'They need to get loud about this'
CHICAGO — Chicago public health officials reported 173 monkeypox cases on Monday — up from 105 last week — and with vaccines scarce and hard to find, alarm is growing among doctors and those in the gay community that the city is not doing enough to address the spread .
Health officials are imploring the city to do more by not only increasing resources such as contact tracing, but also public awareness and education. Some in the gay community feel that the lack of public concern about the virus is because it's mostly affecting men who have sex with other men, but health officials warn there is nothing to stop the virus from spreading to the entire population.
"It doesn't care if you're gay or not," said Dr. Aniruddha Hazra, an infectious disease physician at LGBTQ-focused Howard Brown Health Center and the University of Chicago Medicine. "We have the tools to stop this from moving to other populations."
Nine Chicagoans have been hospitalized because of the illness, Chicago Department of Public Health spokesperson Andrew Buchanan said Monday. The city has received over 5,400 doses of the vaccine and expects another 15,000 doses in coming days, he said. The federal government has ordered millions of doses.
He said the city's vaccination effort is focused on people with the highest risk of exposure, which includes gay men, bisexual men and other men who have sex with men at venues, with multiple or anonymous partners, or for money. People who think they qualify for the vaccine should contact their health care provider, Buchanan said.
"Please be patient. There is not currently enough vaccine for all those who qualify to receive a dose, but we will expand where the vaccine is available as we receive additional doses," he said.
The list of patients requesting monkeypox vaccines from Northstar Healthcare Medical Center has grown to 240 names, medical director Dr. Daniel Berger said. But the gay-focused primary care site Berger founded could only give 25 vaccination appointments on Monday.
"It's not enough," he said. The response to the generally nonfatal but serious viral illness reminds the HIV specialist of the early days of the AIDS epidemic. He said he doesn't think there's enough information about the virus being shared.
"I don't see there being a concerted effort from the city or the government in terms of getting that word out there," Berger said.
Brian Gee, 36, of Garfield Park, said he couldn't find any clear information from the city on where to get a shot, so he turned to Twitter, Instagram and TikTok for help.
"Everything that I'm seeing in terms of awareness and knowledge about vaccinations themselves are happening through word-of-mouth," said Gee, who was able to get his shot at Howard Brown last Wednesday.
After weathering the "nightmare of trying to get info," Gee said he worries that people who live outside of gay neighborhoods like Northalsted, previously known as Boystown, will have a harder time learning about the virus and how to take care of themselves. He said more people need to know how disruptive, painful and dangerous a monkeypox infection can be.
Shaun Kimbrow, 32, said he searched hard for a week to find a vaccination appointment before also securing a slot at Howard Brown last Wednesday.
With his appointment secure, he texted friends to sign up at the clinic. Only some were successful. Others locked down inoculations at Northstar.
"It's kind of like the wild, wild West right now when it comes to vaccination," Kimbrow said.
He said everything he's learned about monkeypox has come from friends and social media. He's worried that there will be a more widespread outbreak if the monkeypox response doesn't ramp up and fears that minority and less wealthy communities will be disproportionately affected by the virus.
"I just desperately want all the health officials to be more aggressive about it," Kimbrow said.
Christopher Balthazar, executive director of TaskForce Prevention and Community Services, said the city has targeted communities of color in its vaccination efforts. The West Side organization provides health and social services to LGBTQ youth of color and has vaccinated 216 people for monkeypox so far. TaskForce will continue to host vaccination clinics twice a week.
But he said the people it serves are often unaware of monkeypox and they're working to teach people about the virus.
"They need to get loud about this," Balthazar said.
Rogers Park Ald. Maria Hadden, 49th, is trying to amp up public awareness. She's planned a virtual town hall on monkeypox on her Facebook page with Howard Brown on Thursday and she wants the CDPH to start holding monkeypox briefings at the City Council.
"They're sharing information, as much as they have. There's not a lot of information available," Hadden said. She, like many in the gay community, has sought monkeypox information independently, even looking to health experts on TikTok.
