August 25, 2022 • 35 mins
Monkeypox has been around for a long time. But with the recent increase in cases, the virus seems to be dominating our headlines and social feeds. Titi and Zakiya learn what Monkeypox is, how it got here, and why public health recommendations don’t always align with science. Guests: Dr. Angie Rasmussen and Kenyon Farrow. You can find more Dope Labs, show notes, and cheat sheets at http://dopelabspodcast.com.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Monkeypox has been in the news and on social media.
Folks are really trying to make sense of what's happening.
I don't think everybody's got it quite right. I mean,
I don't know all the answers, but some of the
things I'm seeing are wrong. What we're also seeing, though,
is that a dog was likely infected with monkeypox recently,
and so that was August eighteenth. There's just a lot
to wrap my arms around. So I think we gotta
(00:21):
look at this thing a little closer.
Speaker 2 (00:23):
I'm TT and I'm Zachiah and from Spotify.
Speaker 3 (00:26):
This is Dope Labs.
Speaker 2 (00:53):
Welcome to Dope Labs, a weekly podcast that mixes hardcore science,
pop culture, and a healthy dosa friendship. We're talking all
about monkey pox, and it's only fitting because it's been
everywhere in the news, not just in the news but
on social media. We've seen y'all talking about.
Speaker 1 (01:09):
It, and honestly, this episode has been in the making
for weeks, but it's just that every time we go
to press record, something new is happening.
Speaker 2 (01:18):
So what do we know.
Speaker 1 (01:20):
Monkey Pox has the word pos in it, so I
know that means painful skin lesions. When I think about
monkey pox, I think about smallpox and chicken pox, which
I had when I was in kindergarten painful.
Speaker 2 (01:33):
Yeah, and we know that monkey pos has been around
for a while.
Speaker 1 (01:38):
Monkey pox has been around for a while, but the
cases we're seeing now in the United States are primarily
concentrated among men having sex with men. This has led
some folks that think monkeypox must be sexually transmitted, but that's.
Speaker 2 (01:50):
Not the case. So what do we want to know? Well,
I think we first got to start with what is
monkey pox?
Speaker 3 (01:56):
Right?
Speaker 2 (01:56):
That is a very good question to start with, And
my question right after that one is how did it
get here?
Speaker 1 (02:03):
I think the other thing I want to know is
what does the science tell us about monkeypox? And how
is that different from what we're seeing public health recommendations
telling us about monkeypox, because those.
Speaker 2 (02:12):
Are two different things.
Speaker 1 (02:13):
We know that there's, yes, the science, but there's all
the context around it, right, So we want to know
the fact and the fiction and the context when it
comes to monkeybox.
Speaker 2 (02:25):
That's right, CT, let's jump into the dissection. So we
really wanted to make sure that we were covering this
issue from multiple angles because there's so much to discuss.
(02:46):
So this week we have not just one, but two
guest experts, doctor Angie Rasmussen, who's going to talk to
us about the virus and the vaccine, and Kenyan Farroh,
who provides the social and public health context.
Speaker 4 (02:58):
I'm Angie Rasmussen. I am virologists. That's the Vaccine and
Infectious Disease Organization at the University of Saskatchewan Here in Saskatoon, Canada.
I studied the host response to emerging viruses, including monkey pox.
Speaker 5 (03:11):
My name is Kenyon Farroll. I am the managing director
of the advocacy in organizing with an organization called Prep
for All, and I am also generally an activist and
a writer.
Speaker 2 (03:22):
So let's talk about the virus. What is it?
Speaker 4 (03:25):
So? Monkeypox virus is an orthopox virus.
Speaker 1 (03:28):
Orthopox Viruses are part of a family of viruses that
cause disease, and back in the old days, used to
be called generally pox. Pox is used to represent the
marx and lesions left on the skin. Another orthopox virus
that you may have heard of is smallpox, and that
was declared eradicated in nineteen eighty. So monkey pox is
(03:50):
not new, right.
Speaker 4 (03:52):
Smallpox hasn't been around for a long time. But monkeypox
was actually discovered in nineteen fifty eight in a group
of Labne monkeys that had been imported into Denmark and
they developed the smallpox like disease that turned out not
to be smallpox. It was monkey pox, and so that's
how it was named.
Speaker 1 (04:09):
And there was a lot of stigma with this. How
you name something carries.
Speaker 2 (04:13):
A lot of weight.
Speaker 3 (04:14):
Oh my gosh.
Speaker 2 (04:15):
We saw this with COVID early on.
Speaker 1 (04:17):
We saw it with our then President Trump calling COVID
the Chinese virus, which was inaccurate. And similarly, we're calling
monkey pox monkey pox because it was discovered in monkeys,
but that's not where it came from, Like, that's not
where the reservoir for the virus was. And the only
reason it's called monkey pox is because that's where we
got a scientific snapshot of it. And so there's been
(04:40):
a push to rename the virus, but it just hasn't
taken hold yet.
Speaker 2 (04:43):
The symptoms of monkey pox can include fever, headache, muscle
aches and backache, swollen lymph nodes, chills, respiratory issues, and
a rash or lesions on the skin.
Speaker 4 (04:54):
So there's a whole process with the rash that happens,
and generally speaking, it starts off as a a rash
with some flu like symptoms associated with it. That becomes
a versicular rash, which eventually becomes like a pustule or
a blister, and then that scabs over and then the
scabs fall off. The new skin is underneath. When the
scabs fall off, that's when people are thought to be
(05:17):
no longer contagious.
Speaker 1 (05:19):
Monkey pops can be extremely painful, but its fatality rate
is much lower than smallpox, which has a fatality rate
of about thirty percent.
Speaker 2 (05:34):
What about how it's spread, I think there's a lot
of confusion around this. Can it be spread on surfaces
or is it airborne like stars coovy two or.
Speaker 4 (05:43):
The pox viruses can be transmitted by both aerosols and faumites.
Speaker 1 (05:48):
A fomite is an object, fabric or surface that can
carry and spread disease, so like clothing, bedding, or towels.
And while the virus can be transmitted by objects, the
risk of TRANSMITSI and via this route is low.
Speaker 4 (06:02):
So there are clearly examples of fomite transmission for orthopox viruses,
and I think that probably is just a matter of
the extent of the exposure. So if you are doing
laundry in a hospital that's full of monkey POGs patients,
they're going to be at a higher risk of fomite
exposure than if you're just living in the same house
(06:25):
as somebody and you sat on the same couch with them.
Speaker 2 (06:28):
So there's no need to start disinfecting your groceries like
we were doing for COVID.
Speaker 1 (06:33):
This is so important because what we saw in COVID
is initially people were concerned about getting COVID from touching
things right surfaces.
Speaker 2 (06:42):
I bought so much lyesol.
Speaker 1 (06:45):
I have friends who were putting their mail and they
had like a seven day rotation. They let that mail
cure for a week basically, and then they would open it.
Speaker 2 (06:53):
Yep.
Speaker 1 (06:54):
But a lot of that comes from not having kind
of the right information. So what we know is, yes,
monkey pox is primarily spread from direct skin to skin contact,
but also there can be transmission from aerosols. Aerosol transmission
means a virus can be transmitted through the air, specifically
through respiratory secretions. Scientists are still researching how often monkey
(07:18):
pox is spread through these respiratory secretions. But again, doctor
Rasmussen says the risk here is low. Otherwise we wouldn't
be seeing such a concentrated outbreak in one specific community.
Speaker 4 (07:29):
If aerosol transmission we're driving this outbreak that's happening now.
People in the queer community have families, they have co workers,
they're around a lot of people. We would see many
more cases occurring outside of that community. And the same
is true with fo MIC. Certainly there is the possibility
for transmission in schools, and there have been a few
(07:51):
women and some children who have contracted monkey pox, and
that's because sex is not the only activity that involves
close physical contact between people. If it were possible to
be transmitting this by trying on clothing and other types
of really incidental contact, we'd be seeing a lot more
monkey pox cases, and we're just not. The vast, vast
(08:15):
majority of these cases are occurring in men, in trans
people and non binary folks who are part of these
sexual networks within the queer community.
