Speaker 1: Monkeypox has been in the news and on social media.
Speaker 1: Folks are really trying to make sense of what's happening.
Speaker 1: I don't think everybody's got it quite right. I mean,
Speaker 1: I don't know all the answers, but some of the
Speaker 1: things I'm seeing are wrong. What we're also seeing, though,
Speaker 1: is that a dog was likely infected with monkeypox recently,
Speaker 1: and so that was August eighteenth. There's just a lot
Speaker 1: to wrap my arms around. So I think we gotta
Speaker 1: look at this thing a little closer.
Speaker 2: I'm TT and I'm Zachiah and from Spotify.
Speaker 3: This is Dope Labs.
Speaker 2: Welcome to Dope Labs, a weekly podcast that mixes hardcore science,
Speaker 2: pop culture, and a healthy dosa friendship. We're talking all
Speaker 2: about monkey pox, and it's only fitting because it's been
Speaker 2: everywhere in the news, not just in the news but
Speaker 2: on social media. We've seen y'all talking about.
Speaker 1: It, and honestly, this episode has been in the making
Speaker 1: for weeks, but it's just that every time we go
Speaker 1: to press record, something new is happening.
Speaker 2: So what do we know.
Speaker 1: Monkey Pox has the word pos in it, so I
Speaker 1: know that means painful skin lesions. When I think about
Speaker 1: monkey pox, I think about smallpox and chicken pox, which
Speaker 1: I had when I was in kindergarten painful.
Speaker 2: Yeah, and we know that monkey pos has been around
Speaker 2: for a while.
Speaker 1: Monkey pox has been around for a while, but the
Speaker 1: cases we're seeing now in the United States are primarily
Speaker 1: concentrated among men having sex with men. This has led
Speaker 1: some folks that think monkeypox must be sexually transmitted, but that's.
Speaker 2: Not the case. So what do we want to know? Well,
Speaker 2: I think we first got to start with what is
Speaker 2: monkey pox?
Speaker 3: Right?
Speaker 2: That is a very good question to start with, And
Speaker 2: my question right after that one is how did it
Speaker 2: get here?
Speaker 1: I think the other thing I want to know is
Speaker 1: what does the science tell us about monkeypox? And how
Speaker 1: is that different from what we're seeing public health recommendations
Speaker 1: telling us about monkeypox, because those.
Speaker 2: Are two different things.
Speaker 1: We know that there's, yes, the science, but there's all
Speaker 1: the context around it, right, So we want to know
Speaker 1: the fact and the fiction and the context when it
Speaker 1: comes to monkeybox.
Speaker 2: That's right, CT, let's jump into the dissection. So we
Speaker 2: really wanted to make sure that we were covering this
Speaker 2: issue from multiple angles because there's so much to discuss.
Speaker 2: So this week we have not just one, but two
Speaker 2: guest experts, doctor Angie Rasmussen, who's going to talk to
Speaker 2: us about the virus and the vaccine, and Kenyan Farroh,
Speaker 2: who provides the social and public health context.
Speaker 4: I'm Angie Rasmussen. I am virologists. That's the Vaccine and
Speaker 4: Infectious Disease Organization at the University of Saskatchewan Here in Saskatoon, Canada.
Speaker 4: I studied the host response to emerging viruses, including monkey pox.
Speaker 5: My name is Kenyon Farroll. I am the managing director
Speaker 5: of the advocacy in organizing with an organization called Prep
Speaker 5: for All, and I am also generally an activist and
Speaker 5: a writer.
Speaker 2: So let's talk about the virus. What is it?
Speaker 4: So? Monkeypox virus is an orthopox virus.
Speaker 1: Orthopox Viruses are part of a family of viruses that
Speaker 1: cause disease, and back in the old days, used to
Speaker 1: be called generally pox. Pox is used to represent the
Speaker 1: marx and lesions left on the skin. Another orthopox virus
Speaker 1: that you may have heard of is smallpox, and that
Speaker 1: was declared eradicated in nineteen eighty. So monkey pox is
Speaker 1: not new, right.
Speaker 4: Smallpox hasn't been around for a long time. But monkeypox
Speaker 4: was actually discovered in nineteen fifty eight in a group
Speaker 4: of Labne monkeys that had been imported into Denmark and
Speaker 4: they developed the smallpox like disease that turned out not
Speaker 4: to be smallpox. It was monkey pox, and so that's
Speaker 4: how it was named.
Speaker 1: And there was a lot of stigma with this. How
Speaker 1: you name something carries.
Speaker 2: A lot of weight.
Speaker 3: Oh my gosh.
Speaker 2: We saw this with COVID early on.
