Putting monkeypox front and centre: two journalists explain the importance of continuing to talk about the outbreak – World Health Organization
During any disease outbreak – and the ongoing monkeypox emergency has been no exception – the media play a vital role in communicating health risks and the measures people can take to protect themselves against them. This gives people – and those most at risk in particular – the opportunity to make their own informed decisions about safeguarding their health.
Six months after the first cases of monkeypox were reported in the WHO European Region, we interviewed two journalists who have made it their mission to highlight the issues surrounding the monkeypox outbreak to thousands of people through their podcasts, news articles and research. They have created platforms where people recovering from monkeypox can find support, where academics can provide information on the evolving situation, and where all members of society can add their voice to the conversation.
Martin Joseph is a comedian, host and producer of the “What the Pox?” podcast. He is based in London, United Kingdom, and created the podcast after he experienced monkeypox himself. “When I was home alone with monkeypox in all kinds of pain, feeling scared and alone, I had very little information, so I went online to find help. ‘What the Pox?’ is the information and support I wish I’d had at my disposal when I was going through monkeypox.”
Globally renowned journalist Kai Kupferschmidt is a contributing correspondent for Science Magazine, one of the world’s top academic journals, and is based in Berlin, Germany. He writes on a variety of issues, but primarily on infectious diseases. “It’s a really interesting area to be in because it’s fast-moving, it’s important, and it’s interesting,” he says.
Communicating uncertainty
Although monkeypox has been reported in humans for over 50 years, at the start of the current European outbreak, there were many unknowns about how the virus was spreading, who was most at risk, the range of symptoms people were experiencing, and the best ways to prevent transmission.
“The information I was getting wasn’t accurately reflecting the way that this virus was presenting,” says Martin. “I was seeing people covered in blisters all over their bodies and that was not how I was experiencing it.”
Kai says, “Whenever you’re writing about infectious disease, in the beginning, there’s just a ton of uncertainty. And you’re faced with people’s fears. They want to know how much risk there is and, at the outset, it’s very hard to give them any good answers. So, a lot of what you’re going to say is, ‘it looks like this, but we don’t really know’”.
“We were really frank in ‘What the Pox?’ about what we did and didn’t know,” says Martin, “but information is so key in feeling OK. It gives you some security even if the facts are scary.”
Changing the language around monkeypox
Both Martin and Kai are gay men writing about a virus that, in this outbreak, has mainly affected men who have sex with men (MSM), particularly those who have multiple sexual partners. Communicating clearly about how some sexual behaviours make this group most vulnerable to the virus has been crucial, but it has been equally important not to cause stigma or feed into misinformed stereotypes.
Kai describes how experts were sometimes unwilling to be interviewed because they found it hard to talk about sexual behaviour and worried they would be accused of discrimination. “They made choices for understandable reasons, but I do think there’s a residual discomfort with talking about this that, at its core, is actually a type of homophobia.”
“It’s hard to talk about sex,” he continues. “It’s hard to talk about sexual behaviour. I think you just have to kind of plough through that and do it, even if it feels uncomfortable. I think very small tweaks in language make a huge difference. There were sentences that I changed after I wrote them because I realized that this is not spread by gay men – it is spreading amongst gay men. They are the group that’s most vulnerable”.
Martin is angry about language that implicitly blamed the gay and MSM communities that he is part of for monkeypox:
“I feel like this landed on our doorstep and we swept it away. We got out and did the hard work. The fact that the numbers are dropping is, yes, attributed to the amazing sexual health services and the work of institutions like WHO, but also to the fact that we went out and queued up for four hours to get vaccinated, that we helped each other, that people did change sexual behaviour and had honest conversations about sex”.
Trusted voices
Martin’s “What the Pox?” podcast is a 10-part exploration of some of the issues raised by the monkeypox outbreak through interviews with patients and experts, including Dr Richard Pebody, who leads the High-threat Pathogen team at the WHO Regional Office for Europe. It is also interlaced with Martin’s own monkeypox experience. Although he had initially planned an anonymous contribution, hearing other people’s experiences brought him such comfort that he decided to share his story with listeners, many of whom were at home, isolating with monkeypox symptoms. “There is a real power in hearing people’s personal stories,” he says.
Kai’s audience, by contrast, includes many people working in science and public health. His most trusted sources for his articles are people who have worked on monkeypox prior to this outbreak, those who are publishing on it now, and individuals at international institutions like WHO, who can give him a global overview.
He identifies the explosion of information available online, coupled with an erosion of trust in health authorities linked to the pandemic, as big challenges to getting nuanced, evidence-based information out to the public in the coming years.
“It comes down to the trust of the population in public health officials, in journalists of certain media, and I think we we’ve been ignoring that at our peril. I don’t have any simple answers. It’s a difficult task to build that trust, but I think that’s essentially what we have to do,” he notes.
An interconnected world
Despite the encouraging reduction in monkeypox cases in the European Region, Kai believes that to understand the way forward on monkeypox, we first need to determine whether the decline has been down to increasing immunity among the most sexually active and connected groups or to behaviour change. Ending the outbreak completely could still pose challenges, he cautions:
“These last cases are always the hardest to prevent because it’s the people that maybe you haven’t reached with your information so far. It’s the people that maybe face huge barriers to accessing health care or health information. It can be people in countries where gay sex is criminalized, where they’re being stigmatized. They might be afraid of even being diagnosed if that means an isolation period that might not be feasible or might lead to them being outed [revealed as being gay]”.
Martin advocates for more global vaccine and resource sharing and improved health-care services for the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual) community. He also calls for more to be done to tackle homophobia, which he sees as a barrier to reducing human-to-human transmission and achieving the goal of eliminating monkeypox from the Region. Kai, too, proposes a global approach that includes tackling inequities in health care and giving more consideration to the intersections between health and commerce and our interactions with the natural world:
“As a journalist, I see my job as trying to connect the dots and explain to people, not just how this plays out this time with monkeypox, but what it means in the future, with other diseases. I’m trying to show people how what they’re experiencing is connected to the way that we’ve set up the world. That, to me, is the core mission – to make people understand how we’re all connected and how that impacts them right now.”
From the outset of the monkeypox outbreak in the Region, in addition to partnering with national and regional health experts and the media, WHO/Europe has consulted and collaborated with MSM and the civil society organizations that support and represent them, recognizing their knowledge and engagement as essential in the drive to control and eliminate monkeypox. This collaboration has helped to disseminate crucial information via multiple channels and platforms through the summer of 2022 and well beyond.