Speaker 1 (08:25):
And that makes sense because the vast majority of infections
are being driven by extensive, direct skin to skin contact
between people.
Speaker 2 (08:31):
Which, of course sex fits the bill for if you're
doing it the way that I think you're doing it.
Speaker 1 (08:36):
Yes, you're in very close physical contact with another person.
And so I've been seeing some people confuse this and say, like, oh,
monkeypox is an STI.
Speaker 2 (08:44):
But we want to be really clear.
Speaker 1 (08:45):
While there is some evidence that monkeypox virus could be
in semen, meaning it could be sexually transmitted, the vast
majority of people are contracting it via skin to skin contact.
Speaker 5 (08:54):
We do that it is spread through contact with lesions
or blisters and also bodily fluids of a person who
has monkey pots, but that doesn't necessarily mean that it's
sexually transmitted per se. We just know that in sects
you're going to be having a lot of physical contact
with someone, and so it is easy to facilitate transmission
that way.
Speaker 1 (09:13):
Monkey Pox wasn't reported outside of Africa until two thousand
and three, so even though it had been occurring in
the seventies, a lot of this was animal to human transmission,
so encounters with wildlife right, and now what we're facing
is a different mode of transmission, which is primarily driven
by human to human. Before it was usually like import
of exotic animals and things like that that people shouldn't
(09:34):
have been bringing in. Another thing to understand is that
the median age range for monkeypox infection in Central and
West Africa has increased, so in the nineteen seventies and eighties,
the median age range for MONKEYPOXX infections was four to
(09:56):
five years old. Then from the two thousand to twenty
tens it moved to the median age range being ten
to twenty one years old, and cases outside of Africa
also occurred more frequently in males and primarily in adults.
A lot of this has to do with the way
that we live. Your risk for monkeypox infection is directly
related to where there is reservoir of virus. So when
(10:21):
virus was primarily in animals and spread from animal to human,
the riskiest behavior was sleeping in a forest, being near
those animals that are reservoirs for monkeypox virus. Now that
we have monkey pops in humans and in a larger population,
the risk behavior is living in the same house with someone,
(10:41):
having a lot of direct skin to skin contact and
sharing dishes and eating.
Speaker 2 (10:46):
The same food as someone else. When we say things
like sexual transmission, when we're talking about these viruses, I
really worry about vilifying the queer community. I mean, we've
seen throughout history people in the queer community be the
scapegoats for a lot of different things for virus spread.
They try and say that homosexuality is like you're a
(11:08):
sexual deviant. They'd like to say that they're more likely
to be pedophiles, all of which is not true. So
when I hear sexual transmission coming up and we're talking
about monkey pots, it really makes me nervous because it's
like we are doomed to repeat the same toxic cycles
over and over again, and the folks in the queer
(11:29):
community are always the ones that are taking the brunt
of the toxicity, and it's really dangerous. People are losing
their lives because of all of this false information.
Speaker 4 (11:40):
That's right, and that's to me right now is the
community that needs to be advised on how to decreach
their risk.
Speaker 6 (11:48):
Most significantly, monkey pox we have known about for fifty years,
and yet because we're now seeing a new manifestation of
monkey pots in the United States for.
Speaker 5 (11:58):
The first time, and because it sort of entered the
US kind of through gay men first, it is being
framed as a gay disease. And there's no such thing
as a gay disease or a gay virus.
Speaker 2 (12:11):
Let me repeat that one more time for the people
in the back. There is no such thing as a
gay disease or a gay virus, you know.
Speaker 1 (12:21):
The truth of it is, anybody can get monkeypos absolutely,
and this is not the first time it's entered the
United States. There are forty seven cases of monkeypox before,
but that was associated with collecting exotic animals. So if
you have skin and you're having skin to skin contact,
the truth of it is, you can get monkeypos It's
(12:43):
not about being gay or having sex. It's just that
our reservoir has changed now. The reservoir is human. So
the more humanly behavior you're having a human in human contact,
the higher risk.
Speaker 2 (12:54):
And just like with COVID, some people may not know
they have monkey pox or that they're contagiou.
Speaker 4 (13:00):
And I think that that is one question is like
when does somebody actually become contagious after they get monkey pox. Now,
monkeybox has a relatively long incubation period, so people may
not realize that they have it until a week or
two after they've been exposed.
Speaker 2 (13:16):
This sounds just like COVID, all the adding and subtracting
the number of days you're contagious or potentially contagious. It
just feels like we are all living in this constant
state of anxiety, and you might think the experience with
COVID that we're still kind of going through, that we
would be better prepared for monkey pox, But it sounds
(13:37):
like that's not the case. Both experts agree that we're
not showing that we learned too much from COVID.
Speaker 5 (13:45):
We haven't learned a damn thing in terms of our
response in a lot of ways.
Speaker 2 (13:52):
So how concerned should we be about monkey pocks?
Speaker 4 (13:55):
What concerns me the most is really how this has
exposed our massive failures to respond effectively, and how it
really shows that we haven't actually internalized a lot of
the lessons that we should have learned from the COVID
nineteen pandemic.
Speaker 2 (14:11):
I think one of the lessons that we didn't internalize
is vaccine availability, what it takes to roll out a vaccine.
I don't think that we learn anything from that because
here we are another virus is spreading and there are
no vaccines, just like when COVID was spreading and we
were like, uh oh, there are no vaccines. But folks
(14:32):
have been working on a coronavirus vaccine for a long time,
so it felt like we should have been a little
bit more prepared, but it feels like the powers that
be just don't take these things as seriously as they should.
Speaker 1 (14:43):
I think we also see that we have big, clunky
machines of governments and public health systems that don't really
communicate with one another, right and because it takes them
a long time to all get on the same page,
folks are just typing and sharing whatever information have, whether
it's accurate or not, and that can be really tricky,
(15:04):
and I think we're starting to see that with monkeypox,
just like we saw with COVID, and it's taken a
while to get recommendations, which feels very similar to what
we saw with COVID. But I'm a little concerned because
it's not new, so it feels like it didn't have
to be that way.
Speaker 4 (15:21):
Right early on, when we knew that monkey pox was
beginning to spread outside of endemic countries, we had the
opportunity then to make testing available, to really reach out
to the community that's being affected, and to be very
clear right now, that is the community of gay, bisexual
men who have sex with men. We had the opportunity
to make testing accessible to that community. We had the
(15:44):
opportunity to actually do contact tracing and provide vaccines for
people who had been close contacts of people who ended
up getting monkey pox. And we actually also have antiviral
drugs that can make the symptoms of monkey pox a
lot less difficult.
Speaker 2 (16:01):
That does sound very, very familiar to the last you know,
almost three years of our global experience, right.
Speaker 1 (16:11):
So when we think about endemic countries, we're talking about
places where there are reservoirs or virus and where there
are consistent infections or consistent occurrences of viral infections. And
when you look at the literature, monkey pox is endemic
to two regions, Central and West Africa.
Speaker 2 (16:26):
There's evidence that this particular clade or strain that we're
seeing now in the United States was seen first in
Nigeria in twenty seventeen.
Speaker 4 (16:35):
And my colleagues, auditions scientists in Africa could have told
you twenty years ago that monkey pox was going to
be a problem, and that it's a problem they deal
with regularly, and because it's not impacting people in wealthier countries,
there just hasn't been that concern that it's something that
needs to be a priority. The reason that we don't
(16:58):
have any data on monkey pos or not that much
data on monkey pops. The reason why research hasn't been
funded in the US or Canada, where I live now,
or Europe is that it was happening primarily in endemic
countries in Africa. So things that happen in Africa, you know,
people have had a tendency to say, Oh, it's happening
over there, or it's happening somewhere that doesn't affect me,
(17:22):
because I don't know people who live there, and I'm
not going there and it's not affecting my life, And
I think that that is a terrible mistake. The fact
that we are a global world really shows the crucial
importance of not just health equity, but also scientific equity.