Speaker 1: We saw it with our then President Trump calling COVID
Speaker 1: the Chinese virus, which was inaccurate. And similarly, we're calling
Speaker 1: monkey pox monkey pox because it was discovered in monkeys,
Speaker 1: but that's not where it came from, Like, that's not
Speaker 1: where the reservoir for the virus was. And the only
Speaker 1: reason it's called monkey pox is because that's where we
Speaker 1: got a scientific snapshot of it. And so there's been
Speaker 1: a push to rename the virus, but it just hasn't
Speaker 1: taken hold yet.
Speaker 2: The symptoms of monkey pox can include fever, headache, muscle
Speaker 2: aches and backache, swollen lymph nodes, chills, respiratory issues, and
Speaker 2: a rash or lesions on the skin.
Speaker 4: So there's a whole process with the rash that happens,
Speaker 4: and generally speaking, it starts off as a a rash
Speaker 4: with some flu like symptoms associated with it. That becomes
Speaker 4: a versicular rash, which eventually becomes like a pustule or
Speaker 4: a blister, and then that scabs over and then the
Speaker 4: scabs fall off. The new skin is underneath. When the
Speaker 4: scabs fall off, that's when people are thought to be
Speaker 4: no longer contagious.
Speaker 1: Monkey pops can be extremely painful, but its fatality rate
Speaker 1: is much lower than smallpox, which has a fatality rate
Speaker 1: of about thirty percent.
Speaker 2: What about how it's spread, I think there's a lot
Speaker 2: of confusion around this. Can it be spread on surfaces
Speaker 2: or is it airborne like stars coovy two or.
Speaker 4: The pox viruses can be transmitted by both aerosols and faumites.
Speaker 1: A fomite is an object, fabric or surface that can
Speaker 1: carry and spread disease, so like clothing, bedding, or towels.
Speaker 1: And while the virus can be transmitted by objects, the
Speaker 1: risk of TRANSMITSI and via this route is low.
Speaker 4: So there are clearly examples of fomite transmission for orthopox viruses,
Speaker 4: and I think that probably is just a matter of
Speaker 4: the extent of the exposure. So if you are doing
Speaker 4: laundry in a hospital that's full of monkey POGs patients,
Speaker 4: they're going to be at a higher risk of fomite
Speaker 4: exposure than if you're just living in the same house
Speaker 4: as somebody and you sat on the same couch with them.
Speaker 2: So there's no need to start disinfecting your groceries like
Speaker 2: we were doing for COVID.
Speaker 1: This is so important because what we saw in COVID
Speaker 1: is initially people were concerned about getting COVID from touching
Speaker 1: things right surfaces.
Speaker 2: I bought so much lyesol.
Speaker 1: I have friends who were putting their mail and they
Speaker 1: had like a seven day rotation. They let that mail
Speaker 1: cure for a week basically, and then they would open it.
Speaker 2: Yep.
Speaker 1: But a lot of that comes from not having kind
Speaker 1: of the right information. So what we know is, yes,
Speaker 1: monkey pox is primarily spread from direct skin to skin contact,
Speaker 1: but also there can be transmission from aerosols. Aerosol transmission
Speaker 1: means a virus can be transmitted through the air, specifically
Speaker 1: through respiratory secretions. Scientists are still researching how often monkey
Speaker 1: pox is spread through these respiratory secretions. But again, doctor
Speaker 1: Rasmussen says the risk here is low. Otherwise we wouldn't
Speaker 1: be seeing such a concentrated outbreak in one specific community.
Speaker 4: If aerosol transmission we're driving this outbreak that's happening now.
Speaker 4: People in the queer community have families, they have co workers,
Speaker 4: they're around a lot of people. We would see many
Speaker 4: more cases occurring outside of that community. And the same
Speaker 4: is true with fo MIC. Certainly there is the possibility
Speaker 4: for transmission in schools, and there have been a few
Speaker 4: women and some children who have contracted monkey pox, and
Speaker 4: that's because sex is not the only activity that involves
Speaker 4: close physical contact between people. If it were possible to
Speaker 4: be transmitting this by trying on clothing and other types
Speaker 4: of really incidental contact, we'd be seeing a lot more
Speaker 4: monkey pox cases, and we're just not. The vast, vast
Speaker 4: majority of these cases are occurring in men, in trans
Speaker 4: people and non binary folks who are part of these
Speaker 4: sexual networks within the queer community.
Speaker 1: And that makes sense because the vast majority of infections
Speaker 1: are being driven by extensive, direct skin to skin contact
Speaker 1: between people.
Speaker 2: Which, of course sex fits the bill for if you're
Speaker 2: doing it the way that I think you're doing it.
Speaker 1: Yes, you're in very close physical contact with another person.
Speaker 1: And so I've been seeing some people confuse this and say, like, oh,
Speaker 1: monkeypox is an STI.
Speaker 2: But we want to be really clear.
Speaker 1: While there is some evidence that monkeypox virus could be
Speaker 1: in semen, meaning it could be sexually transmitted, the vast
Speaker 1: majority of people are contracting it via skin to skin contact.
