late June to distribute at least 1.6 million shots nationwide.

Gay health advocate Jay Lassiter is also underwhelmed by New Jersey’s handling of the monkeypox outbreak and has been tweeting his frustrations at public officials but has yet to prompt a response. “I’m terrified that the Department of Health is going to wait for a bunch of gay people to get really sick with monkeypox before the meter even starts running,” he said.

Lassiter said that while cases here may seem low, the Jersey Shore is a popular destination for gay men from New York City, where most of New York’s 414 cases have been diagnosed and infections grew 26% in one day last week. And many New Jerseyans have second homes in the city or Florida, another hot spot with 72 cases as of Thursday, he said.

“Vaccines should be readily available for anybody who feels like they’ve been exposed to this illness,” said Lassiter, who compared the current confusion to the early days of the COVID-19 vaccine rollout, when people struggled to get access to shots. “And in the absence of a path, or of a plan, people start getting antsy and paranoid and scared.”

“We’ve seen this play out before with AIDS and then we got a refresher course with COVID and here we are, literally ignoring everything we were supposed to have learned,” Lassiter said. “I can scarcely imagine a less constructive reaction.”

Criticism of Murphy

Lassiter also criticized Gov. Phil Murphy, an eager advocate for gay rights and causes, for his relative silence on the issue. “There’s a fine line between pandering and being a true ally. I see Governor Murphy showing up at LGBT events all the time literally wearing a rainbow lei to signal that he is on our side,” he said. “If you can’t be with me when I’m fighting monkeypox then I don’t want you with me when I’m dressed up in a tuxedo swilling overpriced champagne.”

Murphy’s office declined to respond to a request for comment Friday afternoon.

Halkitis said it is possible the slow response reflects public officials’ attempt to avoid stigmatizing the gay community, but he worries that the silence will endanger public health. People who have resources will find a way to get vaccinated, he added, traveling to New York City or Philadelphia if needed, and can more easily access a doctor for testing, but he is worried about people without means who may have few options and little support, who could benefit from more public guidance.

“You’ve got an attentive, eager audience,” Halkitis said, arguing that the COVID-19 pandemic has increased public awareness and understanding of contagious diseases. “Use that enthusiasm to the advantage of the health of the state.”

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published this page in News and Politics 2022-07-18 02:51:41 -0700