Over the past month, the number of people identified with monkeypox in New York City has jumped more than 30 fold, from 10 to 336, a figure that surely underestimates the incidence rate, considering that many cases have gone undiagnosed. During this period, Mayor Eric Adams was busy celebrating Pride, holding a party at Gracie mansion and reminding the world just how deeply New York embraces the L.G.B.T.Q. community, while so many other parts of the country seem bent on a regression to the pre-Stonewall era.
“Here in New York,” the mayor declared, “we’re happy to say ‘we are gay.’”
But “we” are not getting monkeypox, a disease primarily (and currently) afflicting men who have sex with men. The lack of public information about the illness, along with the difficulties around access to the vaccine, have shown how the professed love and support coming from the left can feel rhetorical.
In the most liberal parts of the country we are, ostensibly, in the midst of a new wave of liberation and understanding around sexual and gender identity, one transforming the social order and expanding our cultural vantage. Films like “Fire Island,” to take a recent example, a romantic comedy set among a group of queer, ethnically diverse friends during one hedonistic week in the Pines, enjoy a mainstream popularity that would have eluded them even a decade ago. And yet, at the same time, here we are, decades after the AIDS crisis, unable or unwilling to effectively manage a virus that is disproportionately affecting gay men.
Although monkeypox hasn’t killed anyone in the United States, it brings symptoms similar to smallpox — fever, chills, muscle aches, a violent rash carrying the potential to disrupt a patient’s life for weeks. Among gay men in New York, the epicenter of the outbreak nationwide, anxiety has been mounting. “There’s this pall over the community this summer,” Michael Donnelly, a public health activist, told me. “There’s a real sense of unfairness because we just went through this. So many of us tried to do the right thing.”
The “this” of course, is Covid, which gay men have taken very seriously; from the earliest days of vaccination, Hell’s Kitchen, where many live, maintained one of the highest inoculation rates in the city.
What to Know About the Monkeypox Virus
What is monkeypox? Monkeypox is a virus endemic in parts of Central and West Africa. It is similar to smallpox, but less severe. It was discovered in 1958, after outbreaks occurred in monkeys kept for research, according to the Centers for Disease Control and Prevention.
What are the symptoms? Monkeypox creates a rash that starts with flat red marks that become raised and filled with pus. Infected people may also have a fever and body aches. Symptoms typically appear in six to 13 days but can take as long as three weeks after exposure to show, and can last for two to four weeks. Health officials say smallpox vaccines and other treatments can be used to control an outbreak.
How infectious is it? The virus spreads mainly through body fluids, skin contact and respiratory droplets, though some experts suggest that it could occasionally be airborne. Typically it does not lead to major outbreaks, though it has spread in unusual ways this year, and among populations that have not been vulnerable in the past.
Should I be worried? The likelihood of the virus being spread during sexual contact is high, but the risk of transmission in other ways is low. Most people have mild symptoms and recover within weeks, but the virus can be fatal in a small percentage of cases. Experts say that monkeypox is unlikely to create a pandemic scenario similar to that of the coronavirus.
What’s the situation in the United States? Experts say that the rapid spread of monkeypox across the country and the government’s sluggish response raise questions about the nation’s preparedness for pandemic threats. Tests will not be readily available until later this month and vaccines will be in short supply for months. Official case counts, now in the hundreds, are likely a gross underestimate.
By trade, Mr. Donnelly is a data scientist who served as a consultant to the State of New York during the first year of the pandemic. Because of this, his friends have 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 are getting conflicting messages. Is this an S.T.I. or isn’t it?” Vaguely enough, the Centers for Disease Control explains that people with monkeypox “generally report having close, sustained physical contact” with others who have contracted the virus.
“The system has been creakingly slow in responding to this crisis,” Mr. Donnelly continued. “There is antiviral treatment for this but people aren’t getting treatments because of regulatory hurdles. And beyond that you have other folks who’d settle for pain management, but I think doctors are just not aware of how excruciatingly painful this is — it is knives every time you go to the bathroom — and people are going home with prescriptions for Tylenol.”
On Tuesday, the third time that the city’s health department offered registration for vaccine appointments, the scheduling site shut down quickly, prompting Erik Bottcher, a city councilman who represents Hell’s Kitchen and Chelsea and who knows four people who contracted the virus over the past week, to write on Twitter: “Aaaand the website crashes immediately. Who could have predicted this? a: EVERYONE.”
The first few occasions in which 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 health department said on Twitter that a new round of appointments was on the way, but didn’t follow up again until the early afternoon, at which point officials announced that a “glitch” had resulted in the appointments already being taken.
Vaccine supply has been nowhere near enough to meet demand largely because hundreds of thousands of doses have been sequestered in Denmark, a result of the F.D.A.’s refusal to release them on the grounds that it had not recently inspected the factory in which they were made, even though the European Union’s equivalent of the agency had done so.
“I think it’s embarrassing for us as a country that immediately following the Covid-19 pandemic we’re getting caught off guard by another pandemic and we’re unable to address it properly,” Mr. Bottcher told me.
Facing increasing pressure, Mr. Adams called on the Biden administration earlier this week to deliver more vaccines to the city beyond what has already been allocated, which includes 14,500 new doses that just arrived and that the city plans to distribute in every borough. But that figure represents roughly 10 percent of the national total, even though the city has 32 percent of the country’s cases. Issues around fair access are also concerning, given that the city’s reliance on Twitter to distribute information about vaccine availability has privileged those with the time to linger online.
Among those lucky enough to have received their shots, many were able to book appointments through advance word from a whisper network made up of well-connected men in tech, health care and the media, when a much wider demographic would have benefited from the use of a broad, public-information campaign.
With conversations about diversity, equity and inclusion front of mind in nearly every sector of contemporary life, was this really the way forward?