Speaker 5: We do that it is spread through contact with lesions
Speaker 5: or blisters and also bodily fluids of a person who
Speaker 5: has monkey pots, but that doesn't necessarily mean that it's
Speaker 5: sexually transmitted per se. We just know that in sects
Speaker 5: you're going to be having a lot of physical contact
Speaker 5: with someone, and so it is easy to facilitate transmission
Speaker 5: that way.
Speaker 1: Monkey Pox wasn't reported outside of Africa until two thousand
Speaker 1: and three, so even though it had been occurring in
Speaker 1: the seventies, a lot of this was animal to human transmission,
Speaker 1: so encounters with wildlife right, and now what we're facing
Speaker 1: is a different mode of transmission, which is primarily driven
Speaker 1: by human to human. Before it was usually like import
Speaker 1: of exotic animals and things like that that people shouldn't
Speaker 1: have been bringing in. Another thing to understand is that
Speaker 1: the median age range for monkeypox infection in Central and
Speaker 1: West Africa has increased, so in the nineteen seventies and eighties,
Speaker 1: the median age range for MONKEYPOXX infections was four to
Speaker 1: five years old. Then from the two thousand to twenty
Speaker 1: tens it moved to the median age range being ten
Speaker 1: to twenty one years old, and cases outside of Africa
Speaker 1: also occurred more frequently in males and primarily in adults.
Speaker 1: A lot of this has to do with the way
Speaker 1: that we live. Your risk for monkeypox infection is directly
Speaker 1: related to where there is reservoir of virus. So when
Speaker 1: virus was primarily in animals and spread from animal to human,
Speaker 1: the riskiest behavior was sleeping in a forest, being near
Speaker 1: those animals that are reservoirs for monkeypox virus. Now that
Speaker 1: we have monkey pops in humans and in a larger population,
Speaker 1: the risk behavior is living in the same house with someone,
Speaker 1: having a lot of direct skin to skin contact and
Speaker 1: sharing dishes and eating.
Speaker 2: The same food as someone else. When we say things
Speaker 2: like sexual transmission, when we're talking about these viruses, I
Speaker 2: really worry about vilifying the queer community. I mean, we've
Speaker 2: seen throughout history people in the queer community be the
Speaker 2: scapegoats for a lot of different things for virus spread.
Speaker 2: They try and say that homosexuality is like you're a
Speaker 2: sexual deviant. They'd like to say that they're more likely
Speaker 2: to be pedophiles, all of which is not true. So
Speaker 2: when I hear sexual transmission coming up and we're talking
Speaker 2: about monkey pots, it really makes me nervous because it's
Speaker 2: like we are doomed to repeat the same toxic cycles
Speaker 2: over and over again, and the folks in the queer
Speaker 2: community are always the ones that are taking the brunt
Speaker 2: of the toxicity, and it's really dangerous. People are losing
Speaker 2: their lives because of all of this false information.
Speaker 4: That's right, and that's to me right now is the
Speaker 4: community that needs to be advised on how to decreach
Speaker 4: their risk.
Speaker 6: Most significantly, monkey pox we have known about for fifty years,
Speaker 6: and yet because we're now seeing a new manifestation of
Speaker 6: monkey pots in the United States for.
Speaker 5: The first time, and because it sort of entered the
Speaker 5: US kind of through gay men first, it is being
Speaker 5: framed as a gay disease. And there's no such thing
Speaker 5: as a gay disease or a gay virus.
Speaker 2: Let me repeat that one more time for the people
Speaker 2: in the back. There is no such thing as a
Speaker 2: gay disease or a gay virus, you know.
Speaker 1: The truth of it is, anybody can get monkeypos absolutely,
Speaker 1: and this is not the first time it's entered the
Speaker 1: United States. There are forty seven cases of monkeypox before,
Speaker 1: but that was associated with collecting exotic animals. So if
Speaker 1: you have skin and you're having skin to skin contact,
Speaker 1: the truth of it is, you can get monkeypos It's
Speaker 1: not about being gay or having sex. It's just that
Speaker 1: our reservoir has changed now. The reservoir is human. So
Speaker 1: the more humanly behavior you're having a human in human contact,
Speaker 1: the higher risk.
Speaker 2: And just like with COVID, some people may not know
Speaker 2: they have monkey pox or that they're contagiou.
Speaker 4: And I think that that is one question is like
Speaker 4: when does somebody actually become contagious after they get monkey pox. Now,
Speaker 4: monkeybox has a relatively long incubation period, so people may
Speaker 4: not realize that they have it until a week or
Speaker 4: two after they've been exposed.