Speaker 2 (17:40):
The globalization of our world economy is a huge factor
in how these outbreaks come to be. Because we're moving,
we have planes, trains, and automobiles, which means those viruses
are also on those planes, trains, and automobiles. We have
to consider these things as we are moving about the globe.
We're going to take a break and when we come back,
(18:01):
we'll talk about how we can decrease the risk using vaccines.
Plus what the media is getting wrong about monkeybox. We're back,
(18:27):
and before we get back into monkey pox, let's talk
about our lab for next week.
Speaker 1 (18:32):
In next week's lab, we're talking all about commercial spaceflight.
It seems like everybody and anybody can get into space
these days, so we're breaking down how commercial spaceflight evolved
and where's headed with doctor Jordan Bim.
Speaker 2 (18:48):
All right, so let's talk about monkey po's vaccine. Earlier,
we talked about how smallpox and monkey pox are both
orthopox viruses, and smallpox was eradicated in nineteen eighty thanks
to the success with vaccination. So is there a vaccine
for monkey pox.
Speaker 4 (19:05):
It's a similar enough virus that smallpox vaccines do have
some efficacy against monkey pox. And there's really two smallpox
vaccines that we're talking about here.
Speaker 2 (19:17):
So the vaccine that eradicated smallpox in the late seventies
early eighties has effectiveness against monkey pox. And like doctor
Rasmusen said, there are now two vaccines that are effective
in preventing monkey pox. Let's break them down.
Speaker 1 (19:30):
There's an older one which is called ACAM two thousand,
and it's actually made from another orthopox virus called vaccinia virus.
A fun fact is that's actually how the term vaccine
got its name, so ACAM two thousand was targeted against
vaccinia and is supposed to prevent smallpox, which is really awful.
It's really transmissible, so super contagious, and it has a
(19:54):
high fatality rate. So you can consider something that has
a high fatality rate and can get you really really sick,
is easily transmitted, you're willing to take on a little
bit more risk to make sure that you're not spreading that.
So this is a really hard to take vaccine. AKM
two thousand in some people can cause disease and sometimes
cardiac complications because.
Speaker 2 (20:14):
It's so tough on your immune system.
Speaker 1 (20:16):
Historical data has indicated the smallpox vaccination with vaccinia virus
was approximately eighty five percent protective against monkey pocks in
the past. But when you don't put money behind these programs,
then you see a decrease in smallpox vaccination in these
other countries. And when there's a decrease in vaccination, that
allows us to have more potential hosts.
Speaker 2 (20:37):
So in the early two thousands, another company made a
better vaccinia based vaccine called Genios, which is a lot safer.
The problem is we don't have enough.
Speaker 4 (20:46):
So we already had far fewer doses of genios available
in our stock file for treating monkey pocks, and it
requires two doses. So basically, if you have, you know,
a million doses, that's actually only five hundred thousand people
that can be vaccinated with it.
Speaker 1 (21:02):
So now we're considering two things. We have doses of
something that's really hard on the body, then we only
have limited doses of something that's easier on the body,
and it requires two doses. So cut that stockpile in half.
Once we get more supply of the vaccine, we still
got to conquer another issue.
Speaker 2 (21:20):
Will people take it?
Speaker 1 (21:22):
We ask Kenyon if he thinks people will have a
similar hesitancy around the monkey pox vaccine that they did
with the COVID vaccine.
Speaker 5 (21:29):
So I don't think that we'll have the same vaccination
of take issue with covid if for no other reason
than people are vain, right, So if people are seeing
images of people with these lesions, and I just think
the physical manifestation changes, I think the way a lot
of people see and creates a different kind of urgency
(21:50):
for people to get vaccinated.
Speaker 1 (21:52):
I think, yes, people are vain, but I think there's
some differences between the COVID vaccine, which a lot of
folks complained was that COVID was and they felt like
the vaccine approval process happened really quickly and they weren't
really sure about it. The smallpox vaccines have been around, right,
so if there was hesitation around how quickly this got delivered,
(22:14):
you shouldn't see that same concern if folks are candidates
for a smallpox vaccine because it's been around. I think
there's more to it than people just being vain. There's
a certain reality that you're confronted with when you can
see the physical manifestation of a disease. And so while
you may have trouble breathing with COVID, there wasn't much
(22:35):
you could really see that it is alarming, and it's like, hey,
this is being spread.
Speaker 5 (22:40):
Human nature, I would guess, is you know one that
we only sort of respond to things that we can
sort of see, touch, taste and feel, you know, our
kind of five sensus. And so when you're doing prevention work,
it is very hard to argue to people that actually
we need to prepare for things that are coming, or
that we can anticipate comming that we don't currently have
(23:02):
infrastructure for.
Speaker 2 (23:09):
So if monkey pops has been around for so long
and we have vaccines to prevent it, why is this
happening now.
Speaker 1 (23:16):
Part of the reason we're seeing this spread is just
bad timing and our failure to act knowing the timing.
Speaker 4 (23:23):
June was Pride month, and we knew that monkey pop
was spreading in this community, and it was very difficult
for people to be tested.
Speaker 5 (23:30):
And so you're talking about, you know, just a time
where people are doing parades and doing big circuit parties
and gathering and of course people are having sex, and
you know, all of those dynamics together as probably why
I think we are seeing the outbreak kind of happen
there first. But no one listening to this should believe
that that is where any virus or infectious disease will
(23:53):
stay in one community.
Speaker 2 (23:55):
Additionally, there are a lot of cases that were either
misdiagnosed or undiagnosed because of a coinfection where monkey pocks
went undiagnosed, and that happened in one in three cases
based on a study from the New England Journal of Medicine,
or because the monkey pox was misdiagnosed as something else.
Speaker 1 (24:12):
Kenyon says, all of this points to a disinvestment in
public health systems broadly, and that's a problem that.
Speaker 5 (24:20):
Includes everything from being able to track viruses and diseases
you know, from your United States sort of like epidemiological
surveillance systems, to then testing and contact tracing systems, to
then the sort of research around you know, vaccines, treatments, etc.
Or just research to sort of understand both the basic
(24:42):
science of a virus or a bacteria, to other kinds
of research to understand sort of spread and prevention, et cetera.
Speaker 2 (24:49):
And we also need to prevent the spread of misinformation.
I recently saw video on TikTok of this woman who
was riding a train and she was wearing a mask
so you couldn't really see her face, but she had
some bumps on her skin, and somebody secretly recorded her
and posted it and saying, oh my gosh, that she
have monkey pox or whatever. And the woman on the
(25:11):
train found the video because it was going viral and
posted a response and said, no, I actually don't have
monkey pox. I have another disease that puts these bumps
on my skin. But thank you so much for you know,
making me a target of harassment and it's just so
wild that we are repeating the same mistakes that we
made before. Just like with COVID, the internet and social
(25:34):
media are flooded with all kinds of misinformation about monkeybox,
and so part of.
Speaker 5 (25:40):
What we're seeing in the reporting is this kind of
framing it within the context solely of gay men, and
I think which leads people to think that that is
the only place that the virus will end up. The
second piece is a kind of question about whether it's
a sexally transmitted infection or not, and I I think
(26:00):
the media also has not done a good job of
explaining that it also assumes that gay and bisexual men's
only relationship to one another is sex, so that it
is the only possible way that we may be.
Speaker 2 (26:10):
Contracting it, you know.
Speaker 1 (26:12):
And this can be confusing because you have to kind
of reconcile these different bits of information. Earlier in this
lab we said, hey, this is primarily in the community
of men having sex with men.
Speaker 2 (26:21):
But I think because.
Speaker 1 (26:22):
People are also conflating sex as a vehicle for direct
skin to skin contact, and assuming that monkey pox is
transmitted sexually, they're thinking, oh, you have to be having
sex with men to get monkey pox that's not necessarily
the case, and I think a lot of this is
related to the hyper sexualization of gay.
