Sitting in a cafe in Padanaram, Andy Pollock, president of the South Coast LGBTQ+ Network, was drinking coffee and reflecting on his own coming of age. “I turned 18 in 1981; not a good recipe for a gay man who wants to live a long life.”
“It was 15 years of watching people die,” Pollock said, his browlines deepening. “The gay papers from Boston were filled with obituaries.” But he survived.
After growing up on a horse farm in Dartmouth and “swearing on a manure spreader that I’m never coming back,” Pollock now lives on the very same farm with his husband — though vegetables, not horses, cover the grounds.
Around the cafe, friends from a lifetime on the South Coast stopped to say hello, asked about the latest news, or simply waved to Pollock without leaving their own conversations. He told most about a symposium he was organizing, about monkeypox, and that they should tune in.
Some were surprised. Why was he taking up this cause?
“We have to,” Pollock said. “We learned from HIV … We need to be bold and courageous. We need to take this seriously.”
Monkeypox isn’t the same challenge. Among other differences, there is already an effective vaccine. But like AIDS, a disease that can affect anybody has happened to spread among one tight-knit and embattled community. Men who have sex with men (MSM), account for nearly all of the United States’ 21,274 monkeypox cases, according to the CDC.
“It’s not going to stay in our community,” Pollock said, “but it’s here now.”
The following Wednesday evening, Aug. 24, Pollock delivered his opening remarks at the online symposium.
“With the specter of the AIDS epidemic in living memory,” he said, “the South Coast LGBTQ+ Network decided to address this issue head-on.” With a gravity earned from living through that epidemic, Pollock looked into the camera and said, “We all have a job to do in this battle.”
The United States has reported more cases of monkeypox than any other country in the current outbreak. Massachusetts reported the first domestic case in April, and now there are more than 300 confirmed cases in the Bay State.
At the Greater New Bedford Community Health Center (GNBCHC), which sees patients from across the South Coast, there have been eight diagnostic tests conducted so far, according to Erika Silva, the infectious disease nurse manager overseeing the response. Two have come back positive. One never received a result after the state’s Department of Health declined to perform the test because of shortages earlier this summer; “no result was confirmed with this patient,” Silva said.
“We haven’t quite had an influx, but we’ve definitely had some cases where there was concern,” Silva said.
The most recent case was confirmed about three weeks ago, she said, and that patient’s symptoms were painful enough to administer the first treatment in New Bedford of TPOXX, an antipoxviral drug that resolves monkeypox’s painful lesions. Within two days, the patient’s symptoms improved.
In addition, New Bedford is home to one of only 14 vaccination sites across the state, at Seven Hills Behavioral Health Center. “We have given over 600 vaccines,” said Connie Rocha-Mimosa, the director of community health services. “An average of 25-40 each day,” she estimated.
“We get calls every day,” she said. “It’s a constant.” But so far they have been able to meet demand. “Our access to vaccines has been good. We have been able to fill the need.”
Globally, rates of monkeypox have been showing signs of slowing down. In the United States, however, cases are still rising. According to STAT health news, the first American death was reported in Texas, in a severely immunocompromised individual.
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Experts in New Bedford hope to prevent the spread of the disease through education. “The message we want to get out to people is we want to keep the risk low,” Rocha-Mimosa said. “Protect yourself and others. It really affects everybody.”
“With any new illness, reach out to your primary care or your local urgent care so you can have an evaluation,” said Silva. “The virus does not discriminate.”
Providing education and information to people is a lesson that sticks with Andy Pollock. Coordinating a response between LGBTQ+ groups and health organizations in a symposium was possible, he said he believes, because “of the creativity and desperation of fighting AIDS.”
In the 1980s, “there wasn’t much information,” Pollock said. Even today, he clearly remembers a 1981 article that was buried in the New York Times. Describing an unknown illness that was starting to kill homosexual men, one immunologist was quoted: “It’s an extraordinary business and really quite frightening because nobody knows the cause.” The article is imprinted in Pollock’s memory, though it ran in Section D, page 24.