Speaker 2: This sounds just like COVID, all the adding and subtracting
Speaker 2: the number of days you're contagious or potentially contagious. It
Speaker 2: just feels like we are all living in this constant
Speaker 2: state of anxiety, and you might think the experience with
Speaker 2: COVID that we're still kind of going through, that we
Speaker 2: would be better prepared for monkey pox, But it sounds
Speaker 2: like that's not the case. Both experts agree that we're
Speaker 2: not showing that we learned too much from COVID.
Speaker 5: We haven't learned a damn thing in terms of our
Speaker 5: response in a lot of ways.
Speaker 2: So how concerned should we be about monkey pocks?
Speaker 4: What concerns me the most is really how this has
Speaker 4: exposed our massive failures to respond effectively, and how it
Speaker 4: really shows that we haven't actually internalized a lot of
Speaker 4: the lessons that we should have learned from the COVID
Speaker 4: nineteen pandemic.
Speaker 2: I think one of the lessons that we didn't internalize
Speaker 2: is vaccine availability, what it takes to roll out a vaccine.
Speaker 2: I don't think that we learn anything from that because
Speaker 2: here we are another virus is spreading and there are
Speaker 2: no vaccines, just like when COVID was spreading and we
Speaker 2: were like, uh oh, there are no vaccines. But folks
Speaker 2: have been working on a coronavirus vaccine for a long time,
Speaker 2: so it felt like we should have been a little
Speaker 2: bit more prepared, but it feels like the powers that
Speaker 2: be just don't take these things as seriously as they should.
Speaker 1: I think we also see that we have big, clunky
Speaker 1: machines of governments and public health systems that don't really
Speaker 1: communicate with one another, right and because it takes them
Speaker 1: a long time to all get on the same page,
Speaker 1: folks are just typing and sharing whatever information have, whether
Speaker 1: it's accurate or not, and that can be really tricky,
Speaker 1: and I think we're starting to see that with monkeypox,
Speaker 1: just like we saw with COVID, and it's taken a
Speaker 1: while to get recommendations, which feels very similar to what
Speaker 1: we saw with COVID. But I'm a little concerned because
Speaker 1: it's not new, so it feels like it didn't have
Speaker 1: to be that way.
Speaker 4: Right early on, when we knew that monkey pox was
Speaker 4: beginning to spread outside of endemic countries, we had the
Speaker 4: opportunity then to make testing available, to really reach out
Speaker 4: to the community that's being affected, and to be very
Speaker 4: clear right now, that is the community of gay, bisexual
Speaker 4: men who have sex with men. We had the opportunity
Speaker 4: to make testing accessible to that community. We had the
Speaker 4: opportunity to actually do contact tracing and provide vaccines for
Speaker 4: people who had been close contacts of people who ended
Speaker 4: up getting monkey pox. And we actually also have antiviral
Speaker 4: drugs that can make the symptoms of monkey pox a
Speaker 4: lot less difficult.
Speaker 2: That does sound very, very familiar to the last you know,
Speaker 2: almost three years of our global experience, right.
Speaker 1: So when we think about endemic countries, we're talking about
Speaker 1: places where there are reservoirs or virus and where there
Speaker 1: are consistent infections or consistent occurrences of viral infections. And
Speaker 1: when you look at the literature, monkey pox is endemic
Speaker 1: to two regions, Central and West Africa.
Speaker 2: There's evidence that this particular clade or strain that we're
Speaker 2: seeing now in the United States was seen first in
Speaker 2: Nigeria in twenty seventeen.
Speaker 4: And my colleagues, auditions scientists in Africa could have told
Speaker 4: you twenty years ago that monkey pox was going to
Speaker 4: be a problem, and that it's a problem they deal
Speaker 4: with regularly, and because it's not impacting people in wealthier countries,
Speaker 4: there just hasn't been that concern that it's something that
Speaker 4: needs to be a priority. The reason that we don't
Speaker 4: have any data on monkey pos or not that much
Speaker 4: data on monkey pops. The reason why research hasn't been
Speaker 4: funded in the US or Canada, where I live now,
Speaker 4: or Europe is that it was happening primarily in endemic
Speaker 4: countries in Africa. So things that happen in Africa, you know,
Speaker 4: people have had a tendency to say, Oh, it's happening
Speaker 4: over there, or it's happening somewhere that doesn't affect me,
Speaker 4: because I don't know people who live there, and I'm
Speaker 4: not going there and it's not affecting my life, And
Speaker 4: I think that that is a terrible mistake. The fact
Speaker 4: that we are a global world really shows the crucial
Speaker 4: importance of not just health equity, but also scientific equity.
Speaker 2: The globalization of our world economy is a huge factor
Speaker 2: in how these outbreaks come to be. Because we're moving,
Speaker 2: we have planes, trains, and automobiles, which means those viruses
Speaker 2: are also on those planes, trains, and automobiles. We have
Speaker 2: to consider these things as we are moving about the globe.
