On monkeypox, or COVID, Canadians deserve the truth
The good news about monkeypox is that it shouldn’t be a life-altering event. On Thursday the New England Journal of Medicine published the largest study yet of the first major outbreak outside of Africa — a sample of 528 cases from four continents. Just 13 per cent of those cases required hospitalization, with the majority suffering “no serious complications” and none passing away.
The bad news, thus far at least, has been almost exclusively for men who have sex with other men: They accounted for 98 per cent of those 528 cases. The study authors believe 95 per cent of the cases were transmitted sexually.
This all boils down, or it should, to a very simple and targeted public-health message. But there has been consternation about how to craft such a message without “fuelling hate” (as The Washington Post put it last month). Utah’s Salt Lake County feared “unintended consequences” including “heterosexual people assuming they’re not susceptible,” the Post reported (remember when we were told not to wear masks to avoid COVID-19 because they would give us a “false sense of security”?) and “critics exploiting the infections to sow bigotry.”
Salt Lake County’s solution was “business-card-sized monkeypox warnings urging people to avoid close or sexual contact with anyone experiencing a rash or flu-like symptoms.” The cards didn’t mention the gay community.
We’re meant to think that was very smart, humane and progressive. It isn’t, really. “Many … well-intentioned officials appear fearful of saying something homophobic,” Jim Downs, a professor at Gettysburg College who studies the history of infectious diseases, wrote recently in The Atlantic. “LGBTQ organizers have ample practice with informing their communities about a possible health threat and championing safe-sex practices,” he argued. “Public-health officials should activate those resources rather than tiptoeing around the issue.”
It should come as no surprise to any Canadian consumer of public-health information over the past twoand-a-half years that Health Canada’s monkeypox advice fails this test spectacularly. It lists three forms of person-to-person transmission as if they were equal: “during sexual contact,” “when providing care” and “when living in the same household.” If anything, that risks spreading, rather than countering, the “untouchable” stigma that attached to AIDS patients even into the 1990s.
Indeed, after two-and-ahalf years of being taken for fools by public-health officials and politicians, sometimes twice or three times daily, it’s infuriating to see how many people in important positions still seem to have time to dance around peripheral issues as if they’re maypoles.
The World Health Organization, to its credit, has published specific monkeypox advice “for gay, bisexual and other men who have sex with men.” Meanwhile, however, it has also committed to the ridiculous cause of renaming monkeypox.
Last month, 29 medical experts signed a letter suggesting that the word “monkeypox” discriminates against Africans. They seem to think that’s so self-evident, which it is not. (It’s called monkeypox because it was first identified in monkeys; monkeys are not inherently African; and Africans are not monkeys.) The real complaint seems to be that monkeypox coverage in the Western media often features photos of African patients, which is a fair point (Africa is where monkeypox has historically always been a problem) but that has nothing to do with the name. And the best part is when you discover what they want to call monkeypox instead: MPXV-1, MPXV-2 or MPXV-3, depending on the clade.
As readers will have surmised, “MPXV” is short for “monkeypox virus.”
It’s difficult to imagine a more futile undertaking. But one is immediately reminded of various tall-headed pronouncements in the early days of COVID-19 that insisted we must worry primarily about not stigmatizing Asians and that closing borders was un-canadian and racist. Those begat further insults: masks don’t work, playgrounds are unsafe, the virus isn’t airborne, and on and on. Quite a few of those tall foreheads seem to have learned absolutely nothing over the course of the pandemic.
That’s not such a big deal right now. COVID’S “seventh wave” isn’t thus far very scary, and the gay community — worried as it may be about stigmatization — seems to be well-mobilized to spread frank and appropriate anti-monkeypox messaging where it most needs hearing.
But there is no reason to believe COVID won’t ever be back with a vengeance. You certainly shouldn’t believe any politician who vows a permanent end to anti-pandemic lockdowns — not Alberta Premier Jason Kenney or his would-be successor Danielle Smith, and certainly not would-be prime minister Pierre Poilievre (who, even if he won the Conservative leadership and later became prime minister, couldn’t do anything about the most damaging lockdowns anyway).
“I think we went too far — far too far — too often. But I can’t say we will never have restrictions in the future,” Brian Jean, Smith’s rival for the United Conservative Party leadership, told the Calgary Sun last month. “We can’t say some tools are out of the question because you don’t know how serious the future could get.”
That’s exactly right. Never mind the future for a moment: Even during this summer of relatively few COVID cases, the news has been full of collapsed or collapsing Canadian health-care systems — closed ERS, wait times only measurable on a geologic scale, kids sleeping on floors, crippling staff shortages from sea to sea to shining sea. Politicians can say “no more lockdowns” until they’re blue in the face; layer a deadly new COVID wave on top of that ongoing near-disaster and they will change their tune very, very quickly. Count on it. People dying in the streets will get a premier fired a hell of a lot faster than a mask mandate will.
So, as I’ve been saying for two-and-a-half years, politicians and public-health officials alike desperately need to start treating their constituents like adults. No more transparent insults. No more “we’re following the science.” (We all know the science in question is being chosen to support the measures you’ve agreed are politically possible. It’s fine; it’s how government works.)
And they should be spending this summer considering how to do less harm if restrictions again become necessary. British Columbia remains the large province with the fewest per-capita COVID-19 deaths, and also the province that implemented the loosest restrictions (especially on schools, which must never be allowed to close again, barring a crippling emergency). If Finland and Norway are more compelling examples for colder Canadian climates, they nevertheless offer the same lessons.
While many bien pensant Canadians are horrified by the various backlashes that lockdowns produced, considering what we’ve all been through since March 2020, I’m amazed at how much social solidarity remains. It’s individuals and their decisions who got Canada though this nightmare relatively unscathed, and it’s not too late for politicians and bureaucrats to offer them the respect they bloody well deserve.