OPINION: In epidemics, messaging matters

On Friday, July 29, The Alaska Department of Health released a statement regarding the first case of monkeypox in the state. However, one portion of the statement was ahistorical to the point of alarm:

“While anyone can get or spread monkeypox, in the current outbreak in the United States, most cases have occurred among gay, bisexual, and other men who have sex with men.”

This framework surrounding monkeypox is not unique to Alaska. Similar messaging can be found in the CDC’s own monkeypox response. However, a message being ubiquitous doesn’t make it correct, nor does it make it less dangerous, and while Alaska — and the country at large — is in the critical early stages of a new epidemic, it’s important that messaging not be stripped of important cultural and historical context.

The CDC and DOH’s messaging about monkeypox being spread primarily among men who have sex with men (MSM) has been stripped of these two important contexts. In doing so, it not only endangers a population of Alaskans who are already facing heightened risk due to volatile political climates, but also communicates a relaxed need for caution and common sense for everyone.

While it may be true that a large percentage of monkeypox cases have been found in members of the MSM community, that fact alone doesn’t present a complete picture. For example, it doesn’t take into account the fact that members of the MSM community are statistically far more likely to undergo regular testing for sexually transmitted infections (STIs) than their heterosexual counterparts — a disparity that exists despite guidance that partners of all gender and sexual orientations undergo STI testing each time they have a new sexual partner. The presence of lesions on the body, combined with flattening of monkeypox messaging as “a gay disease” speaks to the trauma of the early days of the AIDS epidemic — called “Gay-Related Immune Deficiency,” or GRID, prior to its final rebranding as AIDS in August of 1982.

When presented to a lay public in a third year of information and pandemic exhaustion, there’s little room for nuance in discussions of public health. People are tired, they’re afraid, and no amount of gentle cautioning from the CDC will take away from the fact that people who are tired and afraid will look for someone to blame.

This, combined with rapidly escalating vitriol toward LGBT people across the country, makes this messaging not only irresponsible, but alarming. With violent anti-LGBT rhetoric positioning itself as a mainstream talking point ahead of the elections in 2022 and 2024, both nationally and at home, with library workers and educators facing termination or threats of violence, all while being deemed pedophiles and groomers for simply existing while gay. LGBT people, particularly trans people, are endangered by reckless or bad-faith messaging, such as the trans woman whose picture was falsely shared as the Buffalo shooter earlier this year.

If monkeypox continues to spread — which, based on tepid response and the corralling of infection to the MSM community, seems likely — what happens when cases begin to rise among heterosexual people? What happens what it begins to show up in children? This summer, the country bore witness to violence that took place in the name of “saving children” from exposure to LGBT people, for whom even existing in public is perceived as deviant or inherently sexual. What happens when those same children contract an infection for which public blame has been placed at the feet of those same people?

Maybe nothing. Maybe not.

But in that same situation, the best-case scenario is those same people — still tired, still afraid — are lax in their own risk-calculating measures. Can we blame them? Even using DOH’s press release as a template, the messaging about MSM communities being disproportionately affected is placed three paragraphs above a description of the onset of symptoms, and four paragraphs above advice on how best to prevent the spread. By that point, how many have stopped reading?

It’s my sincere hope that DOH, AHD, health care workers and Alaskans take time to consider the impact of this messaging, both in terms of re-inflicting historical trauma on vulnerable people, and also in the name of creating a stronger, healthier community between all Alaskans.

However determined governing bodies may be to repeat the mistakes of past epidemics, I hope that we can at least learn this: Messaging matters, and there’s still time to get it right.

Jacqueline Boucher is a writer and instructor from Juneau.

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