The Biden administration’s monkeypox messaging challenge – The Washington Post

The first U.S. case of monkeypox was reported on May 17. As of today, the nation has more than 13,000 cases — far more than any other country experiencing an outbreak.

The virus is overwhelmingly infecting gay and bisexual men and while it’s not a sexually transmitted disease, the majority are contracting it during close contact during sex. It has been identified in semen and saliva, and is known to spread through contact with lesions. (The World Health Organization reported today that in 9,100 cases with data on sexual orientation, 96.9 percent were men who have sex with men. Of more than 6,600 reported types of transmission, 91.2 percent of cases stemmed from a sexual encounter.)

But there is disagreement among the gay community, public health experts and government officials about the best way to communicate with the public and at-risk groups without further stigmatizing an already marginalized group. And it seems that the administration has been struggling with that question as well.

An internet archive shows that earlier this summer, several of the Centers for Disease Control’s pages on monkeypox referenced men who have sex with men, warning that the community made up “a high number of cases.”

As of Wednesday afternoon, that information no longer appeared on the multiple pages, which no longer referenced specific groups and instead said the virus was “spreading mostly through close, intimate contact with someone who has monkeypox.” (H/t to science reporter Benjamin Ryan, who flagged this in a tweet last week.) But the agency’s webpage on monkeypox was updated either Wednesday evening or early Thursday to reinstate the references.

Asked about the changes, CDC spokeswoman Kristen Nordlund said in an email that the agency has tried to be clear in its guidance based on the data.

“Since the beginning of the monkeypox outbreak, CDC has continually emphasized to healthcare providers, media, and partners that most cases are among gay, bisexual, and other men who have sex with men,” she said. “We’ve been in close contact with the LGBTQ+ community throughout the outbreak on our recommendations and guidance for prevention, treatment, and vaccination.”

Monkeypox information released by the White House references gay and bisexual men, and the officials President Biden tapped to lead the response to the virus regularly speak about how that community has been most affected.

In a White House monkeypox briefing this morning, officials announced that the U.S. is boosting its vaccine supply with 1.8 million more doses — and that 50,000 doses are being set aside for local health jurisdictions where large LGBTQ events are happening.

A risk for all

Some experts say putting too much emphasis on the spread of monkeypox in gay communities can put a target on gay men. Conservative pundits and politicians have begun using monkeypox as the punchline of crass, often homophobic jokes, and D.C. police are investigating a recent attack on a gay couple as a hate crime after the couple told officers the assailants used an anti-gay slur and referenced monkeypox.

Experts say while the virus is currently mostly contained within the gay community, it’s important for everyone to understand that they could contract the virus too. Some activists have compared the situation to the HIV/AIDS crisis, saying the messaging in that era left people outside of the gay male community vulnerable by giving them a false sense of security.

Julie Swann, a disease modeler at North Carolina State University who has advised the CDC, said representing monkeypox as a gay disease ignores other populations that could be at risk of contracting it — and could also decrease the likelihood of someone outside of the gay male community getting tested.

“If people don’t want to ask to be tested for this disease because they don’t identify as [a man who has sex with men] and don’t want the health care provider to identify them as an MSM, then that is going to cause additional problems,” Swann told The Daily 202.

But others argue that not being clear about who is most likely to be affected by the virus leaves hundreds of thousands of gay men vulnerable to an agonizing illness that has not led to U.S. fatalities but can cause painful lesions.

Demetre Daskalakis, deputy coordinator of the White House Monkeypox Response Team, told writer and veteran AIDS activist Mark S. King last week that “clear and culturally appropriate” communication on monkeypox is a priority for the CDC. At the time, King was pleased with the center’s candor.

But looking at the revised CDC guidance Wednesday, King was frustrated.

“We have come way too far, I would hope, to regress to being coy about the who’s and how’s of monkeypox,” he told The Daily 202. “Why make people read between the lines? Tell the truth, plainly.”

King said the delicate messaging is likely a well-intentioned overcorrection from the homophobia of the HIV/AIDS era (the illness was first referred to as “gay-related infectious disease,” or GRID), but intentions aren’t what matter in a public health crisis. People who are going to stigmatize gay men are going to do it regardless of monkeypox messaging, he said.

Overall struggles

How to talk about the infection is far from the only monkeypox problem the Biden administration has. Even on the heels of the coronavirus pandemic, officials failed to recognize how aggressively monkeypox was spreading and struggled to meet demand for testing, vaccines and treatments. Officials also failed to order enough vaccines to combat the outbreak, later opting to stretch the supply by splitting doses into fifths, angering the vaccine’s manufacturer.

In their story Wednesday, my colleagues Dan Diamond, Fenit Nirappil and Lena H. Sun explained what we should be keeping an eye on as the nation grapples with its latest public health crisis:

“The coming weeks will reveal whether the administration has overcome its early struggles — or whether too much time was lost as the virus took hold in the United States under a president who had vowed to prevent pandemics.”

What’s happening now

Federal judge to hear arguments on releasing Mar-a-Lago affidavit

“The document is believed to hold key details about the government’s investigation into Trump’s potential mishandling of classified materials. Multiple media outlets, including The Washington Post, are seeking the affidavit’s public release,” John Wagner and Mariana Alfaro report. Arguments are scheduled for 1 p.m. Eastern time.

Allen Weisselberg, longtime Trump executive, pleads guilty to tax scheme

“Allen Weisselberg, the longtime top financial officer of former president Donald Trump’s company, pleaded guilty to more than a dozen counts on Thursday, more than a year after he and the business were indicted and charged with undertaking a long-term scheme to avoid paying taxes by concealing executive pay,” Sheila McClear and Mark Berman report.