Speaker 2 (26:44):
And bisexual men.
Speaker 4 (26:45):
Right.
Speaker 1 (26:45):
People think, Oh, all they're doing is having sex, and
so that's how this is spreading. But as Kenya notes,
they are full of humans. They are having close relationships
with other people in their lives, children, their parents, their siblings, right,
and so there's an opportunity for direct skin to skin contact.
So even though we're seeing this concentrated in this one
community right now, it doesn't mean it will always be
(27:08):
that way.
Speaker 4 (27:09):
I do think that it's really important that when we
are talking about this, we're talking about it in the
context of the people who are being affected, the people
who are at the highest risk, and their behavior is irrelevant.
It's not about moral judgment. It's about the risk of exposure,
and that's what we need to be focusing on, not
(27:31):
sex with multiple partners, not people who are having sex
with people of the same sex or people who are
on the gender spectrum. We need to be talking about
this as people who are at risk, a community that
is specifically at risk, without stigmatizing or passing moral judgment
on that community. Because ultimately, having sex is a human need.
(27:52):
We need to focus on the fact that we can't
just tell people not to have sex. We can tell
people in a judgmental, stigmatizing way that their behavior needs
to change. And that's the one thing that's keeping us
from controlling monkey coocks. That's completely unacceptable. What we need
to do is reach out to the community that's at
(28:12):
risk and do everything in our power to prioritize them
for education, for access to testing, to vaccines, to treatments.
Speaker 1 (28:21):
We're also failing because of an inability to plan ahead,
and that's a real problem because if we don't plan ahead,
it's the marginalized communities that are affected the most.
Speaker 5 (28:32):
One of the things that we have as an issue too,
is that you know, infections diseases often track along the
lines of structural oppression in our societies. Right, So racism, xenophobia, homophobia, transphobia, sexism, classism. Right, So,
it's no surprise when we see infectionous diseases begin to
impact poor people, communities of color, the LGBT community, right,
(28:56):
places in the South, places that are resource for first,
because those are folks who are often in structural positions
that put them more at risk.
Speaker 1 (29:06):
Right, Doctor Rasmussen was saying, if you get monkey pops,
you may need to stay home and isolate for up
to four to five weeks.
Speaker 2 (29:13):
That is a long time.
Speaker 1 (29:14):
Can you imagine they don't even want you to isolate
with COVID then that's breathable, And.
Speaker 4 (29:19):
With our sickly policies with our healthcare in the US,
that's just simply not a realistic proposition. So again, a
lot of our failures to control this come back to
failures and health equity and making sure that people have
the resources they need to protect themselves and to protect
others around them from potentially becoming infected.
Speaker 5 (29:41):
People for various reasons, blame those communities for the outbreaks
that happen, as opposed to understanding our social conditions are
structured in such a way that those individuals, if the
virus doesn't enter that community first, it'll spread there faster.
Speaker 2 (29:58):
So recently, the World Health Organization or WHO declared monkey
pops a global health emergency. We asked Kenyon, what's the
significance of these declarations?
Speaker 5 (30:09):
So countries that are members of the Oral Health Organization
part of their sort of responsibility. Once they become a
member of the who IS, then they have to actually
sort of mobilize a response in their countries, right, but
it also gives a wahhow the possibility of kind of
mobilizing and coordinating internationally, right, so that there's data being
(30:30):
collected everywhere, that there are cases that there's a kind
of streamlining of funding, and it can accelerate the advancement
of In the case of things like COVID, where we
didn't have vaccines with therapeutics or diagnostics, right, the resources
come together to be able to kind of create those things.
Speaker 1 (30:48):
The United States declared monkey pops a National Health emergency.
This means that all states are legally required to report
cases to the CDC. States are also required to track
and report or demographic information associated with infection like age, gender,
and race.
Speaker 5 (31:05):
So we can then begin to understand sort of how
transmission is happening and part of what it also sort
of hopefully will trigger once that happens is Congress then
can take that to then allocate emergency resources to better
find a response.
Speaker 1 (31:22):
That response means better testing, and better testing means more
tests available, It means better education for providers, and that
leads to less misdiagnosis, So people being diagnosed for something
else when it actually is monkeypox or undiagnosed, where people
aren't diagnosed with anything, they just say, we don't know
what it is. And so we need better testing, more
(31:44):
resources to help and expand the services that are available.
We need to create more vaccine access, and we need
to produce more anti viral treatment to alleviate the awful
symptoms of monkeypox.
Speaker 5 (31:57):
Too often we mobilize, we turn up show up in
instances where either people die at the end of a
police revolver or because of a kind of white vigilante
right in many cases. But we don't do as much
when actually more of our folks die prematurely from systems
(32:19):
of neglect, of which public health and our kind of
healthcare infrastructure certainly fits the build. And so we have
got to also, as people of contience and communities, really
begin to take seriously our healthcare and public health infrastructure
as much as we do policing and voting and education
and schools and the things that we typically will show
(32:42):
up in mass mobilizations that we'll tweet about, etc.
Speaker 4 (32:45):
Etc.
Speaker 5 (32:46):
And not just assume that somehow somebody else has the
healthcare piece down, or just assume that the system that
we have is the one that we need that is
intractable and unfixable. I think that we can really begin
to ask ourselves, what is the future of public health,
What is the future of healthcare so that it serves people,
so that we don't keep rolling from one pandemic to
(33:08):
one crisis after another and reinvent the wheel every time.
Speaker 1 (33:12):
Doctor Rasmussen is spot on.
Speaker 2 (33:14):
Okay.
Speaker 1 (33:15):
When I was going back to the literature to look
at kind of what's going on, I was looking at
this overview of all these other studies of monkeypos I
saw that there was a paper submitted in June twenty
twenty one, but it wasn't published until February twenty twenty two,
and it was asking if monkeypox could potentially become a threat.
And part of this is like science takes a long
time to do and some of our processes are really
(33:36):
slow and clunky, and so by the time this article
came out, the answer was yes.
Speaker 2 (33:40):
Girl. But it's really.
Speaker 1 (33:42):
Interesting because we're just starting to consider this a threat
in the United States. But folks have been kind of
telling us, The literature has been saying, hey, this is
a thing that's happening. We know we live in a
very global society. And what that study was showing was
that decade, over decades, there were increases in monkeypox cases.
Speaker 3 (33:58):
Wow.
Speaker 1 (33:58):
And so folks signed scientist physicians in Central and West
Africa have been ringing the alarm that something was going
on with monkey pops and that it was spreading. But
like she said, you gotta put the dollars where.
Speaker 2 (34:10):
Something is happening. That's it for this lab.
Speaker 1 (34:20):
Call us at two zero two five six seven seven
zero two eight and tell us what you thought, or
give us an idea for a different lab you think
we should do this semester. We like hearing from you.
That's two zero two five six seven seven zero two eight.
Speaker 2 (34:32):
And don't forget that there is so much more to
dig into on our website. There'll be a cheat sheet
for today's lab, additional links and resources in the show notes.
Plus you can sign up for our newsletter check it
out at Dope labspodcast dot com. Special thanks to today's
guest experts, doctor Angie Rasmussen and Kenyan Pharaoh.
Speaker 1 (34:51):
You can find doctor Rasmussen on Twitter at Angie Underscore
Rasmussen and Kenyon Pharaoh is at Kenyon Pharaoh.
Speaker 2 (34:58):
And you can find us on Twitter and Instagram at
Dope Blabs.
Speaker 1 (35:00):
Podcast, TT's on Twitter and Instagram at d R Underscore
t Sho.
Speaker 2 (35:05):
And you can find Zakia at z said So. Dope
Labs is a Spotify original production from Mega Owned Media Group.
Speaker 1 (35:12):
Our producers are Jenny Ratleick Mask and Lydia Smith of
WaveRunner Studios.
Speaker 2 (35:17):
Editing in sound design by Rob Smerciak, Mixing by Hannes Brown.
