New monkeypox cases have declined by 85% since August peak. Here’s why.

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Since a peak in August, the number of reported daily cases of the monkeypox virus has declined 85%.

That’s the latest seven-day average data from the Centers for Disease Control, indicating a drop from 443 reported cases at the height of the outbreak on August 6, to 60 cases reported on October 12.

As of yesterday, 27,022 cases of the monkeypox virus have been reported in the U.S.

Experts attribute the drop to a variety of factors. The monkeypox vaccine, with an 85% efficacy rate, helped slow the virus down. Men who have sex with men reduced their partners following the rise of cases in the wake of large gatherings around Pride month in June. And the virus, spread by close skin-to-skin contact, was self-limiting, unlike the airborne coronavirus, finding fewer places to spread as potential hosts reduced their exposure and the vaccine proved effective.

Centers for Disease Control

Another factor was a change in communications strategy. As cases began to rise sharply, it became clear that the virus was disproportionally affecting men who have sex with men, but officials at all levels of government were reluctant to highlight the fact, fearing the stigmatizing effect of a virus mislabeled as a “gay disease.”

In the middle of July, the New York City Health Department debated a strategy calling for gay men to reduce partners, issuing a statement that counseled caution: “For decades, the LGBTQ+ community has had their sex lives dissected, prescribed, and proscribed in myriad ways, mostly by heterosexual and cis people,” the statement read. New York would offer direction cognizant of “how poorly abstinence-only guidance has historically performed with this disgraceful legacy in mind.”

“Telling people not to have sex or not to have multiple sex partners or not to have anonymous sex is just a no-go, and it’s not going to work,” longtime AIDS activist and Housing Works chief executive Charles King told The New York Times at the time. “People are still going to have sex, and they’re going to have it even if it comes with great risk.”

In San Francisco, local officials decided the data should do the talking, expanding eligibility for the vaccine to all men who have sex with men who’d had multiple sexual partners in the previous 14 days. On July 28, the city announced a public health state of emergency, in an effort to prompt a more urgent response from the federal government and to put the city’s most at-risk population on high alert.

New York City followed suit with their own monkeypox state of emergency, at about the same time the World Health Organization’s director general recommended that men who have sex with men should consider limiting their partners. The CDC highlighted that guidance not long after.

At the federal level, in the beginning of August, the White House enlisted Dr. Demetre Daskalakis to help lead the administration’s response to the growing crisis and rectify a stumbling rollout of the vaccine. Daskalakis, who is gay, responded with a strategy directly targeting the MSM community, through outreach at large events attracting gay men, and even participating in a live Grindr forum addressing the issue, with explicit guidance for men who have sex with men to reduce their number of sex partners.

The new messaging seems to have worked. According to the CDC, by the middle of August, men who have sex with men reported changing their behavior because of the monkeypox outbreak: 48% reported reducing their number of sex partners, 50% reported reducing one-time sexual encounters, and 50% reported reducing sex with partners met on dating apps or at sex venues.

Centers for Disease Control

“The strategy worked,” Daskalakis told LGBTQ Nation, describing what he calls “a three-part trick that always works in addressing outbreaks and epidemics: community engagement, science and political will.”

“I think that the really frank, direct information that we generated through governmental public health, and then saw the community alter, magnify, and contextualize, got out,” said Daskalakis. “Seeing people who reduced their behaviors that could potentially expose them to monkeypox was definitely a part of this.”

Daskalakis added: “What’s important is that you don’t associate a virus with an identity, but rather talk about the behaviors that are associated with transmission of virus, and make sure the right people know.”

“I think the Biden administration kind of got its act together, but it was slower than it should have been,” Supervisor Raphael Mandelman, who pushed hard for San Francisco’s monkeypox emergency declaration, told LGBTQ Nation. “It was not a pleasant exercise, seeing this health crisis that the federal government was not adequately addressing, and seeing how slow the country was to get this vaccine, that had already been discovered, distributed into people’s arms.”

But, says Mandelman, “It seems like the gays have done a good job of getting their monkeypox vaccines, and it seems like we’ve kind of turned a corner. I can say this cautiously.”

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