When monkeypox was first reported in the United States in late May, Hadden asked the city's public health department and Howard Brown to prep information about the virus. She printed flyers and put them up in stores that cater to the gay community, hoping to curb any spread that could have happened during the International Mr. Leather conference, which brought thousands of men who have sex with men to Chicago in late May, she said.
The city reported its first monkeypox case on June 2, but officials haven't said it was related to the conference. Ten days later, the city reported seven cases.
Hadden's worried that the city, state and country aren't doing enough to prepare for the spreading virus and wonders if CDPH has the capacity to respond as it continues to grapple with the ongoing COVID-19 pandemic.
"This is going to be a very unique challenge if it continues to be the rapidly growing threat that it is," Hadden said.
The monkeypox vaccine, which also treats smallpox, includes two shots spaced four weeks apart and provides strong immunity two weeks after its second dose, said Berger, from Northstar Healthcare Medical Center. He thinks Chicago needs thousands more doses to inoculate those most at risk.
"I believe everyone in our community should be vaccinated. This is just the beginning," Berger said. He wants local health officials to do a better job of telling people with common signs of monkeypox, including lesions and flu-like symptoms, to stay home and quarantine.
One Chicago man recovering from monkeypox told the Tribune that he sought medical help after finding small, firm bumps on his penis. The bumps first appeared to him and a practitioner to be another kind of rash, but when they became inflamed and began to weep, he went back to get tested for monkeypox.
The bumps spread to his arms, neck and forehead. A week later, the test came back positive.
"I think that has to be more widespread than it seems," said the man, who spoke on the condition of anonymity because he is not openly bisexual. The disease's rarity and current association with the gay community can make it stigmatizing, he said.
Because he works remotely, he was able to isolate at home as his painful blisters festered. It would be hard "if you had to go to work or you had to explain why you couldn't go to work," he said.
Another man told the Tribune he first feared he might have monkeypox when intense rectal pain lingered after a chlamydia diagnosis. Doctors tested him for monkeypox and the probe came back positive. He said he's suffering from constipation and discharging blisters.
He had already received one dose of the monkeypox vaccine.
"This is a profoundly unpleasant experience. The symptoms are very awful," said the man, who requested anonymity because of the stigma associated with the virus. He took a day off from work because of the debilitating pain.
"I cannot imagine how this would be if I had the pox all over my body," he said.
Buchanan, from the city's public health department, said that its contact tracing capacity allows it to investigate all reported monkeypox cases, but identifying all contacts for positive individuals has been challenging.
"Contact tracing conducted by public health along with public awareness about prevention and post-exposure recommendations are fundamentally important in controlling the MPV outbreak," he said.
He said the amount of testing available for monkeypox exceeds what is currently needed and it will grow as more laboratories start to conduct the test, he added.
Monkeypox is a virus related to smallpox that was first detected in humans in 1970 and is endemic to parts of west and central Africa. A past American outbreak occurred in Illinois in 2003, which was linked to prairie dogs and infected 71 people across the Midwest.
The viral illness typically begins with flu-like symptoms and swelling of the lymph nodes before progressing to distinct, large rashes on the face and body that look like pimples or blisters. The illness typically lasts two to four weeks.
Monkeypox is generally passed on through close physical contact with the scab or bodily fluids of someone with the virus, as well as contact with objects they've touched. Spread could occur through normal acts like sharing a towel or having intimate sexual contact. According to the Centers for Disease Control and Prevention, monkeypox cannot be spread by people who don't have symptoms.
The CDC reported 1,814 cases in the United States as of Friday. The current outbreak is severe in parts of western Europe. Cases have been reported across the globe.
Hazra, of Howard Brown, encouraged people about to make intimate physical contact to check for lesions and to have "open and honest" discussions with their partners. He said there isn't enough testing happening to tell how widespread the virus is or stop its spread.
The city also needs more contact tracers, who could take advantage of the virus's one- to two-week-long incubation period to effectively isolate people exposed, he added.
"There definitely is a need to increase the workforce around this," Hazra said.