Original music composed and produced by Taka Yasuzawa and Alex
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(35:39):
US T T Show, Dia and Zakiah Wattley
Monkeypox has been in the news and on social media.
Folks are really trying to make sense of what's happening.
I don't think everybody's got it quite right. I mean,
I don't know all the answers, but some of the
things I'm seeing are wrong. What we're also seeing, though,
is that a dog was likely infected with monkeypox recently,
and so that was August eighteenth. There's just a lot
to wrap my arms around. So I think we gotta
(00:21):
look at this thing a little closer.
Speaker 2 (00:23):
I'm TT and I'm Zachiah and from Spotify.
Speaker 3 (00:26):
This is Dope Labs.
Speaker 2 (00:53):
Welcome to Dope Labs, a weekly podcast that mixes hardcore science,
pop culture, and a healthy dosa friendship. We're talking all
about monkey pox, and it's only fitting because it's been
everywhere in the news, not just in the news but
on social media. We've seen y'all talking about.
Speaker 1 (01:09):
It, and honestly, this episode has been in the making
for weeks, but it's just that every time we go
to press record, something new is happening.
Speaker 2 (01:18):
So what do we know.
Speaker 1 (01:20):
Monkey Pox has the word pos in it, so I
know that means painful skin lesions. When I think about
monkey pox, I think about smallpox and chicken pox, which
I had when I was in kindergarten painful.
Speaker 2 (01:33):
Yeah, and we know that monkey pos has been around
for a while.
Speaker 1 (01:38):
Monkey pox has been around for a while, but the
cases we're seeing now in the United States are primarily
concentrated among men having sex with men. This has led
some folks that think monkeypox must be sexually transmitted, but that's.
Speaker 2 (01:50):
Not the case. So what do we want to know? Well,
I think we first got to start with what is
monkey pox?
Speaker 3 (01:56):
Right?
Speaker 2 (01:56):
That is a very good question to start with, And
my question right after that one is how did it
get here?
Speaker 1 (02:03):
I think the other thing I want to know is
what does the science tell us about monkeypox? And how
is that different from what we're seeing public health recommendations
telling us about monkeypox, because those.
Speaker 2 (02:12):
Are two different things.
Speaker 1 (02:13):
We know that there's, yes, the science, but there's all
the context around it, right, So we want to know
the fact and the fiction and the context when it
comes to monkeybox.
Speaker 2 (02:25):
That's right, CT, let's jump into the dissection. So we
really wanted to make sure that we were covering this
issue from multiple angles because there's so much to discuss.
(02:46):
So this week we have not just one, but two
guest experts, doctor Angie Rasmussen, who's going to talk to
us about the virus and the vaccine, and Kenyan Farroh,
who provides the social and public health context.
Speaker 4 (02:58):
I'm Angie Rasmussen. I am virologists. That's the Vaccine and
Infectious Disease Organization at the University of Saskatchewan Here in Saskatoon, Canada.
I studied the host response to emerging viruses, including monkey pox.
Speaker 5 (03:11):
My name is Kenyon Farroll. I am the managing director
of the advocacy in organizing with an organization called Prep
for All, and I am also generally an activist and
a writer.
Speaker 2 (03:22):
So let's talk about the virus. What is it?
Speaker 4 (03:25):
So? Monkeypox virus is an orthopox virus.
Speaker 1 (03:28):
Orthopox Viruses are part of a family of viruses that
cause disease, and back in the old days, used to
be called generally pox. Pox is used to represent the
marx and lesions left on the skin. Another orthopox virus
that you may have heard of is smallpox, and that
was declared eradicated in nineteen eighty. So monkey pox is
(03:50):
not new, right.
Speaker 4 (03:52):
Smallpox hasn't been around for a long time. But monkeypox
was actually discovered in nineteen fifty eight in a group
of Labne monkeys that had been imported into Denmark and
they developed the smallpox like disease that turned out not
to be smallpox. It was monkey pox, and so that's
how it was named.
Speaker 1 (04:09):
And there was a lot of stigma with this. How
you name something carries.
Speaker 2 (04:13):
A lot of weight.
Speaker 3 (04:14):
Oh my gosh.
Speaker 2 (04:15):
We saw this with COVID early on.
Speaker 1 (04:17):
We saw it with our then President Trump calling COVID
the Chinese virus, which was inaccurate. And similarly, we're calling
monkey pox monkey pox because it was discovered in monkeys,
but that's not where it came from, Like, that's not
where the reservoir for the virus was. And the only
reason it's called monkey pox is because that's where we
got a scientific snapshot of it. And so there's been
(04:40):
a push to rename the virus, but it just hasn't
taken hold yet.
Speaker 2 (04:43):
The symptoms of monkey pox can include fever, headache, muscle
aches and backache, swollen lymph nodes, chills, respiratory issues, and
a rash or lesions on the skin.
Speaker 4 (04:54):
So there's a whole process with the rash that happens,
and generally speaking, it starts off as a a rash
with some flu like symptoms associated with it. That becomes
a versicular rash, which eventually becomes like a pustule or
a blister, and then that scabs over and then the
scabs fall off. The new skin is underneath. When the
scabs fall off, that's when people are thought to be
(05:17):
no longer contagious.
Speaker 1 (05:19):
Monkey pops can be extremely painful, but its fatality rate
is much lower than smallpox, which has a fatality rate
of about thirty percent.
Speaker 2 (05:34):
What about how it's spread, I think there's a lot
of confusion around this. Can it be spread on surfaces
or is it airborne like stars coovy two or.
Speaker 4 (05:43):
The pox viruses can be transmitted by both aerosols and faumites.
Speaker 1 (05:48):
A fomite is an object, fabric or surface that can
carry and spread disease, so like clothing, bedding, or towels.
And while the virus can be transmitted by objects, the
risk of TRANSMITSI and via this route is low.
Speaker 4 (06:02):
So there are clearly examples of fomite transmission for orthopox viruses,
and I think that probably is just a matter of
the extent of the exposure. So if you are doing
laundry in a hospital that's full of monkey POGs patients,
they're going to be at a higher risk of fomite
exposure than if you're just living in the same house
(06:25):
as somebody and you sat on the same couch with them.
Speaker 2 (06:28):
So there's no need to start disinfecting your groceries like
we were doing for COVID.
Speaker 1 (06:33):
This is so important because what we saw in COVID
is initially people were concerned about getting COVID from touching
things right surfaces.
Speaker 2 (06:42):
I bought so much lyesol.
Speaker 1 (06:45):
I have friends who were putting their mail and they
had like a seven day rotation. They let that mail
cure for a week basically, and then they would open it.
Speaker 2 (06:53):
Yep.
Speaker 1 (06:54):
But a lot of that comes from not having kind
of the right information. So what we know is, yes,
monkey pox is primarily spread from direct skin to skin contact,
but also there can be transmission from aerosols. Aerosol transmission
means a virus can be transmitted through the air, specifically
through respiratory secretions. Scientists are still researching how often monkey
(07:18):
pox is spread through these respiratory secretions. But again, doctor
Rasmussen says the risk here is low. Otherwise we wouldn't
be seeing such a concentrated outbreak in one specific community.
Speaker 4 (07:29):
If aerosol transmission we're driving this outbreak that's happening now.
People in the queer community have families, they have co workers,
they're around a lot of people. We would see many
more cases occurring outside of that community. And the same
is true with fo MIC. Certainly there is the possibility
for transmission in schools, and there have been a few
(07:51):
women and some children who have contracted monkey pox, and
that's because sex is not the only activity that involves
close physical contact between people. If it were possible to
be transmitting this by trying on clothing and other types
of really incidental contact, we'd be seeing a lot more
monkey pox cases, and we're just not. The vast, vast
(08:15):
majority of these cases are occurring in men, in trans
people and non binary folks who are part of these
sexual networks within the queer community.
Speaker 1 (08:25):
And that makes sense because the vast majority of infections
are being driven by extensive, direct skin to skin contact
between people.
