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With more than 1,300 cases, California is second only to New York in spread of the disease — which transmits via skin-to-skin contact and bodily fluids and can cause painful lesions, among other symptoms.
For Latinos, who make up 37% of monkeypox cases in the state, the impact of the virus has grown deeper. The San Francisco Public Health Department announced this month that nearly 27% of its monkeypox cases are among Latinos despite their making up 15% of the county. Further south in Santa Clara County, 41% of cases are among Latinos even though they make up 26% of the county’s population. (Latinos currently appear to have fewer cases than expected in L.A. County relative to their population share, but that could be an undercount, as happened for COVID cases in L.A. and elsewhere.)
As more data of California’s monkeypox cases gets reported, Latinos, especially those in the LGBTQ community, are emerging as a high-risk group. If we do not act swiftly to halt the spread of monkeypox among Latinos, this latest public health emergency will echo disparities we saw at the outset of the COVID-19 pandemic.
It doesn’t have to. The strategy to combat monkeypox must begin with dramatically ramping up access to vaccines — and applying lessons learned from COVID on how to deliver health resources to marginalized groups.
The national emergency declaration will help to increase the production and availability of vaccines, expand testing and treatment access, and conduct robust outreach to LGBTQ communities. Last week, in a letter to Health and Human Services Secretary Xavier Becerra, Sens. Dianne Feinstein (D-Calif.) and Alex Padilla (D-Calif.) requested 600,000 to 800,000 vaccines for the state. The federal government should honor this request to meet the demand here as swiftly as possible.
Meanwhile, if state and county governments stall on taking action, such as delivering the vaccine doses that are currently available, cases could very well continue to skew toward low-income communities of color and immigrant communities, for whom lack of access to healthcare, time off from work and immigration status pose serious obstacles.
Local governments should prioritize equity at all stages. Urgency around vaccines must be accompanied by ample testing and timely information that is culturally competent and linguistically inclusive, including in Spanish and other languages.
The California public health department’s monkeypox communications toolkit rightly offers resources in multiple languages. But it will take focused communication strategies to make sure those resources actually reach people on the ground.
As public health doctors, we know from COVID that real-time updates on a public health crisis are more effective coming from trusted community messengers, including local leaders and healthcare providers. Delays or gaps in information could delay testing and vaccinations and create room for misinformation, placing communities at further risk of infection.
In this anxious moment for California, we should also not lose track of the most vulnerable. Nearly 60,000 LGBTQ undocumented individuals live in California — the largest number in the nation, according to the UCLA Williams Institute. As we have seen during the pandemic, undocumented populations experience additional barriers to health services because of a lack of health insurance and fears of repercussions for their immigration status.
It is imperative that the public health response aggressively incorporate undocumented individuals in testing and vaccination efforts, with reassurances that governments and healthcare providers will guard their privacy. In their messaging about monkeypox, public health and other officials should make clear that healthcare providers will keep people’s immigration status confidential. And they should communicate on the platforms most likely to reach undocumented Californians, such as radio programs and WhatsApp.
We can use tactics that we know worked in Latino communities for the COVID vaccine. At the Latino Coalition for a Healthy California, for example, our partnership with community health clinics across the state to launch ¡Ándale! ¿Qué esperas? leaned on direct community outreach efforts. Our health workers known as promotoras held community vaccine clinics, promoted accurate information and dispelled disinformation, reaching people in culturally relevant spaces such as through paleteros and at Liga MX soccer games.
This statewide, multi-generational COVID vaccine campaign reached more than 4 million Latinos on social media, TV and radio and more than 2 million in person. A similar playbook, backed by public, private and philanthropic funding, can and should be adopted for the emerging monkeypox crisis.
Latino communities across California are depending on us to act. For their sake, and for our state and nation, let’s not repeat past mistakes.
Jeffrey Reynoso is executive director of the Latino Coalition for a Healthy California, where Seciah Aquino is deputy director.
This story originally appeared in Los Angeles Times.