Guest Post: Tweeting The Monkeypox Virus Away
Malta has finally received a batch of the monkeypox vaccine, and we only learnt about it through a tweet by Chris Fearne, Deputy Prime Minister and Minister for Health, on Tuesday.
Fearne tweeted about the first batch and wrote that it had been procured through the EU Joint Procurement Mechanism.
The vaccine will be offered to primary contacts. It’s the last thing we heard from the Minister.
Newsrooms picked up the tweet and regurgitated its contents without questioning it. At the time of writing, the tweet had attracted 40 likes, 12 retweets and 3 comments.
Having read the much-awaited news, GU patients contacted the clinic inquiring into how they could get the vaccine, only to be told that the clinic has not received any instructions on how to administer the vaccine.
No news on how or where it will be distributed.
As the world starts responding to this outbreak, with some slower than others and a vaccine shortage, Malta, with a population of a little over half a million is incapable (wilfully, negligently, or recklessly) to have a similar reaction.
It has not launched a public health campaign and vaccine roll-out strategy that would inform high-risk populations and stop monkeypox from continuing to spread.
What is monkeypox?
Monkeypox is a virus from the same family of smallpox. It’s endemic in certain parts of Africa but has been spreading in the global north since last May, with more than 35,000 cases reported to date.
It has since been escalated to a Public Health Emergency of International Concern (23 July 2022) and declared by the US as a National Public Health Emergency (4 August 2022). Since May, Malta has reported 31 cases, arguably a small number compared to those seen in countries like the US (13,516), Spain (5,792), and the UK (3,081).
The overwhelming majority of those affected by it are gay, bi+ and men who have sex with men and its mainly being spread through prolonged close contact, particularly among sexual networks.
This doesn’t mean that it cannot spread to the rest of the population, but the risk for the wider population remains low.
The virus is spread through close contact with someone with symptoms. It spreads through skin-on-skin contact particularly during sex, droplets in air in prolonged contact (three to six hours), and sharing sheets and towels.
Symptoms include fever, headache, muscle aches, and swollen lymph nodes. After a few days, one also gets skin spots, ulcers, or blisters. Some people do not get any symptoms at all.
What are we waiting for?
The vaccine Invanex/Jynneos has been recommended for the prevention of monkeypox. It’s a great tool which breaks the chain of transmission.
Its arrival in Malta is welcome news, but the way the news was delivered is equally incomprehensible and irresponsible. Why choose Twitter and hope the media would pick it up and make it newsworthy themselves?
Why is it that the clinicians at the GU clinic have not been informed of the vaccine arrival or the eligibility criteria?
The government and public health had at least three months to come up with a public health strategy informing high-risk populations how to protect themselves and what to do if they think they have come into contact with someone who has monkeypox.
To date, the information is limited to a single page on the Ministry’s website – inaccessible to most.
How many high-risk people does the Ministry estimate should be offered the vaccine?
How many vaccines has Malta received and is expecting to receive?
Does this number tally with the estimates and, if it doesn’t, what’s the plan?
The vaccine is given in two doses 28 days apart, but some countries are only offering a single jab for now. What’s Malta’s protocol on this?
According to the tweet, the vaccine is only being offered to primary contracts. Why isn’t it also being offered to all high-risk populations? With Malta Pride events in a few weeks’ time, and the vaccine taking a few weeks to reach full efficacy, high-risk populations should be offered the vaccine without any delay.
We don’t talk about it
Inbred in our culture is the notion that if we don’t talk about something, it somehow goes away.
This does not work.
Not talking about sexual health won’t discourage anyone from engaging in high-risk behaviours. Equally, not talking openly about monkeypox, who is at highest risk and what we can do to stop it from spreading won’t make it go away.
Some may fear that in talking about it, we may be risking stigmatising the high-risk populations it affects, but it is in fact the total opposite.
It’s the systemic silence that creates stigma and puts people at greater risk.
Monkeypox is going to be with us for the next few months and we must have continuous honest conversations about what it is, whom it affects and what tools we have that will stop its spread. A single tweet won’t cut it.
If you think you may have monkeypox or have been exposed to someone with monkeypox contact your GP or the GU clinic on 25457494
Dr Mark Josef Rapa is a lecturer in Bioethics at the University of Manchester. They are the founder of PrEPingMalta and a member of the European AIDS Treatment Group
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Do you think Malta is addressing the monkeypox situation appropriately? Sound off in the comments below