Speaker 2 (08:31):
Which, of course sex fits the bill for if you're
doing it the way that I think you're doing it.
Speaker 1 (08:36):
Yes, you're in very close physical contact with another person.
And so I've been seeing some people confuse this and say, like, oh,
monkeypox is an STI.
Speaker 2 (08:44):
But we want to be really clear.
Speaker 1 (08:45):
While there is some evidence that monkeypox virus could be
in semen, meaning it could be sexually transmitted, the vast
majority of people are contracting it via skin to skin contact.
Speaker 5 (08:54):
We do that it is spread through contact with lesions
or blisters and also bodily fluids of a person who
has monkey pots, but that doesn't necessarily mean that it's
sexually transmitted per se. We just know that in sects
you're going to be having a lot of physical contact
with someone, and so it is easy to facilitate transmission
that way.
Speaker 1 (09:13):
Monkey Pox wasn't reported outside of Africa until two thousand
and three, so even though it had been occurring in
the seventies, a lot of this was animal to human transmission,
so encounters with wildlife right, and now what we're facing
is a different mode of transmission, which is primarily driven
by human to human. Before it was usually like import
of exotic animals and things like that that people shouldn't
(09:34):
have been bringing in. Another thing to understand is that
the median age range for monkeypox infection in Central and
West Africa has increased, so in the nineteen seventies and eighties,
the median age range for MONKEYPOXX infections was four to
(09:56):
five years old. Then from the two thousand to twenty
tens it moved to the median age range being ten
to twenty one years old, and cases outside of Africa
also occurred more frequently in males and primarily in adults.
A lot of this has to do with the way
that we live. Your risk for monkeypox infection is directly
related to where there is reservoir of virus. So when
(10:21):
virus was primarily in animals and spread from animal to human,
the riskiest behavior was sleeping in a forest, being near
those animals that are reservoirs for monkeypox virus. Now that
we have monkey pops in humans and in a larger population,
the risk behavior is living in the same house with someone,
(10:41):
having a lot of direct skin to skin contact and
sharing dishes and eating.
Speaker 2 (10:46):
The same food as someone else. When we say things
like sexual transmission, when we're talking about these viruses, I
really worry about vilifying the queer community. I mean, we've
seen throughout history people in the queer community be the
scapegoats for a lot of different things for virus spread.
They try and say that homosexuality is like you're a
(11:08):
sexual deviant. They'd like to say that they're more likely
to be pedophiles, all of which is not true. So
when I hear sexual transmission coming up and we're talking
about monkey pots, it really makes me nervous because it's
like we are doomed to repeat the same toxic cycles
over and over again, and the folks in the queer
(11:29):
community are always the ones that are taking the brunt
of the toxicity, and it's really dangerous. People are losing
their lives because of all of this false information.
Speaker 4 (11:40):
That's right, and that's to me right now is the
community that needs to be advised on how to decreach
their risk.
Speaker 6 (11:48):
Most significantly, monkey pox we have known about for fifty years,
and yet because we're now seeing a new manifestation of
monkey pots in the United States for.
Speaker 5 (11:58):
The first time, and because it sort of entered the
US kind of through gay men first, it is being
framed as a gay disease. And there's no such thing
as a gay disease or a gay virus.
Speaker 2 (12:11):
Let me repeat that one more time for the people
in the back. There is no such thing as a
gay disease or a gay virus, you know.
Speaker 1 (12:21):
The truth of it is, anybody can get monkeypos absolutely,
and this is not the first time it's entered the
United States. There are forty seven cases of monkeypox before,
but that was associated with collecting exotic animals. So if
you have skin and you're having skin to skin contact,
the truth of it is, you can get monkeypos It's
(12:43):
not about being gay or having sex. It's just that
our reservoir has changed now. The reservoir is human. So
the more humanly behavior you're having a human in human contact,
the higher risk.
Speaker 2 (12:54):
And just like with COVID, some people may not know
they have monkey pox or that they're contagiou.
Speaker 4 (13:00):
And I think that that is one question is like
when does somebody actually become contagious after they get monkey pox. Now,
monkeybox has a relatively long incubation period, so people may
not realize that they have it until a week or
two after they've been exposed.
Speaker 2 (13:16):
This sounds just like COVID, all the adding and subtracting
the number of days you're contagious or potentially contagious. It
just feels like we are all living in this constant
state of anxiety, and you might think the experience with
COVID that we're still kind of going through, that we
would be better prepared for monkey pox, But it sounds
(13:37):
like that's not the case. Both experts agree that we're
not showing that we learned too much from COVID.
Speaker 5 (13:45):
We haven't learned a damn thing in terms of our
response in a lot of ways.
Speaker 2 (13:52):
So how concerned should we be about monkey pocks?
Speaker 4 (13:55):
What concerns me the most is really how this has
exposed our massive failures to respond effectively, and how it
really shows that we haven't actually internalized a lot of
the lessons that we should have learned from the COVID
nineteen pandemic.
Speaker 2 (14:11):
I think one of the lessons that we didn't internalize
is vaccine availability, what it takes to roll out a vaccine.
I don't think that we learn anything from that because
here we are another virus is spreading and there are
no vaccines, just like when COVID was spreading and we
were like, uh oh, there are no vaccines. But folks
(14:32):
have been working on a coronavirus vaccine for a long time,
so it felt like we should have been a little
bit more prepared, but it feels like the powers that
be just don't take these things as seriously as they should.
Speaker 1 (14:43):
I think we also see that we have big, clunky
machines of governments and public health systems that don't really
communicate with one another, right and because it takes them
a long time to all get on the same page,
folks are just typing and sharing whatever information have, whether
it's accurate or not, and that can be really tricky,
(15:04):
and I think we're starting to see that with monkeypox,
just like we saw with COVID, and it's taken a
while to get recommendations, which feels very similar to what
we saw with COVID. But I'm a little concerned because
it's not new, so it feels like it didn't have
to be that way.
Speaker 4 (15:21):
Right early on, when we knew that monkey pox was
beginning to spread outside of endemic countries, we had the
opportunity then to make testing available, to really reach out
to the community that's being affected, and to be very
clear right now, that is the community of gay, bisexual
men who have sex with men. We had the opportunity
to make testing accessible to that community. We had the
(15:44):
opportunity to actually do contact tracing and provide vaccines for
people who had been close contacts of people who ended
up getting monkey pox. And we actually also have antiviral
drugs that can make the symptoms of monkey pox a
lot less difficult.
Speaker 2 (16:01):
That does sound very, very familiar to the last you know,
almost three years of our global experience, right.
Speaker 1 (16:11):
So when we think about endemic countries, we're talking about
places where there are reservoirs or virus and where there
are consistent infections or consistent occurrences of viral infections. And
when you look at the literature, monkey pox is endemic
to two regions, Central and West Africa.
Speaker 2 (16:26):
There's evidence that this particular clade or strain that we're
seeing now in the United States was seen first in
Nigeria in twenty seventeen.
Speaker 4 (16:35):
And my colleagues, auditions scientists in Africa could have told
you twenty years ago that monkey pox was going to
be a problem, and that it's a problem they deal
with regularly, and because it's not impacting people in wealthier countries,
there just hasn't been that concern that it's something that
needs to be a priority. The reason that we don't
(16:58):
have any data on monkey pos or not that much
data on monkey pops. The reason why research hasn't been
funded in the US or Canada, where I live now,
or Europe is that it was happening primarily in endemic
countries in Africa. So things that happen in Africa, you know,
people have had a tendency to say, Oh, it's happening
over there, or it's happening somewhere that doesn't affect me,
(17:22):
because I don't know people who live there, and I'm
not going there and it's not affecting my life, And
I think that that is a terrible mistake. The fact
that we are a global world really shows the crucial
importance of not just health equity, but also scientific equity.
Speaker 2 (17:40):
The globalization of our world economy is a huge factor
in how these outbreaks come to be. Because we're moving,
we have planes, trains, and automobiles, which means those viruses
are also on those planes, trains, and automobiles. We have
to consider these things as we are moving about the globe.
