People wait to recieve the monkeypox shot at a mass...

People wait to recieve the monkeypox shot at a mass vaccination site in Manhattan on July 26. Credit: China News Service via Getty Images/China News Service

It’s a virus with a different name, different symptoms, and different forms of transmission.

Yet as monkeypox spreads, we find ourselves mired in the same mess of mixed signals, contradictory advice, and unclear — sometimes even incorrect — messaging we saw early in the COVID-19 pandemic.

Why can't medical authorities speak honestly and directly about new viruses that impact us — and how we can best protect ourselves?

With COVID, some early stumbles could be explained by the virus being previously unknown. But monkeypox, though new to many, is very familiar to scientists and physicians. It's hard to understand why they couldn't get this right from the beginning. Why couldn't they clearly explain who was more likely to be infected, under what circumstances, and what anyone should do differently?

Instead, we face another public health emergency with rising case numbers — above 2,500 in New York State and more than 50 on Long Island — a limited vaccine supply, and a lack of clear direction and advice.

Now, the effort to get more vaccine doses out of a vial adds another layer of uncertainty.

Making matters worse is the stigma looming over the monkeypox conversation, a stigma all too familiar from the not-so-distant memory of the AIDS crisis.

Monkeypox is spread by close, physical contact. While often spread through sex, it can also pass from person to person through other forms of prolonged touch and skin-to-skin contact, or even via bedding and clothing. And while it has primarily impacted the gay, bisexual and transgender community, and the vast majority of transmission has occurred among men who've had sexual contact with other men, particularly with multiple partners, it’s not limited to that, either.

It shouldn't be hard to talk about — and it shouldn't be hard to balance definitive messaging and clear advice to those at risk with the nuance this virus requires. But public health officials so far have failed on all fronts.

In New York City, Dr. Don Weiss, the former surveillance director for the city health department's communicable disease department, was reassigned controversially by the department last month after Weiss publicly criticized the city's monkeypox messaging. He had emphasized the importance of telling men who have sex with other men to temporarily limit their number of partners to reduce transmission, a strategy other city officials avoided perhaps because of the fear of stigmatization. The city's approach may have led to increased spread; shutting down important voices like Weiss' doesn't help those at risk. 

Other experts, however, have at times eschewed nuance altogether. Earlier this month, Suffolk County Health Commissioner Gregson Pigott spoke at a community forum with the LGBT Network, and addressed men who are in a “stable” relationship with another man.

“There’s no risk,” Pigott incorrectly said. “You’re not someone who has to worry about contracting monkeypox.”

It's not that simple. The risk extends to social settings, gatherings with friends, or sharing a vacation home or other space where physical contact can occur, so individuals can remain at risk even if they're in a committed relationship. 

At least in Suffolk and NYC, officials are talking about monkeypox. In Nassau, little has been said — and vaccines remain elusive, though officials say they're waiting for more from the state.

Public health experts are working to get monkeypox under control.

But without a clear, accurate message, and vaccinations for all who need them, we're left with another spreading virus — with little end in sight. 

Columnist Randi F. Marshall's opinions are her own.

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