In the past month, the number of people identified with monkeypox in New York has jumped more than 30-fold, from 10 to 336, a figure that surely underestimates the incidence rate, given that many cases remain undiagnosed. During this period, Mayor Eric Adams was busy celebrating Pride, throwing a party at Gracie’s Mansion and reminding the world how deeply New York embraces the LGBTQ community, while so many other parts of the country seem bent on regressing to the pre-Stonewall era.
“Here in New York,” the mayor declared, “we are happy to say ‘we are gay.'”
But “we” don’t get monkeypox, a disease that mostly (and currently) affects men who have sex with men. The lack of public information about the disease, along with the difficulties surrounding access to the vaccine, showed how the professed love and support coming from the left can seem rhetorical.
In the most liberal parts of the country, we are seemingly in the midst of a new wave of liberation and understanding around sexual and gender identity that is transforming the social order and expanding our cultural advantage. Movies like Fire Island, to take a recent example, a romantic comedy set among a group of quirky, ethnically diverse friends during a hedonistic week in the Pines, enjoy mainstream popularity that would have eluded them even a decade ago. Yet, at the same time, here we are, decades after the AIDS crisis, unable or unwilling to effectively manage a virus that disproportionately affects gay men.
Although monkeypox has not killed anyone in the United States, it carries symptoms similar to smallpox — fever, chills, muscle aches, a severe rash that has the potential to disrupt a patient’s life for weeks. Among gay men in New York, the epicenter of the nationwide epidemic, anxiety is growing. “This summer, society is caught up in this summer,” Michael Donnelly, a public health activist, told me. “There’s a real sense of injustice because we just went through it. So many of us tried to do the right thing.
“That” is, of course, Covid, which gay men have taken very seriously; from the earliest days of vaccination, Hell’s Kitchen, home to many, maintained one of the highest inoculation rates in the city.
What you need to know about the monkeypox virus
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What is monkeypox? Monkeypox is a virus endemic to parts of Central and West Africa. It is similar to smallpox, but milder. It was discovered in 1958 after an outbreak in monkeys kept for research, according to the Centers for Disease Control and Prevention.
What are the symptoms? Monkeypox produces a rash that starts as flat red spots that become raised and filled with pus. Infected people may also have fever and body aches. Symptoms usually appear after six to 13 days, but may take up to three weeks after exposure to appear and may last two to four weeks. Health officials say smallpox vaccines and other treatments can be used to control an outbreak.
How contagious is it? The virus is spread mainly through bodily fluids, skin contact and respiratory droplets, although some experts suggest it can sometimes be airborne. It does not normally lead to large outbreaks, although this year it has spread in unusual ways and among populations that were not vulnerable in the past.
What is the situation in the United States? Experts say the rapid spread of monkeypox in the country and the government’s sluggish response raise questions about the nation’s preparedness for pandemic threats. Tests won’t be readily available until later this month, and vaccines will be in short supply for months. The official number of cases, now in the hundreds, is likely a vast underestimate.
Mr. Donnelly is a data scientist by trade who served as a consultant to New York State during the first year of the pandemic. So his friends turned to him for help in figuring out what to do about monkeypox. One friend, he said, has been suffering for eight days and still hasn’t received his test results. “They’re getting mixed messages. Is this an STI or not?” Vaguely enough, the Centers for Disease Control explains that people with monkeypox “generally report close, prolonged physical contact” with others who contracted the virus.
“The system has been extremely slow to respond to this crisis,” Mr Donnelly continued. “There is an antiviral treatment for it, but people are not getting treatment because of regulatory hurdles. And then there are other people who would settle for pain management, but I think doctors just don’t realize how excruciatingly painful it is – it’s knives every time you go to the toilet – and people go home with prescriptions for Tylenol.”
On Tuesday, the third time the city health department offered registration for vaccination appointments, the scheduling site quickly shut down, prompting Eric Boettcher, a city councilman who represents Hell’s Kitchen and Chelsea and who knows four people who contracted the virus in last week , to write on Twitter: “Ah and the website immediately crashes. Who could have predicted this? a: EVERYONE.”
The first few cases where vaccine appointments became available in late June and again earlier this month were also beset by problems. On the morning of July 6, the city’s health department tweeted that another round of appointments was coming up, but didn’t reach out again until early afternoon, at which point officials announced that a “bug” had caused the appointments to already be taken.
Vaccine supply is insufficient to meet demand, largely because hundreds of thousands of doses have been sequestered in Denmark as a result of the FDA’s refusal to release them on the grounds that it had not recently inspected the factory where they were manufactured. even though the agency’s equivalent in the European Union had done so.
“I think it’s embarrassing for us as a country that right after the Covid-19 pandemic we’re caught off guard by another pandemic and we’re not able to deal with it properly,” Mr Bottcher told me.
Facing mounting pressure, Mr. Adams called on the Biden administration earlier this week to deliver more vaccines to the city beyond those already distributed, which includes 14,500 new doses that have just arrived that the city plans to distribute to every neighborhood. But that figure represents roughly 10 percent of the national total, even though the city has 32 percent of the country’s cases. Questions surrounding equitable access are also troubling, given that the city’s reliance on Twitter to spread information about vaccine availability has privileged those with time to linger online.
Among those lucky enough to receive their photos, many were able to book appointments through advance information from a whisper network made up of well-connected men in technology, health and media, when a much wider demographic would have benefited from the use of a broad public information campaign.
With talk of diversity, equity and inclusion in almost every sector of modern life, is this really the way forward?
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