We're going to take a break and when we come back,
(18:01):
we'll talk about how we can decrease the risk using vaccines.
Plus what the media is getting wrong about monkeybox. We're back,
(18:27):
and before we get back into monkey pox, let's talk
about our lab for next week.
Speaker 1 (18:32):
In next week's lab, we're talking all about commercial spaceflight.
It seems like everybody and anybody can get into space
these days, so we're breaking down how commercial spaceflight evolved
and where's headed with doctor Jordan Bim.
Speaker 2 (18:48):
All right, so let's talk about monkey po's vaccine. Earlier,
we talked about how smallpox and monkey pox are both
orthopox viruses, and smallpox was eradicated in nineteen eighty thanks
to the success with vaccination. So is there a vaccine
for monkey pox.
Speaker 4 (19:05):
It's a similar enough virus that smallpox vaccines do have
some efficacy against monkey pox. And there's really two smallpox
vaccines that we're talking about here.
Speaker 2 (19:17):
So the vaccine that eradicated smallpox in the late seventies
early eighties has effectiveness against monkey pox. And like doctor
Rasmusen said, there are now two vaccines that are effective
in preventing monkey pox. Let's break them down.
Speaker 1 (19:30):
There's an older one which is called ACAM two thousand,
and it's actually made from another orthopox virus called vaccinia virus.
A fun fact is that's actually how the term vaccine
got its name, so ACAM two thousand was targeted against
vaccinia and is supposed to prevent smallpox, which is really awful.
It's really transmissible, so super contagious, and it has a
(19:54):
high fatality rate. So you can consider something that has
a high fatality rate and can get you really really sick,
is easily transmitted, you're willing to take on a little
bit more risk to make sure that you're not spreading that.
So this is a really hard to take vaccine. AKM
two thousand in some people can cause disease and sometimes
cardiac complications because.
Speaker 2 (20:14):
It's so tough on your immune system.
Speaker 1 (20:16):
Historical data has indicated the smallpox vaccination with vaccinia virus
was approximately eighty five percent protective against monkey pocks in
the past. But when you don't put money behind these programs,
then you see a decrease in smallpox vaccination in these
other countries. And when there's a decrease in vaccination, that
allows us to have more potential hosts.
Speaker 2 (20:37):
So in the early two thousands, another company made a
better vaccinia based vaccine called Genios, which is a lot safer.
The problem is we don't have enough.
Speaker 4 (20:46):
So we already had far fewer doses of genios available
in our stock file for treating monkey pocks, and it
requires two doses. So basically, if you have, you know,
a million doses, that's actually only five hundred thousand people
that can be vaccinated with it.
Speaker 1 (21:02):
So now we're considering two things. We have doses of
something that's really hard on the body, then we only
have limited doses of something that's easier on the body,
and it requires two doses. So cut that stockpile in half.
Once we get more supply of the vaccine, we still
got to conquer another issue.
Speaker 2 (21:20):
Will people take it?
Speaker 1 (21:22):
We ask Kenyon if he thinks people will have a
similar hesitancy around the monkey pox vaccine that they did
with the COVID vaccine.
Speaker 5 (21:29):
So I don't think that we'll have the same vaccination
of take issue with covid if for no other reason
than people are vain, right, So if people are seeing
images of people with these lesions, and I just think
the physical manifestation changes, I think the way a lot
of people see and creates a different kind of urgency
(21:50):
for people to get vaccinated.
Speaker 1 (21:52):
I think, yes, people are vain, but I think there's
some differences between the COVID vaccine, which a lot of
folks complained was that COVID was and they felt like
the vaccine approval process happened really quickly and they weren't
really sure about it. The smallpox vaccines have been around, right,
so if there was hesitation around how quickly this got delivered,
(22:14):
you shouldn't see that same concern if folks are candidates
for a smallpox vaccine because it's been around. I think
there's more to it than people just being vain. There's
a certain reality that you're confronted with when you can
see the physical manifestation of a disease. And so while
you may have trouble breathing with COVID, there wasn't much
(22:35):
you could really see that it is alarming, and it's like, hey,
this is being spread.
Speaker 5 (22:40):
Human nature, I would guess, is you know one that
we only sort of respond to things that we can
sort of see, touch, taste and feel, you know, our
kind of five sensus. And so when you're doing prevention work,
it is very hard to argue to people that actually
we need to prepare for things that are coming, or
that we can anticipate comming that we don't currently have
(23:02):
infrastructure for.
Speaker 2 (23:09):
So if monkey pops has been around for so long
and we have vaccines to prevent it, why is this
happening now.
Speaker 1 (23:16):
Part of the reason we're seeing this spread is just
bad timing and our failure to act knowing the timing.
Speaker 4 (23:23):
June was Pride month, and we knew that monkey pop
was spreading in this community, and it was very difficult
for people to be tested.
Speaker 5 (23:30):
And so you're talking about, you know, just a time
where people are doing parades and doing big circuit parties
and gathering and of course people are having sex, and
you know, all of those dynamics together as probably why
I think we are seeing the outbreak kind of happen
there first. But no one listening to this should believe
that that is where any virus or infectious disease will
(23:53):
stay in one community.
Speaker 2 (23:55):
Additionally, there are a lot of cases that were either
misdiagnosed or undiagnosed because of a coinfection where monkey pocks
went undiagnosed, and that happened in one in three cases
based on a study from the New England Journal of Medicine,
or because the monkey pox was misdiagnosed as something else.
Speaker 1 (24:12):
Kenyon says, all of this points to a disinvestment in
public health systems broadly, and that's a problem that.
Speaker 5 (24:20):
Includes everything from being able to track viruses and diseases
you know, from your United States sort of like epidemiological
surveillance systems, to then testing and contact tracing systems, to
then the sort of research around you know, vaccines, treatments, etc.
Or just research to sort of understand both the basic
(24:42):
science of a virus or a bacteria, to other kinds
of research to understand sort of spread and prevention, et cetera.
Speaker 2 (24:49):
And we also need to prevent the spread of misinformation.
I recently saw video on TikTok of this woman who
was riding a train and she was wearing a mask
so you couldn't really see her face, but she had
some bumps on her skin, and somebody secretly recorded her
and posted it and saying, oh my gosh, that she
have monkey pox or whatever. And the woman on the
(25:11):
train found the video because it was going viral and
posted a response and said, no, I actually don't have
monkey pox. I have another disease that puts these bumps
on my skin. But thank you so much for you know,
making me a target of harassment and it's just so
wild that we are repeating the same mistakes that we
made before. Just like with COVID, the internet and social
(25:34):
media are flooded with all kinds of misinformation about monkeybox,
and so part of.
Speaker 5 (25:40):
What we're seeing in the reporting is this kind of
framing it within the context solely of gay men, and
I think which leads people to think that that is
the only place that the virus will end up. The
second piece is a kind of question about whether it's
a sexally transmitted infection or not, and I I think
(26:00):
the media also has not done a good job of
explaining that it also assumes that gay and bisexual men's
only relationship to one another is sex, so that it
is the only possible way that we may be.
Speaker 2 (26:10):
Contracting it, you know.
Speaker 1 (26:12):
And this can be confusing because you have to kind
of reconcile these different bits of information. Earlier in this
lab we said, hey, this is primarily in the community
of men having sex with men.
Speaker 2 (26:21):
But I think because.
Speaker 1 (26:22):
People are also conflating sex as a vehicle for direct
skin to skin contact, and assuming that monkey pox is
transmitted sexually, they're thinking, oh, you have to be having
sex with men to get monkey pox that's not necessarily
the case, and I think a lot of this is
related to the hyper sexualization of gay.
Speaker 2 (26:44):
And bisexual men.
Speaker 4 (26:45):
Right.
Speaker 1 (26:45):
People think, Oh, all they're doing is having sex, and
so that's how this is spreading. But as Kenya notes,
they are full of humans. They are having close relationships
with other people in their lives, children, their parents, their siblings, right,
and so there's an opportunity for direct skin to skin contact.