Speaker 2: We're going to take a break and when we come back,
Speaker 2: we'll talk about how we can decrease the risk using vaccines.
Speaker 2: Plus what the media is getting wrong about monkeybox. We're back,
Speaker 2: and before we get back into monkey pox, let's talk
Speaker 2: about our lab for next week.
Speaker 1: In next week's lab, we're talking all about commercial spaceflight.
Speaker 1: It seems like everybody and anybody can get into space
Speaker 1: these days, so we're breaking down how commercial spaceflight evolved
Speaker 1: and where's headed with doctor Jordan Bim.
Speaker 2: All right, so let's talk about monkey po's vaccine. Earlier,
Speaker 2: we talked about how smallpox and monkey pox are both
Speaker 2: orthopox viruses, and smallpox was eradicated in nineteen eighty thanks
Speaker 2: to the success with vaccination. So is there a vaccine
Speaker 2: for monkey pox.
Speaker 4: It's a similar enough virus that smallpox vaccines do have
Speaker 4: some efficacy against monkey pox. And there's really two smallpox
Speaker 4: vaccines that we're talking about here.
Speaker 2: So the vaccine that eradicated smallpox in the late seventies
Speaker 2: early eighties has effectiveness against monkey pox. And like doctor
Speaker 2: Rasmusen said, there are now two vaccines that are effective
Speaker 2: in preventing monkey pox. Let's break them down.
Speaker 1: There's an older one which is called ACAM two thousand,
Speaker 1: and it's actually made from another orthopox virus called vaccinia virus.
Speaker 1: A fun fact is that's actually how the term vaccine
Speaker 1: got its name, so ACAM two thousand was targeted against
Speaker 1: vaccinia and is supposed to prevent smallpox, which is really awful.
Speaker 1: It's really transmissible, so super contagious, and it has a
Speaker 1: high fatality rate. So you can consider something that has
Speaker 1: a high fatality rate and can get you really really sick,
Speaker 1: is easily transmitted, you're willing to take on a little
Speaker 1: bit more risk to make sure that you're not spreading that.
Speaker 1: So this is a really hard to take vaccine. AKM
Speaker 1: two thousand in some people can cause disease and sometimes
Speaker 1: cardiac complications because.
Speaker 2: It's so tough on your immune system.
Speaker 1: Historical data has indicated the smallpox vaccination with vaccinia virus
Speaker 1: was approximately eighty five percent protective against monkey pocks in
Speaker 1: the past. But when you don't put money behind these programs,
Speaker 1: then you see a decrease in smallpox vaccination in these
Speaker 1: other countries. And when there's a decrease in vaccination, that
Speaker 1: allows us to have more potential hosts.
Speaker 2: So in the early two thousands, another company made a
Speaker 2: better vaccinia based vaccine called Genios, which is a lot safer.
Speaker 2: The problem is we don't have enough.
Speaker 4: So we already had far fewer doses of genios available
Speaker 4: in our stock file for treating monkey pocks, and it
Speaker 4: requires two doses. So basically, if you have, you know,
Speaker 4: a million doses, that's actually only five hundred thousand people
Speaker 4: that can be vaccinated with it.
Speaker 1: So now we're considering two things. We have doses of
Speaker 1: something that's really hard on the body, then we only
Speaker 1: have limited doses of something that's easier on the body,
Speaker 1: and it requires two doses. So cut that stockpile in half.
Speaker 1: Once we get more supply of the vaccine, we still
Speaker 1: got to conquer another issue.
Speaker 2: Will people take it?
Speaker 1: We ask Kenyon if he thinks people will have a
Speaker 1: similar hesitancy around the monkey pox vaccine that they did
Speaker 1: with the COVID vaccine.
Speaker 5: So I don't think that we'll have the same vaccination
Speaker 5: of take issue with covid if for no other reason
Speaker 5: than people are vain, right, So if people are seeing
Speaker 5: images of people with these lesions, and I just think
Speaker 5: the physical manifestation changes, I think the way a lot
Speaker 5: of people see and creates a different kind of urgency
Speaker 5: for people to get vaccinated.
Speaker 1: I think, yes, people are vain, but I think there's
Speaker 1: some differences between the COVID vaccine, which a lot of
Speaker 1: folks complained was that COVID was and they felt like
Speaker 1: the vaccine approval process happened really quickly and they weren't
Speaker 1: really sure about it. The smallpox vaccines have been around, right,
Speaker 1: so if there was hesitation around how quickly this got delivered,
Speaker 1: you shouldn't see that same concern if folks are candidates
Speaker 1: for a smallpox vaccine because it's been around. I think
Speaker 1: there's more to it than people just being vain. There's
Speaker 1: a certain reality that you're confronted with when you can
Speaker 1: see the physical manifestation of a disease. And so while
Speaker 1: you may have trouble breathing with COVID, there wasn't much
Speaker 1: you could really see that it is alarming, and it's like, hey,
Speaker 1: this is being spread.
