The question:

If refraining from sexual contact for three-to-eight weeks could save lives and put a stop to suffering in your community, would you do it?

The history:

Monkeypox is an animal virus that can be transmitted to and between humans. In 1970, the first human case of monkeypox was identified in a child in the Democratic Republic of the Congo. It has appeared since then mostly in tropical African countries. The 2003 outbreak in the U.S. was via infected prairie dog pets that had been housed with infected animals imported from Ghana. Most outbreaks outside of the African continent have originated from contact with travelers from Nigeria.

The science:

The current monkeypox outbreak is, almost exclusively, a sexually transmitted disease. The World Health Organization has declared it a disease of global public health importance. The cohort being infected during this outbreak is the MSM community. No, not the mainstream media; the men who have sex with men. Nowadays I guess that would be the males (XYs) who have sex with males (XYs), although anyone in intimate contact with an infected person can get it.

According to WHO, the disease has an incubation period of as few as 5 and as many as 21 days. The first symptoms are fever, intense headache, swollen lymph nodes, back pain, muscle aches, and extreme fatigue. The skin lesions usually appear within 1 to 3 days of the fever. Specific to this period, which lasts from two to four weeks, WHO says:

The rash tends to be more concentrated on the face and extremities rather than on the trunk. It affects the face (in 95% of cases), and palms of the hands and soles of the feet (in 75% of cases). Also affected are oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (20%), as well as the cornea. The rash evolves sequentially from macules (lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off. The number of lesions varies from a few to several thousand. In severe cases, lesions can coalesce until large sections of skin slough off.

The R naught—the reproductive rate of the virus—is probably less than that of smallpox, which is 3.5 to 6.0. Monkeypox is infectious from the first sign of symptoms until the rash is fully healed and new skin has formed.

According to the CDC, it is spread through intimate contact with the rash, scabs, or bodily fluids, including close contact with respiratory secretions while kissing, touching items that have touched a rash or such body fluids, and traveling through the placenta. Monkeypox virus enters the body through broken skin, the respiratory tract, eyes, nose, and mouth.

The pictures of infected people with widespread rashes look horrific. The rash can be very painful and leave scars. More worrying is that the case fatality rate is between 3% and 6%. With more than 15,000 people worldwide known to be infected, that’s 450 to 900 expected deaths right there. Risk factors according to Healthline include having a more severe case, being a younger person, prolonged exposure to the virus, and having overall poor health. That would naturally include anyone already at risk of higher STD exposure.

There’s lots of talk of mass vaccinations to prevent contagion. With this vaccine, that might work. It will take time, logistics, money, and the public’s cooperation with governments currently in several hot seats with their people to make it effective. How about we try something else, in addition to a vaccination outreach?

The appeal:

Unlike SARS-CoV-2 (COVID-19), this is a virus that has limited opportunity for transmission. Imagine! What a wonder it would be if the most at-risk members of our world were to stop the spread of this potentially deadly contagion in its tracks. What a powerful show of force and determination for a historically disparaged group.

How would this work? Let’s pick an arbitrary date, say August 1, 2022. Every man who engages in sexual relations with other men, and others whose sexual partner does so, refrains from sexual intimacy, including kissing and intimately touching the genitals, eyes, noses, and mouths of others, for three weeks. At this point, with no symptoms of fever, achiness, enlarged lymph nodes, tremendous fatigue, or rash, one can presume to be uninfected. The uninfected know what to do to remain safe from this virus—refrain from indiscriminate intimacy. Those that do experience symptoms seek medical care and supervision of their progress—and continue to refrain from vector activities until the virus has run its course.

Meanwhile, countries, governments, international and multilateral organizations like the UN and WHO, political parties, communities, advocacy groups, and many others can broadcast public service announcements telling folks that only they can stop the monkeypox.  It probably will not surprise anyone that the same group most at risk of catching monkeypox is also at a high risk of contracting HIV.  The CDC's budget includes HIV prevention.  American embassies in countries with a high HIV/AIDS burden have funding in place through the PEPFAR (the President’s Emergency Plan for AIDS Relief) program to support outreach in communities, like the MSM, to reduce the incidence of transmission. 

Raves can be postponed; gay bars can become more sedate gathering places, reminding folks that they are saving lives by making their own lives somewhat uncomfortable for a few weeks. Friends can have conversations with friends; ditto family members. Those mutually attracted can make a date for later, perhaps during the holidays. Public health officials can reach out to their local MSM sex workers with help and financial support during this period. Those working with teens in the MSM world can encourage them to shoulder the responsibility that comes with a high-risk lifestyle.

Within eight weeks, the LGBTQ village can eradicate this terrible scourge. Then they could rightfully claim it takes a village to save a world. Let’s have the Pride family show the world what it’s made of—strength, wisdom, and sacrificial care for its own.

Calling on all our gay conservatives, especially, and their friends and allies, to announce and support a very time-limited movement to Stop the Pox.

Image made using a public domain image.

Anony Mee is the nom de blog of a retired public servant.