FTC threatens to sue firm allegedly revealing abortion clinic visits

“The agency’s proposed complaint, against Idaho-based Kochava, argues the company violates laws that prohibit ‘unfair or deceptive practices’ by allowing its customers to license data collected from mobile devices that can identify people and track their visits to health-care providers,” Cat Zakrzewski reports.

Lunchtime reads from The Post

How the Mar-a-Lago search has helped fuel GOP attacks on the IRS

“As Republicans work to find their message in the days after their standard-bearer’s Florida residence was searched by the FBI, the verbal attacks on federal law enforcement have become enmeshed with another talking point tied to a totally different issue: the idea that Democrats are supercharging a tax agency to surveil regular Americans,” Marianna Sotomayor reports.

CDC, under fire, lays out plan to become more nimble and accountable

“The nation’s top public health official acknowledged Wednesday that the Centers for Disease Control and Prevention had failed to respond effectively to the coronavirus pandemic, and announced plans for extensive changes, including faster release of scientific findings and easier-to-understand guidance,” Lena H. Sun and Dan Diamond report.

Trump rakes in millions off FBI search at Mar-a-Lago

“Contributions to Trump’s political action committee topped $1 million on at least two days after the Aug. 8 search of his Palm Beach, Fla., estate, according to two people familiar with the figures. The daily hauls jumped from a level of $200,000 to $300,000 that had been typical in recent months, according to the people, who spoke on the condition of anonymity to discuss nonpublic information,” Josh Dawsey and Isaac Arnsdorf report.

… and beyond

Jan. 6 grand jury has subpoenaed White House documents

“Federal prosecutors investigating the role that former President Donald J. Trump and his allies played in the events leading up to the Jan. 6, 2021, attack on the Capitol have issued a grand jury subpoena to the National Archives for all the documents the agency provided to a parallel House select committee inquiry, according to a copy of the subpoena obtained by The New York Times,” Alan Feuer, Maggie Haberman and Luke Broadwater report.

Trump supporters’ threats to judge spur democracy concerns

“The threats against [U.S. Magistrate Judge Bruce Reinhart] are part of a broader attack on law enforcement, particularly the FBI, by Trump and his allies in the aftermath of the search. But experts warn that the focus on a judge, coming amid an uptick in threats to the judiciary in general, is dangerous for the rule of law in the U.S. and the country’s viability as a democracy,” the Associated Press‘s Gary Fields and Nicholas Riccardi report.

The Biden agenda

U.S., Taiwan to begin formal trade talks amid Pelosi visit’s fallout

“The Office of the U.S. Trade Representative said it expects the formal talks on the U.S.-Taiwan Initiative on 21st-Century Trade to begin in the fall. Washington had excluded Taiwan from the Indo-Pacific Economic Framework, a trade initiative widely seen as an effort to counter China’s influence in the region, despite some U.S. lawmakers lobbying for Taiwan’s inclusion,” Eva Dou and Lyric Li report.

Biden signs bill to help police respond to those with mental health issues

“Biden signed the measure Tuesday without fanfare. It would renew the existing Justice and Mental Health Collaboration Program and provide funding for a new training program for law enforcement and other first responders,” Jonathan D. Salant reports for NJ.com.

How Education Dept. plans to lift 7.5 million borrowers out of default

“The Biden administration has created a plan to bring 7.5 million Americans in default on their federal student loans back into good standing, restoring their eligibility for financial aid and removing the incident from their credit history, according to documents obtained by The Washington Post,” Danielle Douglas-Gabriel reports.

How ranked-choice voting works, visualized

“With a traditional ballot, all the votes are added up, and the candidate with the most votes wins, even if that candidate did not win a majority of votes,” Harry Stevens explains.

“With the ranked-choice ballot, if none of the candidates receives a majority of first-choice votes, the last-place candidate is eliminated, and her votes are distributed to her voters’ second-choice candidates. The process repeats until one of the candidates collects more than half the votes.”

Hot on the left

Liz Cheney product warning label

“In her crusade against Trump, it doesn’t work for Cheney to run as a Republican. She’d serve as a foil to energize Trump’s base and help him win the nomination,” Robert Kuttner writes for the American Prospect.

“Her more logical path is as an independent. At first glance, that course sounds like a winner—for democracy and for Democrats. Cheney takes 10 or even 20 percent of the vote, mostly from the Republican, and throws the election to the Democrat. But be careful what you wish for.”

“Cheney has become such a heroic figure that she could also take plenty of votes from the Democrat. If it’s Trump against Biden, she’s a far more effective debater than either, and more than two decades younger.”

Hot on the right

Musk tells GOP elite to be more compassionate

“Elon Musk told GOP congressional leaders and big-dollar donors on Tuesday that Republicans need to present a more compassionate front to voters and appeal to immigrants like himself,” Axios‘s Hans Nichols reports.

“While Musk has been publicly flirting with the Republican Party all year, his attendance at an exclusive GOP retreat in Wyoming marks a new level of involvement in helping the party define its agenda and prepare for its potential takeover of the House.”

Today in Washington

The president is in Delaware and has no events on his public schedule.

In closing

Aurora borealis could dazzle skies in northern United States this week

“A brilliant display of auroras could grace northern skies Wednesday through Friday after the sun shot off several waves of energy toward Earth earlier this week. Activity is expected to peak Thursday into Friday as a strong geomagnetic storm, rated G3, reaches Earth,” Zach Rosenthal reports.

Where to watch: From New England across the Great Lakes into northwest Oregon and Washington state

Thanks for reading. See you tomorrow.