WaPo wonders: Why aren't health officials urging a certain kind of "social distancing" in monkeypox outbreak?

Shawn Thew/Pool via AP

Good question, especially since the same health officials had no problem ordering lockdowns and perpetual mask mandates for COVID-19, no matter the strength of the variants in question. Public health officials and elected leaders are announcing emergencies in the spread of monkeypox, the transmission of which has almost exclusively come from unprotected sex between males.

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Shouldn’t these health officials make note of that and warn against it? The expert class is suddenly shy about dictating private behavior, the Washington Post reports:

Thousands of gay men clad in leather, latex — and often much less — partied along Folsom Street here last weekend during the annual kink and fetish festival. Even after the city had just declared the monkeypox outbreak striking its gay community a health emergency — one day after the World Health Organization urged men to sleep with fewer men to reduce transmission — San Francisco public health officials made no attempt to rein in festivities or warn attendees to have less sex.

As the Centers for Disease Control and Prevention weighs whether to recommend limiting sex partners, health officials in San Francisco, Chicago, New York and other U.S. cities battling surges disproportionately sickening gay men are avoiding calls for sexual restraint, wary of further stigmatizing same-sex intimacy.

Public health authorities typically emphasize safer sex over abstinence to prevent the spread of diseases through intimate contact. But monkeypox is presenting new challenges in calibrating the right message to stop the rare virus from becoming endemic while limiting government intrusion into the bedroom.

Really? It doesn’t seem all that long ago when public health officials felt no such modesty about COVID-19. The CDC’s subsidiary National Prevention Information Network (NPIN) promulgated a full guideline for sex in the age of COVID, complete with information about who to let into your bedroom. For instance:

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For preventing the spread of the COVID-19 virus, the safest sex partners are those who already live with you and are at low risk of infection. If you and your partner are healthy and feeling well, staying at least 6 feet from other people outside the household, washing your hands often, and wearing face masks or cloth face coverings in public settings, sex is likely to be safe.

Emphasis mine. Why wouldn’t public health officials feel comfortable offering the same advice to couples regarding COVID-19? It’s true that COVID is a respiratory disease, but the outbreak of monkeypox in the US is being primarily driven through sexual contact, which makes this advice even more applicable.

The CDC and NPIN went so far as to advise couples to wear masks during sex and to avoid kissing during COVID:

Based on what we know about the COVID-19 virus, there are additional measures you can take for safer sex to lower your potential risk:

  • Avoid kissing8
  • Wear a face mask or cloth face covering and ask your partner to do the same9,10
  • Use condoms to reduce your contact with saliva, semen and feces during anal and oral sex11*

Why not publicly offer that same advice — and specifically the third instruction — for monkeypox? Wasn’t that guidance an “intrusion” into the bedroom when it came to COVID? The segment on hook-ups is even more “intrusive” in that sense, with a strong exhortation to abstain and a warning about compliance with social-distancing “recommendations,” which had turned into mandates in many jurisdictions in other areas of life and commerce:

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What about sex with a new partner? This person does not live with me. If you would like to start a new relationship, just met someone you’d like to have sex with, or want to engage in casual sex and/or hookups, the risks should be considered very carefully. CDC recommends practicing social distancing at this time to protect your health during this pandemic, and having sex with a person not in your immediate household does not comply with recommendations for social distancing (CDC link). The safest choice is to not to have sex with a person outside your household at this time.

Suddenly, public health officials are gun-shy about recommending abstinence even in a quasi-STD outbreak. Instead, everyone in public health and public office have become libertarians in the monkeypox era:

“If people want to have sex, they are going to have sex,” said California state Sen. Scott Wiener (D-San Francisco), who is involved in the city’s monkeypox response. “I know people who normally go to sex parties who will not. People will make their own decisions about their own risk levels.”

If that’s the basis for public health policy, then Sen. Wiener should have no problem passing a bill in the legislature preventing public mask mandate orders in California. After all, some people will go shopping and some won’t, but if they want to go shopping, they will. Shouldn’t the default for public policy be exactly what Wiener says: “People will make their own decisions about their own risk levels”?

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Actually yes, that’s precisely how public health policy should be calculated. The CDC and other public-health agencies should publish data and risk analyses and — except in cases of the most dire emergencies — people should make their own decisions about their own risk levels. The Washington Post shouldn’t question why those officials aren’t pressing for behavioral modification policies in the monkeypox outbreak, but why we’ve tolerated it for as long as we have in the post-vaccine COVID era. Give at least one cheer to the LGBTQ community for exposing the hypocrisy and political manipulations of so-called “experts” and public officials.

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