Speaker 5: Human nature, I would guess, is you know one that
Speaker 5: we only sort of respond to things that we can
Speaker 5: sort of see, touch, taste and feel, you know, our
Speaker 5: kind of five sensus. And so when you're doing prevention work,
Speaker 5: it is very hard to argue to people that actually
Speaker 5: we need to prepare for things that are coming, or
Speaker 5: that we can anticipate comming that we don't currently have
Speaker 5: infrastructure for.
Speaker 2: So if monkey pops has been around for so long
Speaker 2: and we have vaccines to prevent it, why is this
Speaker 2: happening now.
Speaker 1: Part of the reason we're seeing this spread is just
Speaker 1: bad timing and our failure to act knowing the timing.
Speaker 4: June was Pride month, and we knew that monkey pop
Speaker 4: was spreading in this community, and it was very difficult
Speaker 4: for people to be tested.
Speaker 5: And so you're talking about, you know, just a time
Speaker 5: where people are doing parades and doing big circuit parties
Speaker 5: and gathering and of course people are having sex, and
Speaker 5: you know, all of those dynamics together as probably why
Speaker 5: I think we are seeing the outbreak kind of happen
Speaker 5: there first. But no one listening to this should believe
Speaker 5: that that is where any virus or infectious disease will
Speaker 5: stay in one community.
Speaker 2: Additionally, there are a lot of cases that were either
Speaker 2: misdiagnosed or undiagnosed because of a coinfection where monkey pocks
Speaker 2: went undiagnosed, and that happened in one in three cases
Speaker 2: based on a study from the New England Journal of Medicine,
Speaker 2: or because the monkey pox was misdiagnosed as something else.
Speaker 1: Kenyon says, all of this points to a disinvestment in
Speaker 1: public health systems broadly, and that's a problem that.
Speaker 5: Includes everything from being able to track viruses and diseases
Speaker 5: you know, from your United States sort of like epidemiological
Speaker 5: surveillance systems, to then testing and contact tracing systems, to
Speaker 5: then the sort of research around you know, vaccines, treatments, etc.
Speaker 5: Or just research to sort of understand both the basic
Speaker 5: science of a virus or a bacteria, to other kinds
Speaker 5: of research to understand sort of spread and prevention, et cetera.
Speaker 2: And we also need to prevent the spread of misinformation.
Speaker 2: I recently saw video on TikTok of this woman who
Speaker 2: was riding a train and she was wearing a mask
Speaker 2: so you couldn't really see her face, but she had
Speaker 2: some bumps on her skin, and somebody secretly recorded her
Speaker 2: and posted it and saying, oh my gosh, that she
Speaker 2: have monkey pox or whatever. And the woman on the
Speaker 2: train found the video because it was going viral and
Speaker 2: posted a response and said, no, I actually don't have
Speaker 2: monkey pox. I have another disease that puts these bumps
Speaker 2: on my skin. But thank you so much for you know,
Speaker 2: making me a target of harassment and it's just so
Speaker 2: wild that we are repeating the same mistakes that we
Speaker 2: made before. Just like with COVID, the internet and social
Speaker 2: media are flooded with all kinds of misinformation about monkeybox,
Speaker 2: and so part of.
Speaker 5: What we're seeing in the reporting is this kind of
Speaker 5: framing it within the context solely of gay men, and
Speaker 5: I think which leads people to think that that is
Speaker 5: the only place that the virus will end up. The
Speaker 5: second piece is a kind of question about whether it's
Speaker 5: a sexally transmitted infection or not, and I I think
Speaker 5: the media also has not done a good job of
Speaker 5: explaining that it also assumes that gay and bisexual men's
Speaker 5: only relationship to one another is sex, so that it
Speaker 5: is the only possible way that we may be.
Speaker 2: Contracting it, you know.
Speaker 1: And this can be confusing because you have to kind
Speaker 1: of reconcile these different bits of information. Earlier in this
Speaker 1: lab we said, hey, this is primarily in the community
Speaker 1: of men having sex with men.
Speaker 2: But I think because.
Speaker 1: People are also conflating sex as a vehicle for direct
Speaker 1: skin to skin contact, and assuming that monkey pox is
Speaker 1: transmitted sexually, they're thinking, oh, you have to be having
Speaker 1: sex with men to get monkey pox that's not necessarily
Speaker 1: the case, and I think a lot of this is
Speaker 1: related to the hyper sexualization of gay.
Speaker 2: And bisexual men.
Speaker 4: Right.
Speaker 1: People think, Oh, all they're doing is having sex, and
Speaker 1: so that's how this is spreading. But as Kenya notes,
Speaker 1: they are full of humans. They are having close relationships
Speaker 1: with other people in their lives, children, their parents, their siblings, right,
Speaker 1: and so there's an opportunity for direct skin to skin contact.
