I won't repeat the gravest sin of the public health establishment and those in their circles: I won't tell a well-meaning lie to try to coax the behavior I want.
I will tell them the truth: they are operating at a severe credibility deficit, and I am *very* reluctant to say a version of "I will let the CDC tell me when I can stop paying close attention to issues that people at the CDC personally think are important".
I just can't muster it right now. I think most can't. I hope the establishment attempts to engage the population where it is rather than where it wishes we were, but lol.
Regarding the idea that not engaging in risky behavior is the best precaution individuals can take… gay hookup culture is kind of the elephant in the room. As a gay man in a monogamous marriage, it confuses me that engaging in high-risk behaviors through hookup culture is often considered part of the gay experience, and that not being sufficiently “sex positive” is considered homophobic in some circles. For a fairly sizable contingent of people, to suggest that that behavior is harmful is to “demonize” it and perpetuate homophobia. This is obviously flawed thinking, but it is prevalent and it complicates prevention efforts. Sex with strangers is kind of a high risk, low reward behavior. It’s a weird thing to cling to as a part of one’s identity.
Gotta believe there's a very tired public health officer briefing a bunch of politicians right now who are all asking "wait, what do you mean there's a second disease?"
Maybe the CDC or the Government should say that having "a lifestyle that includes touching the skin of people you don’t know well in darkened conditions" (quite the euphemism for an orgy) is a bad idea and you shouldn't do it.
Nah. That would be judgmental and we can't have that.
It’s getting worse from such an incredibly low base that it reminds me much more of Ebola, for which I have no concern at all, than COVID in late 2019, for which I had a ton of concern.
I’m not planning on changing that assessment unless something breaks badly.
I’m not saying you’re wrong, but I am saying I have a limited amount of fucks to give these days and I’m not convinced yet that this qualifies for one.
International travel (and orgies) was a mistake. Shut it down!
Or, for the more neoliberally inclined, perhaps we could collect a tax to properly price the negative public health externalities associated with antisocial behavior like sex partying or going to an international professional conferences.
Important addendum or caveat: aren’t the smallpox vaccines (at least the older ones?) only 85% effective for monkeypox? Obviously that would still be very good. However, for high risk groups, that’s a point worth taking into account in the calculus, esp. re: MY’s suggestion of having people volunteer to take the riskier older the vaccine to protect themselves from monkeypox.
Does monkeypox prefer men who have sex with men in Nigeria? Given the demographics of the patients mentioned it doesn’t sound like it.
STI viruses benefit from the biology of sex: HIV likes the amount of fluid transmission, particularly in anal sex; HPV only infects certain kinds of cells. As far as I can tell, there is no similar reason monkey pox would benefit from sex per se. Sex just happens to be a common activity that checks the boxes for physics of transmission, but so would holding hands if someone happens to have a sore. So would sitting in church, or on a plane for an hour next to an infectious person. Sex may well be the best place to transmit, but that’s true of many disease we don’t call STIs. I would think if you had sex with someone that had COVID you’d be likely to get a cold... but we would be foolish to call it an STI.
So it seems likely that this outbreak hit the gay community second for social reasons, not biological reasons. We should not buy in to “*men who have sex with men* should be interested in getting a vaccine this summer”. I think it’s a mistake to follow the statistics too far this early in that regard. That’s myopic public health guidance, like telling people not to buy masks because you need them all for nurses. Buying this line will have negative social consequences for gay men, particularly in the locations in which we are already most maligned, and it won’t be accurate once the virus has found some other vectors to break into the broader community. Like if younger social circles start passing it: since Gen Z is both in their social bloom and are much more likely to identify as bi, so that the barriers that historically isolated gay populations are more permeable.
The public health apparatus should learn to “see through” statistical aberrations, like the Fed does with inflation, by contextualizing epidemiological information with known chemical, biomedical, and social facts.
We have three cases now in Sacramento that are all linked to the original patient who was at one of those raves I guess, but the news coverage is still coy and just says that the three people were "close contacts" which I assume means that they were sexual partners, but those words mean something broader to me and I wish they would just be factual and precise so we could better understand how this virus is moving. I am old enough to be headed to get my second shingles vaccine today, but young enough that I just missed small pox vaccination (literally it was declared eradicated days before I was set to get the vaccine) so I feel a little naked right now and part of me would just like to get a small pox vaccine and not have to worry.
The challenge of pandemic preparation is to find a way for our society to protect itself from diseases in a way that's actually sustainable and comes with a minimal risk of overreacting to non-entities like monkeypox is likely to be. And I think most of that work happens below the hood (by improving testing and funding research and other good ideas you have advocated that work against infectious disease in general), not by opening up a vaccine to a bunch of hypochondriacs at zero risk.
Michael Lewis's book about COVID praised its protagonists, who were actually a bunch of alarmist "experts" who wanted to shut down society for swine flu. Obviously this would have been stupid, would have tanked Obama's presidency, and would have left us even worse prepared for the actual pandemic when it hit. But Lewis praised those experts because he thought the precautionary principle is good (it is bad).
I appreciate that this post isn't praising the precautionary principle. But if we treat Monkeypox as a unique threat the way that Lewis's protagonists saw swine flu as a unique threat (as opposed to a common problem where we just need a better response infrastructure), then we'll see it as a success once it goes away on its own like swine flu did, and there will be even less motivation to fix the underlying issues.
At least this one has a scary name and gross effects.
Sometimes it’s the little things that get people to act more rationally.
I won't repeat the gravest sin of the public health establishment and those in their circles: I won't tell a well-meaning lie to try to coax the behavior I want.