Those who organized and educated on the South Coast at that time were a light for Pollock. He says a former nurse at the GNBCHC and “hero of mine,” Liz DiCarlo, exemplifies that spirit. In the late ’80s, DiCarlo was a “nurse educator” who did street outreach to sex workers, the gay community, and drug addicts.
“We went to every place that people were hanging out,” DiCarlo remembered on a recent phone call. “Talking with them about preventing the spread of HIV.”
New Bedford was the “epicenter in our part of the state,” she said, where the disease affected people who were “gay, straight, injection drug users [or] a child born to a mother who had HIV.”
“In New Bedford it was really important for people to understand that this could happen to anybody,” she said, which is “similar to what’s going on with monkeypox.”
“It’s ridiculous to have to deal with stigmatization of any disease. … You don’t get these diseases because you deserve them; you get them because you’re unlucky.”
That’s why Pollock decided to host the symposium. “When we lead, we take away stigma,” he said.
Dozens of people streamed the symposium live. They listened to Pollock’s opening remarks, and heard doctors and public policy experts take turns dispensing the latest and best information. More have since watched the recording on YouTube.
One expert was Sandra Custodio, the nurse practitioner at the GNBCHC who identified, tested, and diagnosed the first case of monkeypox there, an ordeal she described as “quite a process.”
“At that point, there were several swabs, pictures had to be taken, the state epidemiologist had to be called,” Custodio said. She even needed approval to send the specimens to a special state lab.
A declaration of a public health emergency by the federal Department of Health and Human Services, she said, helped to reduce bureaucratic obstacles to vaccination, testing and care.
“We’ve moved quite a long way in the last two months,” Custodio said.
Another speaker was Dr. Donald Rice, who specializes in internal medicine and infectious disease at SSTAR. He answered common questions about monkeypox with calm advice. “Not all rashes are monkeypox,” he said. “Take a deep breath and call your doctor.”
One area of focus in Dr. Rice’s practice is the ongoing treatment of individuals with HIV in the South Coast region. “It’s still prevalent,” he said. “We have it; we see it.”
He has partnered with the South Coast LGTBQ+ Network before, speaking at their World AIDS Day event. He said HIV cases have actually undergone “an increase over the last 10 years related to the opioid epidemic.” But science has advanced to where the disease is manageable. “People are well treated,” he said.
After the experiences of HIV/AIDS, these doctors, health professionals, and LGBTQ+ Network advocates are committed to taking on the challenge of monkeypox.
DiCarlo said education is the one constant. “For those who know how this and any other disease is spread, we need to talk about it. We need to talk about vaccinations and how to protect yourself around any communicable disease.”.
“How lucky are we?” DiCarlo said about fighting monkeypox. “HIV didn’t have a vaccine, and we still don’t.”
What is monkeypox?
The viral disease usually presents as a rash that looks like pimples or blisters, but also can cause fever, headache, or swollen lymph nodes, according to the CDC. Normally endemic to Africa, more than 99% of cases in the current outbreak are outside the disease’s historical geography, with most cases in the United States.
Is monkeypox fatal?
Almost never. Out of more than 21,000 cases of this strain in the United States there has been one reported death; the individual reportedly had other health complications.
Is New Bedford a center for monkeypox cases? What about Massachusetts?
No. There have been two positive tests in New Bedford, plus another early presumptive case that never received a test result. In Massachusetts, there have been 336 cases as of publication, while New York state, for example, has had over 3,500 cases, according to the CDC.
Who should get vaccinated?
The CDC is recommending vaccination only for those who have a known exposure to monkeypox or are included in a high risk category, such as people who had multiple sexual partners in the past 2 weeks in an area with known monkeypox.
Where can I get a vaccine?
If you think you may be eligible for vaccination, the CDC recommends talking with your healthcare provider. An appointment can be made by calling the Seven Hills Behavioral Health at 774-634-3725, Monday through Friday between 9 a.m. and 5 p.m.
Email Colin Hogan at firstname.lastname@example.org
Correction: This story was modified on Friday, Sept. 9, 2022, to clarify that Liz DiCarlo is a former nurse.