Canada urges gay and bisexual men to reduce their sexual partners to stem monkeypox. Advocates want help instead – Toronto Star
The federal government is asking gay and bisexual men to reduce their number of sexual partners to curb the spread of monkeypox. But community health workers and advocates say that spread is being fuelled by the lack of government support, financial and otherwise, for those who are at risk.
“The Public Health Agency of Canada recommends practising safer sex (and) having fewer sexual partners, particularly anonymous partners, even when they don’t have symptoms, can also reduce your risk of getting infected,” said Dr. Theresa Tam, Canada’s chief public health officer, at a news conference Wednesday. Tam also stressed the value of vaccination in thwarting the disease.
Graeme Lamb, a union steward of Steamworks Baths, a bathhouse in Toronto’s Gay Village, responded by saying, “Monkeypox is not spreading because gay men are having too much sex. It’s spreading because we have not had governments that are willing to commit the resources that are necessary to stop it from spreading and stopping it from causing people a lot of pain.”
Lamb said the lack of paid sick days available, concerns about access to fast testing and access to treatment are major issues community members are discussing right now.
Gay and bisexual men have already been limiting sexual contacts, he said. What deserves more discussion, according to Lamb, is funding for paid leave: “Our governments have decided that we’re not worth being supported through up to a month or month and a half of isolation, that’s stigmatizing.”
Researchers and community advocates have also told the Star that the lack of paid sick days available for those infected and lack of support for patients to help them care for themselves has caused many to feel left in the dark.
Tam was asked whether governments, while recommending safe sex, are looking at how to financially support those who need to isolate.
“In COVID-19 governments did step up and make sure people are supported if they need to be isolated from others, and I do think from a public health perspective we need to be able to do that,” she said. Tam said she’s encouraging provinces and territories to implement supports so that those who are infected can reduce contacts.
“What we’re trying to do is consult community organizations and the front-line health care workers … on the practical ways to make sure people are protecting themselves and others.”
The federal provided over 70,000 doses of the smallpox vaccine Imvamune to provinces and territories to combat growing monkeypox cases in the country, said Tam. About 27,000 doses have been used so far and the federal government can provide more if needed, but there are “limited supplies,” said Tam.
However, vaccine uptake has declined in recent weeks and Tam emphasized that the risk of the disease has not receded. Monkeypox cases have continued to rise in Canada, with the majority in Ontario and Quebec; Tam said that as of Tuesday, there were 745 confirmed cases in Canada: 346 in Quebec, 326 in Ontario, 58 in British Columbia, 12 in Alberta, two in Saskatchewan, and one in the Yukon.
More than 99 per cent of the Canadian cases are in men, the majority of whom reported “intimate sexual contact” with other men, which is in line with international trends, but the disease can spread to anyone, added Tam.
She also said that Public Health Agency of Canada (PHAC) is continuing to work with jurisdictions across the country to combat monkeypox through vaccination efforts and connections and promoting public health information about the virus. PHAC is advertising on dating apps like Grindr to target at-risk populations.
On Saturday, the World Health Organization (WHO) declared monkeypox a global health emergency, a move that Canadian academics and advocates welcomed as they told the Star the designation will encourage institutions to put more resources behind the illness. The current outbreak that began in May has now resulted in more than 19,000 cases worldwide, according to the WHO.
Toronto Public Health and its community partners report having vaccinated 11,154 people against monkeypox as of July 25. But despite the vaccination effort, the Star spoke to a man diagnosed with monkeypox in mid-June who said public resources to support those with the illness are scarce, and the lack of paid sick days for those who need to isolate is a major concern.
Those calls have been echoed by the provincial NDP. MPP Kristyn Wong-Tam noted at a news conference Tuesday that the recommended isolation period for those sick with monkeypox is 21 days and can be longer, so the province needs to introduce 10 paid sick days for infectious diseases and an additional 14 days during public health emergencies, she said.
“The rates of (monkeypox) infection are going up,” Wong-Tam said. “This is why we’re raising the alarm bells.”
Dr. Darrell Tan, an infectious diseases physician at St. Michael’s Hospital, told the Star that he and his colleagues who are rushing to study the virus to improve public policy and patient care are noticing many patients struggling with the financial consequences of isolation.
The illness spread mostly after prolonged close contact, through respiratory droplets — from breathing, talking, coughing or sneezing — or through skin-to-skin contact, or contact with objects that have been used by someone with the virus.
Lamb said there needs to be compensation for lost wages and funding services that support patients through isolation. Tam stating that she is encouraging provinces and territories to implement supports is not enough, he said.
“Municipally, Toronto Public Health have been very good in trying to reach out to the community and take direction when needed. But when someone gets monkeypox and they aren’t able to isolate at home, what are they going to do?” he said.
“The province is not dedicating funding, that’s the missing piece,” said Lamb.
Any public health messaging meant for marginalized groups should be done in consultation with community leaders, said Praney Anand, the executive director of the Alliance for South Asian AIDS Prevention, a Toronto-based non-profit that provides health and support services for LGBTQ people within racialized communities.
“It’s not so much about how (the message) can be delivered. It’s more about getting the process right, and that hasn’t happened. It’s about addressing it more systematically,” he said.