So even though we're seeing this concentrated in this one
community right now, it doesn't mean it will always be
(27:08):
that way.
Speaker 4 (27:09):
I do think that it's really important that when we
are talking about this, we're talking about it in the
context of the people who are being affected, the people
who are at the highest risk, and their behavior is irrelevant.
It's not about moral judgment. It's about the risk of exposure,
and that's what we need to be focusing on, not
(27:31):
sex with multiple partners, not people who are having sex
with people of the same sex or people who are
on the gender spectrum. We need to be talking about
this as people who are at risk, a community that
is specifically at risk, without stigmatizing or passing moral judgment
on that community. Because ultimately, having sex is a human need.
(27:52):
We need to focus on the fact that we can't
just tell people not to have sex. We can tell
people in a judgmental, stigmatizing way that their behavior needs
to change. And that's the one thing that's keeping us
from controlling monkey coocks. That's completely unacceptable. What we need
to do is reach out to the community that's at
(28:12):
risk and do everything in our power to prioritize them
for education, for access to testing, to vaccines, to treatments.
Speaker 1 (28:21):
We're also failing because of an inability to plan ahead,
and that's a real problem because if we don't plan ahead,
it's the marginalized communities that are affected the most.
Speaker 5 (28:32):
One of the things that we have as an issue too,
is that you know, infections diseases often track along the
lines of structural oppression in our societies. Right, So racism, xenophobia, homophobia, transphobia, sexism, classism. Right, So,
it's no surprise when we see infectionous diseases begin to
impact poor people, communities of color, the LGBT community, right,
(28:56):
places in the South, places that are resource for first,
because those are folks who are often in structural positions
that put them more at risk.
Speaker 1 (29:06):
Right, Doctor Rasmussen was saying, if you get monkey pops,
you may need to stay home and isolate for up
to four to five weeks.
Speaker 2 (29:13):
That is a long time.
Speaker 1 (29:14):
Can you imagine they don't even want you to isolate
with COVID then that's breathable, And.
Speaker 4 (29:19):
With our sickly policies with our healthcare in the US,
that's just simply not a realistic proposition. So again, a
lot of our failures to control this come back to
failures and health equity and making sure that people have
the resources they need to protect themselves and to protect
others around them from potentially becoming infected.
Speaker 5 (29:41):
People for various reasons, blame those communities for the outbreaks
that happen, as opposed to understanding our social conditions are
structured in such a way that those individuals, if the
virus doesn't enter that community first, it'll spread there faster.
Speaker 2 (29:58):
So recently, the World Health Organization or WHO declared monkey
pops a global health emergency. We asked Kenyon, what's the
significance of these declarations?
Speaker 5 (30:09):
So countries that are members of the Oral Health Organization
part of their sort of responsibility. Once they become a
member of the who IS, then they have to actually
sort of mobilize a response in their countries, right, but
it also gives a wahhow the possibility of kind of
mobilizing and coordinating internationally, right, so that there's data being
(30:30):
collected everywhere, that there are cases that there's a kind
of streamlining of funding, and it can accelerate the advancement
of In the case of things like COVID, where we
didn't have vaccines with therapeutics or diagnostics, right, the resources
come together to be able to kind of create those things.
Speaker 1 (30:48):
The United States declared monkey pops a National Health emergency.
This means that all states are legally required to report
cases to the CDC. States are also required to track
and report or demographic information associated with infection like age, gender,
and race.
Speaker 5 (31:05):
So we can then begin to understand sort of how
transmission is happening and part of what it also sort
of hopefully will trigger once that happens is Congress then
can take that to then allocate emergency resources to better
find a response.
Speaker 1 (31:22):
That response means better testing, and better testing means more
tests available, It means better education for providers, and that
leads to less misdiagnosis, So people being diagnosed for something
else when it actually is monkeypox or undiagnosed, where people
aren't diagnosed with anything, they just say, we don't know
what it is. And so we need better testing, more
(31:44):
resources to help and expand the services that are available.
We need to create more vaccine access, and we need
to produce more anti viral treatment to alleviate the awful
symptoms of monkeypox.
Speaker 5 (31:57):
Too often we mobilize, we turn up show up in
instances where either people die at the end of a
police revolver or because of a kind of white vigilante
right in many cases. But we don't do as much
when actually more of our folks die prematurely from systems
(32:19):
of neglect, of which public health and our kind of
healthcare infrastructure certainly fits the build. And so we have
got to also, as people of contience and communities, really
begin to take seriously our healthcare and public health infrastructure
as much as we do policing and voting and education
and schools and the things that we typically will show
(32:42):
up in mass mobilizations that we'll tweet about, etc.
Speaker 4 (32:45):
Etc.
Speaker 5 (32:46):
And not just assume that somehow somebody else has the
healthcare piece down, or just assume that the system that
we have is the one that we need that is
intractable and unfixable. I think that we can really begin
to ask ourselves, what is the future of public health,
What is the future of healthcare so that it serves people,
so that we don't keep rolling from one pandemic to
(33:08):
one crisis after another and reinvent the wheel every time.
Speaker 1 (33:12):
Doctor Rasmussen is spot on.
Speaker 2 (33:14):
Okay.
Speaker 1 (33:15):
When I was going back to the literature to look
at kind of what's going on, I was looking at
this overview of all these other studies of monkeypos I
saw that there was a paper submitted in June twenty
twenty one, but it wasn't published until February twenty twenty two,
and it was asking if monkeypox could potentially become a threat.
And part of this is like science takes a long
time to do and some of our processes are really
(33:36):
slow and clunky, and so by the time this article
came out, the answer was yes.
Speaker 2 (33:40):
Girl. But it's really.
Speaker 1 (33:42):
Interesting because we're just starting to consider this a threat
in the United States. But folks have been kind of
telling us, The literature has been saying, hey, this is
a thing that's happening. We know we live in a
very global society. And what that study was showing was
that decade, over decades, there were increases in monkeypox cases.
Speaker 3 (33:58):
Wow.
Speaker 1 (33:58):
And so folks signed scientist physicians in Central and West
Africa have been ringing the alarm that something was going
on with monkey pops and that it was spreading. But
like she said, you gotta put the dollars where.
Speaker 2 (34:10):
Something is happening. That's it for this lab.
Speaker 1 (34:20):
Call us at two zero two five six seven seven
zero two eight and tell us what you thought, or
give us an idea for a different lab you think
we should do this semester. We like hearing from you.
That's two zero two five six seven seven zero two eight.
Speaker 2 (34:32):
And don't forget that there is so much more to
dig into on our website. There'll be a cheat sheet
for today's lab, additional links and resources in the show notes.
Plus you can sign up for our newsletter check it
out at Dope labspodcast dot com. Special thanks to today's
guest experts, doctor Angie Rasmussen and Kenyan Pharaoh.
Speaker 1 (34:51):
You can find doctor Rasmussen on Twitter at Angie Underscore
Rasmussen and Kenyon Pharaoh is at Kenyon Pharaoh.
Speaker 2 (34:58):
And you can find us on Twitter and Instagram at
Dope Blabs.
Speaker 1 (35:00):
Podcast, TT's on Twitter and Instagram at d R Underscore
t Sho.
Speaker 2 (35:05):
And you can find Zakia at z said So. Dope
Labs is a Spotify original production from Mega Owned Media Group.
Speaker 1 (35:12):
Our producers are Jenny Ratleick Mask and Lydia Smith of
WaveRunner Studios.
Speaker 2 (35:17):
Editing in sound design by Rob Smerciak, Mixing by Hannes Brown.
Original music composed and produced by Taka Yasuzawa and Alex
Sugier from Spotify Creative producer Miguel Contreras. Special thanks to
Shirley Ramos, Jess Borrison, Jasmine Afifi, Till crack Key, and
Brian Marquis. Executive producers from Mega Own Media Group are
(35:39):
US T T Show, Dia and Zakiah Wattley
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