Demetre Daskalakis, the White House’s deputy national monkeypox coordinator, spoke exclusively with the Los Angeles Blade in a Zoom interview on Wednesday to discuss the latest challenges facing public health officials battling the monkeypox virus (MPV), from combating misinformation and educating the public to transitioning to an intradermal vaccination schedule.
Daskalakis previously served as medical director for the New York-based Mount Sinai Health System and later became deputy commissioner for disease control at the New York City Department of Health and Mental Hygiene. In late 2020, as the U.S. was experiencing thousands of new COVID-19 deaths each day, Daskalakis joined the Centers for Disease Control and Prevention’s Division of HIV/AIDS Prevention.
Daskalakis, a gay man and a leading authority on LGBTQ health, led HIV and STD health programs during his tenure as New York City’s health official and is credited with reducing new HIV infection rates among gay and bisexual men in the city by 35 percent.
So while he points out that the US has never seen a monkeypox outbreak like this one, Daskalakis also had extensive experience as both a clinician and public health official prior to taking on this role in the White House, including working to combat anti-LGBTQ bias and stigma — which is crucial given the disproportionate number of monkeypox cases among gay men.
When it comes to messaging, Dr. Daskalakis said he and his team are taking a more difficult but more effective approach, which focuses on the means of exposure to MPV, “and [messaging] Communicate information “through the right channels” to the right groups based on relative risk.
That will include working with a variety of partners, Daskalakis said, including health care provider associations, groups like the Ryan White HIV/AIDS Program, and community groups that support LGBTQ patients. The goal, he added, is to “give people a straightforward message but be mindful of not creating stigma.”
He says that as new data has come in, the communication strategy has changed accordingly. This flexibility has been key to coordinating the federal response effort because “we can now be much clearer about specific risk factors that may increase or decrease an individual’s risk.”
This means that the recommendation for gay and bisexual men to “reduce their partner networks and, if possible, consider avoiding anonymous sexual partners” is based on solid scientific data about the transmissibility of MPV, Daskalakis said.
Of course, another persistent challenge is the spread of misinformation and disinformation on social media. Last month, far-right Rep. Marjorie Taylor Greene (R-Ga.) questioned on Twitter why children are getting MPV if the virus is sexually transmitted.
Groups like the Anti-Defamation League Citation The move is cited as an example of how “disingenuous questions about the origins and spread of the disease” drawing “an apparent link between monkeypox and ‘gay child sexual abuse,'” giving “oxygen and clout” to such dangerous lies about LGBTQ people.
“Stigma is stigma and homophobia is homophobia,” Daskalakis said, adding that while these issues are older, harder to solve and broader in scope than the public health messaging about MPV, it’s important “not to attach infection to identity.”
“Discrimination and stigmatization of illnesses can lead people to [figuring out] He said it’s important to think about how to respond to epidemics and to focus on the community, focus on knowledge, and focus on data to guide how we get messages to people through online social platforms and other channels.
Daskalakis offered an analogy for his approach to HIV communications: “Focus on exposure,” he said, explaining that “anal sex is the most common way HIV is transmitted” so that the message “reaches the people who need to hear.” That way, men who have sex with men understand the best harm reduction strategies, and “gay sex” and gay and bisexual men aren’t unnecessarily associated with the virus in a way that exacerbates or reinforces stigma.
Monday, The New York Times Reported State and local health officials have raised concerns about the delivery of the MPV vaccine, many of whom blamed federal officials for problems including shipments of the vaccine arriving in a state where the vaccine had spoiled due to high temperatures or improper handling.
While acknowledging the challenges, Daskalakis reaffirmed the CDC and the White House’s commitment to working with state and local partners on these efforts.
“CDC provided technical assistance and even provided videos that countries are actually using to teach. [the proper administration of] “The intradermal injections are really exciting,” he said, “but these are all designed to support jurisdictions, and we see ourselves as really connected with jurisdictions throughout this response.”
Daskalakis also praised the work being done by local and state health officials. “It’s really important to acknowledge that the challenges are real, [also] The creativity with which they’re addressing these challenges at the jurisdictional level will really help us get to the space we all want – more vaccinations… This is a common theme in public health, especially in emergency response,” he said, adding that it’s “encouraging to see how people are taking advantage of federal guidance.” [including] The support we are providing will help keep things moving forward.”
Despite the many challenges that lie ahead, Daskalakis is optimistic about the future, in part because more data is now available to public health officials: “I think we’re really working to accelerate research into vaccine efficacy, surveillance and safety to see how these things are working.”
Asked whether the federal government’s adjustment efforts continue to focus on finding ways to cut bureaucracy and paperwork, Daskalakis again answered in the affirmative.
“In terms of bureaucracy, I think that’s one of the key roles of our coordination efforts,” he said, working with partners at all levels to see how to make the process of vaccinating and treating as many people as possible less onerous, less paperwork and more efficient.
A promising sign of this kind of breakthrough in combating MPV came last week when the FDA approved Emergency Use Authorization for the intradermal injection method of the vaccine, JYNNEOS.
Not only is this method of administration safer, with fewer side effects than subcutaneous injections, but it also allows for larger doses to be administered, Daskalakis said.
Daskalakis said Los Angeles has been “tremendously successful” in rolling out the intradermal MPV vaccine. “It’s been lightning fast. It’s impressive.” It couldn’t have been easy for a city that large to adopt a new vaccination method so quickly, but he said local health officials have been ingenious and “have handled it well.”
Source: Washington Blade: LGBTQ News, Politics, LGBTQ Rights, Gay News – www.washingtonblade.com
