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Andrew Miller: Apathy towards monkeypox will impact all of us in WA

Andrew MillerThe West Australian
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A man receives a vaccine against Monkeypox from a health professional in medical center in Barcelona, Spain, Tuesday, July 26, 2022.
Camera IconA man receives a vaccine against Monkeypox from a health professional in medical center in Barcelona, Spain, Tuesday, July 26, 2022. Credit: Francisco Seco/AP

The headline that nobody needs right now: “Monkeypox is here!”

Mustering the energy to continue our fight against the machine-gun mutations of airborne COVID-19 is difficult enough, without ending our meetings with, “um sorry, there is another virus we need to talk about”.

We like to “take the season one game at a time” so this is an unwelcome rule change, just as the Omicron B4/5 wave may be peaking and we were hoping for a couple of months to refocus our efforts in struggling hospitals and businesses.

Monkeypox is very different to COVID-19, which is a bit like saying fire is different to flood.

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We cannot ignore either of them.

Early signs are that the first people to suffer from monkeypox in the Western world are mostly from the LGBTQIA+ community. However, there is no biological reason why it will not also infect many others, as the Illinois day-care incident, where 40 children now require smallpox vaccination, reminds us.

This raises inevitable comparisons with the HIV pandemic, which since 1981 has claimed more than 40 million lives. I was in my trainee doctor years when it hit Australia, accompanied by the famously arresting Grim Reaper bowling ball ads on TV.

The disease changed everything for our generation. It was a time when endemic prejudice and homophobia was further amplified to cruelly magnify the burden on patients and their loved ones.

Larry Kramer has been one of my heroes and a role model ever since. The American playwright and AIDS activist refused to sit down, or be polite, when he knew that medical authorities could and should be moving faster.

His Broadway play Normal Heart was reviewed by Newsweek as “a damning indictment of a nation in the middle of an epidemic with its head in the sand”.

He made himself unpopular with everyone, loudly demanding better from medical authorities who were unused to being questioned. He was a honey badger, also yelling at his own community to practice safe sex.

He did not care what people thought; he just wanted to reduce preventable deaths.

In 1988 he published an open letter to Dr Anthony Fauci, now familiar to us all, who was at that time running a pedestrian and bureaucratic HIV response in the US. As months went by waiting for drug trials, the death toll from AIDS climbed.

Kramer called Fauci “a monster”, “an incompetent idiot” and “a tragically pompous murderer”.

That is the mild part.

The full letter is worth reading online as the epitome of flamethrower advocacy, if you can handle honest, naked rage.

Fauci was Kafkaesque, saying of HIV treatments that “there are just compounding delays that no one can help” which sounds familiar to those of us nail-biting for a COVID-19 vaccine for our six-month to five-year-olds, which the USA started injecting six weeks ago.

“All the doctors have continuously told the world that All Is Being Done That Can Be Done. Now you admit that isn’t so,” wrote Kramer. “Will this raving do any good at all?”

Kramer wondered if Fauci would “seek redemption and forgiveness by rethinking, retooling, and, like Avis, trying harder”.

He did.

To Fauci’s eternal credit, instead of suing Kramer for defamation, they worked together and ended up as friends and colleagues.

Fauci admitted that Kramer’s theatrical iconoclastic stance was the wake-up call that forced action from embarrassed public health authorities, and saved countless lives. Polite letters would not have done the job.

Our response to Monkeypox, the vaccination of susceptible groups, testing and education must be immediate. There could be 15,000 dead from COVID-19 in Australia during 2022. Our annual road toll is 13 times lower.

Not you though?

The categories of “healthy” and “sick” are illusory and impermanent. Tomorrow, any one of us could find ourselves limping at the edge of the herd. We must stay focused on helping everyone, like Kramer was.

Rethink, retool, try harder.

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