What happened to monkeypox? LGBTQ community appears to have quashed spread for now

Despite concerns that the end of summer vacation or even pride events could further exacerbate monkeypox’s spread, the virus has fallen dramatically in the U.S. and in Central Florida since peaking in August — though there’s no guarantee it will stay that way.

Experts say the spread may have faltered in large part because of actions by the LGBTQ community.

“The community that largely was affected was very responsible,” said Jill Roberts, an associate professor at the University of South Florida College of Public Health. “If that had not been the case, we would have definitely seen a lot of spread well beyond the men who have sex with men population and into other populations.”

Monkeypox, once a term unheard of by many in the general American public, made headlines and sparked widespread concern this summer when it began rapidly spreading in countries that it rarely visits.

The virus causes rashes and sores, often accompanied by a fever, fatigue, chills and itching, according to the U.S. Centers for Disease Control and Prevention. It is spread primarily by skin-to-skin contact with an infected person’s rash or, less commonly, surfaces their rash has touched. It can infect anyone but has mostly spread in men who have sex with men in the current outbreak.

It primarily impacts minorities: During the week of Oct. 30, less than 1 out of 3 U.S. cases were in white individuals: 34% of the people infected were Black, 22% were Latino, 4% were Asian and the rest were another race, the CDC reports.

“Just like with COVID, this is more than likely an access-to-care issue,” Roberts said. “Having transportation to the vaccine, knowing the vaccine exists, having internet access to make an appointment to get the vaccine, it’s not a trivial thing for many people.”

Cases have likely gone down because along with steps such as talking openly and honestly about symptoms and vaccination status, and limiting sexual partners, thousands of people at risk of transmitting the virus got vaccinated, Roberts said.

The Jynneos vaccine for monkeypox and smallpox is available in Florida to known contacts of people with monkeypox, workers who may come into contact with the virus, and people who identify as gay or bisexual men, or other men who have sex with men, according to the Florida Department of Health’s website.

The goal now is to keep cases down and expand access to those at-risk who are still unvaccinated. If changes in behavior did indeed drive down spread, relaxing precautions could drive it back up, said Ira Longini, professor of biostatistics at the University of Florida.

“As the cases go down, monkeypox goes off the radar — the public health radar — and then we stop trying to control it. That’s exactly the situation which eventually would lead to recurrence,” Longini said.

Florida has recorded the fourth-highest number of cases in the U.S.: 2,787, according to Florida Charts Reports. The bulk of those cases were reported before September. In the last month, the state has added less than 200 to its tally, a major decrease.

Community organizations and local health departments still aren’t taking their foot off the gas.

Vaccines were scarce at first in large part because the federal government failed to order enough doses. In August, however, the Food and Drug Administration gave Emergency Use Authorization to a technique that turns one dose into as many as five, allowing more people to get the two-dose immunization.

From June 20 to Nov. 10, the Florida Department of Health in Orange County provided nearly 8,900 first and second doses of the vaccine, said spokesperson Kent Donahue.

With the increased supply and concerted efforts by community organizations and the DOH to focus on gay hubs, progress was made.

The virus also failed to spark any sort of major outbreak at Florida’s college campuses, which most experts didn’t think would happen — but there was a real concern that college students could be at risk because the virus was linked to sexual behaviors and close contact.

“I think the threat to the schools and those kinds of things was probably overblown,” Roberts said.

Organizations such as Harmony Healthcare Orlando and the DOH raised awareness at popular gay bars and events such as Orlando Come Out With Pride. LGBTQ hubs such as The LGBT+ Center Orlando, along with groups such as the Black queer-led grassroots Bros in Convo Initiative, worked in tandem with DOH-Orange to host vaccination sites and outreach events. Downer said the Bros in Convo Initiative plans to hold another vaccination clinic in partnership with the DOH sometime in the future.

“We’ve seen a big improvement in access to the vaccine,” said Daniel J. Downer, executive director of the Bros in Convo Initiative, in a text Monday.

The vaccine is currently available for free at DOH-Orange’s Eastside, Southside, Lake Underhill, and Ocoee campuses, as well as The LGBT+ Center Orlando Hillcrest Street site, Donahue said in a Monday email.

ccatherman@orlandosentinel.com; @CECatherman Twitter