The bittersweet defeat of Mpox
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For a few weeks this summer, the world worried that monkeypox could become the next global pandemic. At its peak in early August, the US was seeing 600 cases a day, and the fumbling response from public health officials was reminiscent of the early days of Covid-19. Vaccines were slow to arrive and were in short supply for most of the fall. Bottlenecks arose during testing. Antiviral drugs, while they existed, were almost unavailable because they weren’t federally approved for the disease. While most cases have affected gay and bisexual men, there have been fears that the rarely fatal but often extremely painful infection, which can take weeks to clear up, could spread to the wider population.
Today, at least for the time being, things look very different. By mid-December, mpox, as the World Health Organization has now renamed it, had appeared in 110 countries, but the spread had slowed dramatically. The US, which had recorded 29,740 cases as of Dec. 21 — more than a third of the world total — was registering barely a handful each day.
While one reason is that access to vaccines and testing has improved and another is that mpox is inherently much more difficult to transmit than Covid, the biggest with which most agree is that the strongest vulnerable individuals took their protection into their own hands in the crucial early weeks, during which the authorities lashed out. “The success was community mobilization,” says Joseph Osmundson, a queer activist, molecular microbiologist, and clinical assistant professor at New York University.
Osmundson helped convey what could be seen as symbolic of the response to mpox: a fleet of large, white-painted vans with windows covered for privacy. Inside each van was a mobile vaccination clinic operated by the New York City Department of Health. Between Labor Day and Thanksgiving, these vans were parked late at night in front of bars and clubs that cater to gay and bisexual men, including some that host sex parties. (Many of these parties also voluntarily closed for periods of time.) The queer community told the city where people were most at risk, and venue owners agreed that protecting their guests was worth the possible stigma the Vans had to be parked outside. The Van vaccination program administered more than 3,000 doses.
The program showed that a health department was smart at finding people who needed help, but it also represented a community unwilling to wait for the health bureaucracy to find them. Since the beginning of the MPOX epidemic, gay and bi men and others in the queer community had reached out, harassed and agitated. Some who caught the disease posted online videos or gave press interviews describing their symptoms in intimate detail, and braved the risk of social shaming (“He’s caught monkeypox, guess what he’s up to”) to warn others of the risks. People posted information on social media and WhatsApp groups about which clinics still had vaccine supplies or how to get diagnosed when most doctors had never seen a case of mpox before. Those lucky enough to get antiviral treatments before they were made widely available shared advice with people to take to their doctors, navigating the brain-numbing bureaucracy to get individual approval.
Pretty much everyone agrees that queer men, especially those with many sexual partners, get the credit for this drop in the ski slope in some cases. As research from the US Centers for Disease Control and Prevention showed this fall, men who felt at risk voluntarily abstained from sex, stayed with one or a small number of partners, unsubscribed from dating apps, or skipped parties such as group sex happens.