I will tell them the truth: they are operating at a severe credibility deficit, and I am *very* reluctant to say a version of "I will let the CDC tell me when I can stop paying close attention to issues that people at the CDC personally think are important".
I just can't muster it right now. I think most can't. I hope the establishment attempts to engage the population where it is rather than where it wishes we were, but lol.
Regarding the idea that not engaging in risky behavior is the best precaution individuals can take… gay hookup culture is kind of the elephant in the room. As a gay man in a monogamous marriage, it confuses me that engaging in high-risk behaviors through hookup culture is often considered part of the gay experience, and that not being sufficiently “sex positive” is considered homophobic in some circles. For a fairly sizable contingent of people, to suggest that that behavior is harmful is to “demonize” it and perpetuate homophobia. This is obviously flawed thinking, but it is prevalent and it complicates prevention efforts. Sex with strangers is kind of a high risk, low reward behavior. It’s a weird thing to cling to as a part of one’s identity.
Is no one mention that the super-spreader events were two raves where there was widespread group sex?
For now it seems like this context is something that we should keep in mind while evaluating the risk.
People, please refrain from Orgies for the next few weeks just to be sure.
Gotta believe there's a very tired public health officer briefing a bunch of politicians right now who are all asking "wait, what do you mean there's a second disease?"
Maybe the CDC or the Government should say that having "a lifestyle that includes touching the skin of people you don’t know well in darkened conditions" (quite the euphemism for an orgy) is a bad idea and you shouldn't do it.
Nah. That would be judgmental and we can't have that.
It’s getting worse from such an incredibly low base that it reminds me much more of Ebola, for which I have no concern at all, than COVID in late 2019, for which I had a ton of concern.
I’m not planning on changing that assessment unless something breaks badly.
I’m not saying you’re wrong, but I am saying I have a limited amount of fucks to give these days and I’m not convinced yet that this qualifies for one.
International travel (and orgies) was a mistake. Shut it down!
Or, for the more neoliberally inclined, perhaps we could collect a tax to properly price the negative public health externalities associated with antisocial behavior like sex partying or going to an international professional conferences.
Important addendum or caveat: aren’t the smallpox vaccines (at least the older ones?) only 85% effective for monkeypox? Obviously that would still be very good. However, for high risk groups, that’s a point worth taking into account in the calculus, esp. re: MY’s suggestion of having people volunteer to take the riskier older the vaccine to protect themselves from monkeypox.
Per Madison Cawthorn, Republican officials in Washington deemed the most at-risk group.
Does monkeypox prefer men who have sex with men in Nigeria? Given the demographics of the patients mentioned it doesn’t sound like it.
STI viruses benefit from the biology of sex: HIV likes the amount of fluid transmission, particularly in anal sex; HPV only infects certain kinds of cells. As far as I can tell, there is no similar reason monkey pox would benefit from sex per se. Sex just happens to be a common activity that checks the boxes for physics of transmission, but so would holding hands if someone happens to have a sore. So would sitting in church, or on a plane for an hour next to an infectious person. Sex may well be the best place to transmit, but that’s true of many disease we don’t call STIs. I would think if you had sex with someone that had COVID you’d be likely to get a cold... but we would be foolish to call it an STI.
So it seems likely that this outbreak hit the gay community second for social reasons, not biological reasons. We should not buy in to “*men who have sex with men* should be interested in getting a vaccine this summer”. I think it’s a mistake to follow the statistics too far this early in that regard. That’s myopic public health guidance, like telling people not to buy masks because you need them all for nurses. Buying this line will have negative social consequences for gay men, particularly in the locations in which we are already most maligned, and it won’t be accurate once the virus has found some other vectors to break into the broader community. Like if younger social circles start passing it: since Gen Z is both in their social bloom and are much more likely to identify as bi, so that the barriers that historically isolated gay populations are more permeable.
The public health apparatus should learn to “see through” statistical aberrations, like the Fed does with inflation, by contextualizing epidemiological information with known chemical, biomedical, and social facts.
We have three cases now in Sacramento that are all linked to the original patient who was at one of those raves I guess, but the news coverage is still coy and just says that the three people were "close contacts" which I assume means that they were sexual partners, but those words mean something broader to me and I wish they would just be factual and precise so we could better understand how this virus is moving. I am old enough to be headed to get my second shingles vaccine today, but young enough that I just missed small pox vaccination (literally it was declared eradicated days before I was set to get the vaccine) so I feel a little naked right now and part of me would just like to get a small pox vaccine and not have to worry.
I’m not worried; the CDC has got my back.
The challenge of pandemic preparation is to find a way for our society to protect itself from diseases in a way that's actually sustainable and comes with a minimal risk of overreacting to non-entities like monkeypox is likely to be. And I think most of that work happens below the hood (by improving testing and funding research and other good ideas you have advocated that work against infectious disease in general), not by opening up a vaccine to a bunch of hypochondriacs at zero risk.
Michael Lewis's book about COVID praised its protagonists, who were actually a bunch of alarmist "experts" who wanted to shut down society for swine flu. Obviously this would have been stupid, would have tanked Obama's presidency, and would have left us even worse prepared for the actual pandemic when it hit. But Lewis praised those experts because he thought the precautionary principle is good (it is bad).
I appreciate that this post isn't praising the precautionary principle. But if we treat Monkeypox as a unique threat the way that Lewis's protagonists saw swine flu as a unique threat (as opposed to a common problem where we just need a better response infrastructure), then we'll see it as a success once it goes away on its own like swine flu did, and there will be even less motivation to fix the underlying issues.
On the general theme of "we're not doing enough to build anti-pandemic state capacity", it's time to rebrand public health as bio-security.