Speaker 1: So even though we're seeing this concentrated in this one
Speaker 1: community right now, it doesn't mean it will always be
Speaker 1: that way.
Speaker 4: I do think that it's really important that when we
Speaker 4: are talking about this, we're talking about it in the
Speaker 4: context of the people who are being affected, the people
Speaker 4: who are at the highest risk, and their behavior is irrelevant.
Speaker 4: It's not about moral judgment. It's about the risk of exposure,
Speaker 4: and that's what we need to be focusing on, not
Speaker 4: sex with multiple partners, not people who are having sex
Speaker 4: with people of the same sex or people who are
Speaker 4: on the gender spectrum. We need to be talking about
Speaker 4: this as people who are at risk, a community that
Speaker 4: is specifically at risk, without stigmatizing or passing moral judgment
Speaker 4: on that community. Because ultimately, having sex is a human need.
Speaker 4: We need to focus on the fact that we can't
Speaker 4: just tell people not to have sex. We can tell
Speaker 4: people in a judgmental, stigmatizing way that their behavior needs
Speaker 4: to change. And that's the one thing that's keeping us
Speaker 4: from controlling monkey coocks. That's completely unacceptable. What we need
Speaker 4: to do is reach out to the community that's at
Speaker 4: risk and do everything in our power to prioritize them
Speaker 4: for education, for access to testing, to vaccines, to treatments.
Speaker 1: We're also failing because of an inability to plan ahead,
Speaker 1: and that's a real problem because if we don't plan ahead,
Speaker 1: it's the marginalized communities that are affected the most.
Speaker 5: One of the things that we have as an issue too,
Speaker 5: is that you know, infections diseases often track along the
Speaker 5: lines of structural oppression in our societies. Right, So racism, xenophobia, homophobia, transphobia, sexism, classism. Right, So,
Speaker 5: it's no surprise when we see infectionous diseases begin to
Speaker 5: impact poor people, communities of color, the LGBT community, right,
Speaker 5: places in the South, places that are resource for first,
Speaker 5: because those are folks who are often in structural positions
Speaker 5: that put them more at risk.
Speaker 1: Right, Doctor Rasmussen was saying, if you get monkey pops,
Speaker 1: you may need to stay home and isolate for up
Speaker 1: to four to five weeks.
Speaker 2: That is a long time.
Speaker 1: Can you imagine they don't even want you to isolate
Speaker 1: with COVID then that's breathable, And.
Speaker 4: With our sickly policies with our healthcare in the US,
Speaker 4: that's just simply not a realistic proposition. So again, a
Speaker 4: lot of our failures to control this come back to
Speaker 4: failures and health equity and making sure that people have
Speaker 4: the resources they need to protect themselves and to protect
Speaker 4: others around them from potentially becoming infected.
Speaker 5: People for various reasons, blame those communities for the outbreaks
Speaker 5: that happen, as opposed to understanding our social conditions are
Speaker 5: structured in such a way that those individuals, if the
Speaker 5: virus doesn't enter that community first, it'll spread there faster.
Speaker 2: So recently, the World Health Organization or WHO declared monkey
Speaker 2: pops a global health emergency. We asked Kenyon, what's the
Speaker 2: significance of these declarations?
Speaker 5: So countries that are members of the Oral Health Organization
Speaker 5: part of their sort of responsibility. Once they become a
Speaker 5: member of the who IS, then they have to actually
Speaker 5: sort of mobilize a response in their countries, right, but
Speaker 5: it also gives a wahhow the possibility of kind of
Speaker 5: mobilizing and coordinating internationally, right, so that there's data being
Speaker 5: collected everywhere, that there are cases that there's a kind
Speaker 5: of streamlining of funding, and it can accelerate the advancement
Speaker 5: of In the case of things like COVID, where we
Speaker 5: didn't have vaccines with therapeutics or diagnostics, right, the resources
Speaker 5: come together to be able to kind of create those things.
Speaker 1: The United States declared monkey pops a National Health emergency.
Speaker 1: This means that all states are legally required to report
Speaker 1: cases to the CDC. States are also required to track
Speaker 1: and report or demographic information associated with infection like age, gender,
Speaker 1: and race.
Speaker 5: So we can then begin to understand sort of how
Speaker 5: transmission is happening and part of what it also sort
Speaker 5: of hopefully will trigger once that happens is Congress then
Speaker 5: can take that to then allocate emergency resources to better
Speaker 5: find a response.
Speaker 1: That response means better testing, and better testing means more
Speaker 1: tests available, It means better education for providers, and that
Speaker 1: leads to less misdiagnosis, So people being diagnosed for something
Speaker 1: else when it actually is monkeypox or undiagnosed, where people
Speaker 1: aren't diagnosed with anything, they just say, we don't know
Speaker 1: what it is. And so we need better testing, more
Speaker 1: resources to help and expand the services that are available.
