Wife texted me a picture of people lining up for the Monkeypox Vaccine, with a message, “Should we line up?”

I texted back, “Are you recently intimate or sexually active?”

She replied, “No.”

I took a sigh of relief and texted, “So, am I. No need to panic and get the vaccine. We’ll be fine.”

She texted a smiley face emoji 😀 followed by an LOL.

Truth: Monkeypox is NOT an LOL Infectious Disease. Its rash, vulgar, disgusting, highly contagious that can last for 2-4 weeks. Its social stigma is discriminatory that can last even longer. Not something we can just walk around unnoticed.

Not a surprise. US now has the world’s biggest monkeypox outbreak. More than 6,600 Americans have been diagnosed since mid-May– USA Today

So how is Monkeypox transmitted?

Monkeypox is transmitted through close, personal, often skin-to-skin contact including:

• Direct contact with a Person with Monkeypox via rash, scabs, or body fluids. Per CDC, this is the common way that monkeypox is spreading in the U.S.
• Touching contaminated objects, fabrics (clothing, beddings, or towels), and surfaces.
• Contact with respiratory secretions. Very reason Healthcare Staff are required full PPE Mode.

Intimate contact includes:

• Oral, anal, and vaginal sex or touching the genitals or anus of a person with Monkeypox.
• Kissing and Hugging.
• Massage
• Prolonged face-to-face contact.
• Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys. Caution on shady hotels and clubs.

Monkeypox may begin with Flu-like or COVID-like symptoms like fever, headache, body aches and fatigue. Lymphadenopathy are common. Rash follows 1-4 days after that can present as a firm, well circumscribed, umbilicated skin lesion, or pimple-like to vesicular to pustular skin lesions on face and mouth, chest/abdomen/back, arms and legs, hands and feet including soles and palms. Rash is centrifugal in distribution like extremities and face. Covering the rash limits the spread to other people and objects.

There is a unique rash distribution that is part of the concern, the Anogenital Region. Also isolated Oral ( Lips and Mouth) Area.

Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. This can take several weeks.

Post-exposure Monkeypox prophylaxis vaccination with Jynneos. Get inoculated within four days of exposure and no later than two weeks to reduce symptoms. Check your city and county website on where to get the vaccines and make the soonest appointment. For now, no walk-ins. Major Pharmacies like CVS and Walgreens, Doctor Clinics and Hospitals don’t have the vaccines.

Inequality of medical care distribution and preferential treatment are happening again like when COVID began. It is in itself, sickening.

This is what’s really happening, People who may be infected are grappling with dead ends, delays, incorrect diagnoses, and inappropriate treatments as they navigate an unprepared and ill-informed health care system.- Kaiser Health News

Too slow, not enough. The Biden administration declared the ongoing monkeypox outbreak a public health emergency on Thursday, a move that comes amid growing case counts and a groundswell of criticism over the way the administration has handled the outbreak. -STAT

Sounds Familiar? There are nearly 2 million courses the highly effective TPOXX antiviral sitting in the Strategic National Stockpile, but many health care providers are still having a hard time getting the medication for their patients.-CNN

Tecovirimat ( TPOXX ) is “not FDA approved” but is available as expanded access INH (EA-IND) protocol. People with severe disease (suspected or confirmed) or Patients who are at risk of getting severe disease should be considered for treatment. Availability is limited. Access is limited. Again, we are not ready nor are we organized to deal with the Monkeypox outbreak emergency if it goes Nationwide and Global.

Last 3 weeks, we have been handling possible Monkeypox Patients and Specimens. I can see the awkwardness and uncertainty, mindfulness and insensitivity, fear and doubt between Patients and Doctors, Patients and Medical Staff, Patients and Public, Patients and News Media. It will take awhile to adjust, be comfortable and be confidently familiar. May take more than 2 years like COVID.

There is a campaign emphasis that Monkeypox is mainly a Men to Men Transmission. That is a lie. That is misinformation. Our children playing at the park contaminated with infected skin lesions or droplets can get infected. We can get infected simply by directly sitting on contaminated public toilet seats or fitting clothes recently fitted by a Person with Monkeypox rashes. Transmission by Fomite to our bare skin is quick, easy and universal. This is not a disease of the sexually active only. Anyone can get it.

Thinking the virus only affects certain Demographics increases our chance of getting infected due to ignorance.

Monkeypox is being spread in the Bay Area, San Francisco and Los Angeles in alarming rate. San Francisco’s new positive cases are doubling in numbers every week that Public Health and Healthcare Facilities are putting in place a mandatory Monkeypox Preparedness Emergency Plan not just in SF, but also its nearby cities. However, preparedness in paper is not the same as readiness in action. This separates the serious from the half hearted.

Thursday, it’s official, the City of San Francisco, Monkeypox Outbreak has been declared a local state of emergency.

On the other hand, I don’t see a sense Emergency in San Francisco among locals or visitors. I was there Sunday. Everyone was just having an amazing fun time indoors and outdoors.

No masks, lots of touching, sharing crowded spaces with strangers from all over the World. It’s like being in a Parallel Universe. From my visual perspective, “nobody cares” about infection anymore, but “everyone cares” about having their lives back with absolute freedom, adventure and happiness.

People are claiming back their biggest and brightest American Dreams as they should be. Today, this is what Normalcy looks like in America. We are the brave and the unafraid.

In Real Life settings and responses, the two outbreaks, Monkeypox and BA.5 does not seem to exist. Exactly, why COVID Pandemic became Endemic, and Monkeypox will be no different.