This is the time of year when gay men say farewell to summer with trips to the beach and resort towns for festivities, parties, and other revelry consisting of shirtless dancing and various forms of intimate contact — now a potential health risk as super-spreader events amid a monkeypox outbreak that continues to spread among men who have sex with men.
With the number of reported cases of monkeypox in the United States reaching 12,689 and demand for vaccines failing to keep up with supply, questions remain about taking precautions like those seen during the coronavirus epidemic as health experts and event organizers point to existing guidance to ensure a reasonable degree of safety.
Wes Combs, president of the CAMP Rehoboth board of directors, said his organization from the beginning of the monkeypox outbreak has been engaging with health officials at the state level in Delaware about what people should be looking for in terms of symptoms, as well as information about how people in high-risk categories can sign up to get vaccinations.
“As is everywhere in the country right now, where LGBTQ communities have big populations people are concerned, so we have received a number of calls about more information about monkeypox, about whether or not people can get vaccinated at CAMP Rehoboth,” Combs said.
A monkeypox town hall hosted by CAMP Rehoboth in conjunction with Delaware state health officials took place Tuesday, providing an opportunity to offer the latest information and answer questions about the monkeypox outbreak. CAMP Rehoboth announced it has been identified as one of two additional sites for vaccinations in addition to what the Department of Health provides from its health centers.
Rehoboth is among the many places in the United States where gay men are expected to flock to celebrate, along with Fire Island and Provincetown on the East Coast, making vaccinations against monkeypox in high demand at a time when the Biden administration is facing criticism for not making them more widely accessible. (Gay cruises for the summer, however, may not be among these events. A Carnival Cruise Line spokesperson said the charters team has no LGBTQ cruises coming up.)
Brad Perkins, chief medical officer at Karius, Inc., when asked about appropriate guidance for these end-of-summer events advised “trying to encourage community awareness and responsibility to isolate yourself and not infect others if you believe that you’ve been exposed or know that you’re infected.”
“But the longer game here is that we don’t want this disease to become endemic in the United States,” Perkins added. “And I think there’s a short-term threat, there’s a long term threat, both of them are really important [and] I think should weigh on decisions like the one you’re suggesting people need to make.”
Perkins said Karius, which works on advanced molecular technology for diagnosis of infectious diseases, is seeking to apply microbial cell-free DNA technology to create monkeypox tests earlier than options currently available, which require a sample from already developed skin lesions. The proposed testing has detected the virus in hospital patients, Perkins said, and following research over the course of the next few months may be available on an outpatient basis.
In Rehoboth, Combs said CAMP Rehoboth as a result of work with state officials is set to obtain 200 doses of JYNNEOS vaccine and, per guidance from the Centers for Disease Control & Prevention, plans to distribute them in a two-dose regimen, with the first dose set for Aug. 23 and second one on Sept. 28. As of Tuesday, Combs said CAMP Rehoboth has already scheduled appointments for 135 shots in the two-doze regimen, which is more than two-thirds of the total available shots.
“We are in talks with the state to [see] if they are able to get additional doses to create a larger vaccination site that’s capable of having more people vaccinated,” Combs added. “Right now, it’s one person every five minutes — over the span of from nine o’clock to three — and that’s the rate based on the number of doses. But if we can get more, we will do more, and we tell that to the state.”
Many of these end-of-summer events consist of gay men engaging in shirtless dancing in close proximity with each other as well as other intimate contact, creating ideal opportunities for a disease transmitted by skin-to-skin contact.
Be honest: While participants aren’t engaging in sexual activity as part of these events per se, they can lead to sexual encounters in the aftermath with a causal partner (or causal partners should these participants elect to have group sex to close out the night).
The CDC has guidance on its website for safer sex and social gatherings amid the monkeypox outbreak, which suggests festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer, as well as being mindful of activities (even kissing) that might spread monkeypox. Enclosed spaces, such as private and public sex parties where intimate and often anonymous sexual contact with multiple partners occurs, the CDC says, may have a higher likelihood of spreading monkeypox.
During the COVID epidemic, many group events required proof of vaccination and were even cancelled in an effort to mitigate the spread of the dangerous and potentially fatal disease. The same, however, cannot be said about events during the monkeypox outbreak, where the disease can be painful, but not fatal, and the availability of vaccines has not kept up with demand.
Combs said he’s unaware of any event being cancelled in Rehoboth due to monkeypox and, in fact, its biggest fundraiser of the year, the annual Sundance dance party is on track to happen over Labor Day weekend. Additionally, Combs said he cannot foresee a proof of vaccination requirement “largely because the availability of vaccines is so difficult to get right now, and there’s…high demand and low supply.”
“Certainly we understand what worked well with COVID, and that was getting information education out to the public about how this virus is transmitted and providing as much access to vaccines as possible,” Combs said. “So the one thing that is different is the number of vaccines available seems to be much lower, so I know that there’s lots of pressure being placed on the government at all levels to ensure that they get more supply to meet the demand that appears to be there.”
Perkins, asked whether precautions taken during COVID would be appropriate for monkeypox, drew a distinction between the two diseases, pointing out “the sort of positive take on monkeypox is that we’re somewhat prepared for this threat, mostly through efforts to prepare for smallpox.”
“Certainly, the most relevant one I think the community at this point is if you think you have been exposed, or, particularly if you’ve been exposed and you’re ill, getting vaccine, accessing the vaccine that’s available, or at least discussing being vaccinated as prophylaxis or at least, if not prophylaxis, prevention of infection, at least decreasing the severity of illness if it does occur,” Perkins said. “I think as is you know, it’s one of the good news stories of the efforts that have been taken to date.”
Although to date the transmission of monkeypox has been overwhelmingly among men who have sex with men, Perkins predicted that could change.
“In fact, we’re starting to see more cases outside that circle,” Perkins said. “I would expect that that will increase unless we control this epidemic. I think that will be a certainty moving forward that we’ll see a broader distribution of cases, because certainly the transmission of this infection, unlike HIV…includes routes of transmission that are non-sexual.”