Speaker 1: We need to create more vaccine access, and we need
Speaker 1: to produce more anti viral treatment to alleviate the awful
Speaker 1: symptoms of monkeypox.
Speaker 5: Too often we mobilize, we turn up show up in
Speaker 5: instances where either people die at the end of a
Speaker 5: police revolver or because of a kind of white vigilante
Speaker 5: right in many cases. But we don't do as much
Speaker 5: when actually more of our folks die prematurely from systems
Speaker 5: of neglect, of which public health and our kind of
Speaker 5: healthcare infrastructure certainly fits the build. And so we have
Speaker 5: got to also, as people of contience and communities, really
Speaker 5: begin to take seriously our healthcare and public health infrastructure
Speaker 5: as much as we do policing and voting and education
Speaker 5: and schools and the things that we typically will show
Speaker 5: up in mass mobilizations that we'll tweet about, etc.
Speaker 4: Etc.
Speaker 5: And not just assume that somehow somebody else has the
Speaker 5: healthcare piece down, or just assume that the system that
Speaker 5: we have is the one that we need that is
Speaker 5: intractable and unfixable. I think that we can really begin
Speaker 5: to ask ourselves, what is the future of public health,
Speaker 5: What is the future of healthcare so that it serves people,
Speaker 5: so that we don't keep rolling from one pandemic to
Speaker 5: one crisis after another and reinvent the wheel every time.
Speaker 1: Doctor Rasmussen is spot on.
Speaker 2: Okay.
Speaker 1: When I was going back to the literature to look
Speaker 1: at kind of what's going on, I was looking at
Speaker 1: this overview of all these other studies of monkeypos I
Speaker 1: saw that there was a paper submitted in June twenty
Speaker 1: twenty one, but it wasn't published until February twenty twenty two,
Speaker 1: and it was asking if monkeypox could potentially become a threat.
Speaker 1: And part of this is like science takes a long
Speaker 1: time to do and some of our processes are really
Speaker 1: slow and clunky, and so by the time this article
Speaker 1: came out, the answer was yes.
Speaker 2: Girl. But it's really.
Speaker 1: Interesting because we're just starting to consider this a threat
Speaker 1: in the United States. But folks have been kind of
Speaker 1: telling us, The literature has been saying, hey, this is
Speaker 1: a thing that's happening. We know we live in a
Speaker 1: very global society. And what that study was showing was
Speaker 1: that decade, over decades, there were increases in monkeypox cases.
Speaker 3: Wow.
Speaker 1: And so folks signed scientist physicians in Central and West
Speaker 1: Africa have been ringing the alarm that something was going
Speaker 1: on with monkey pops and that it was spreading. But
Speaker 1: like she said, you gotta put the dollars where.
Speaker 2: Something is happening. That's it for this lab.
Speaker 1: Call us at two zero two five six seven seven
Speaker 1: zero two eight and tell us what you thought, or
Speaker 1: give us an idea for a different lab you think
Speaker 1: we should do this semester. We like hearing from you.
Speaker 1: That's two zero two five six seven seven zero two eight.
Speaker 2: And don't forget that there is so much more to
Speaker 2: dig into on our website. There'll be a cheat sheet
Speaker 2: for today's lab, additional links and resources in the show notes.
Speaker 2: Plus you can sign up for our newsletter check it
Speaker 2: out at Dope labspodcast dot com. Special thanks to today's
Speaker 2: guest experts, doctor Angie Rasmussen and Kenyan Pharaoh.
Speaker 1: You can find doctor Rasmussen on Twitter at Angie Underscore
Speaker 1: Rasmussen and Kenyon Pharaoh is at Kenyon Pharaoh.
Speaker 2: And you can find us on Twitter and Instagram at
Speaker 2: Dope Blabs.
Speaker 1: Podcast, TT's on Twitter and Instagram at d R Underscore
Speaker 1: t Sho.
Speaker 2: And you can find Zakia at z said So. Dope
Speaker 2: Labs is a Spotify original production from Mega Owned Media Group.
Speaker 1: Our producers are Jenny Ratleick Mask and Lydia Smith of
Speaker 1: WaveRunner Studios.
Speaker 2: Editing in sound design by Rob Smerciak, Mixing by Hannes Brown.
Speaker 2: Original music composed and produced by Taka Yasuzawa and Alex
Speaker 2: Sugier from Spotify Creative producer Miguel Contreras. Special thanks to
Speaker 2: Shirley Ramos, Jess Borrison, Jasmine Afifi, Till crack Key, and
Speaker 2: Brian Marquis. Executive producers from Mega Own Media Group are
Speaker 2: US T T Show, Dia and Zakiah Wattley