As outrage rises over the country’s sluggish monkeypox response, Florida exemplifies how the virus is spreading at a worrisome speed.
With more than 208 confirmed and probable cases in the state, the Florida Department of Health is only now getting Jynneos monkeypox vaccines out to the communities most affected and education on transmission and treatment is sorely lacking.
In Washington, politicians are lambasting the delayed and overly complicated U.S. rollout of monkeypox vaccines and tests as well as the lack of resources given to states.
Caught in the middle of the slow federal, state and local response are members of the public, including Florida’s LGBTQ communities, whose frustrations are mounting as the monkeypox case count rises daily.
“I think the state Department of Health needs to ramp up its efforts to spread the word about the existence of monkeypox and the way to get vaccinated and where the availability of it is,” said Fort Lauderdale Mayor Dean Trantalis. “And the state can also make further effort to work with the federal government to get more supply of vaccines.”
Frustration is visible
Social media is filled with urgent calls for tests, treatments and vaccines from some Floridians as the virus keeps spreading.
Broward County is the epicenter for the outbreak in the state — going from its first case on May 22 to more than 110 as of Wednesday in about a two-month time frame. The virus is spreading mostly in the community of men who have sex with men. Many of those infected have shared their stories of painful symptoms such as lesions in the genitals and mouth and a struggle to get treatment.
Until now, local organizations such as The Pride Center for Equality in Wilton Manors and the AIDS Healthcare Foundation have been behind the efforts to educate Broward’s LGBTQ community rather than the health department — holding town hall meetings, asking for vaccines, and signing up residents to get the shots.
Pride Center CEO Robert Boo said he realized in May how critical education would be and hosted a town hall prior to the local Stonewall Pride Parade and celebrations. “I saw what was happening in Europe,” he said. “I recognized we needed to start the ball rolling so our community could be aware of what was going on.”
Instead of educating the community, Broward County health officials initially focused on giving out information to health care providers to recognize symptoms and test anyone with a suspicious rash.
Only a week ago, state health officials began efforts to vaccinate people other than those exposed to someone infected.
Florida received 10,000 vaccines from the federal government’s stockpile a week after other states, missing out on the initial distribution as new cases further increased. The reasons for the delay are unclear. State health officials and U.S. Health and Human Services pointed fingers at each other for why Florida — with its high number of cases — wasn’t included in the initial distribution.
Vaccines have arrived
Since July 15, more than 25,000 doses now have been given to Florida from the national stockpile.
Vaccine clinics are underway in Broward, where demand has been strong, and in Miami-Dade, which has 56 cases, the second-highest amount in the state. Dr. Bryan Gaudio, medical director of the AHF Healthcare Center in Miami, says the vaccines still aren’t getting to the population most at-risk — men with HIV and AIDS. “We have been unable to get vaccines despite our best effort,” he said.
Gaudio says he is worried about the lack of education and outreach in the LGBTQ community and believes many living locally with HIV still are unaware of their risk. “When I get the vaccines, I will push my patients to get them. I’m a little surprised we don’t have phones ringing asking for them.”
On Wednesday, the Florida Department of Health held a news briefing to address the state’s monkeypox and urged anyone with a suspicious rash to see a health care provider. Testing to confirm the virus has become more accessible in Florida now that private and commercial labs can process the swabs taken by health care providers.
“While most cases have been in men who have sex with men, anyone that has been in close contact with an infected individual is susceptible,” said Dr. Ulyee Choe, statewide medical director for the Florida Department of Health and Health Officer for the Department of Health, Pinellas, said during the briefing.
The illness usually lasts between two to four weeks, and symptoms include fever, headache, muscle and back aches, swollen lymph nodes, chills and exhaustion, according to the CDC.
Choe said Florida’s Department of Health reached out to health care providers in the state early on to raise awareness and provide education on symptoms of monkeypox, and has updated the medical community on guidance for testing and treatment. When it comes to educating the public, he said “the information is available on our Department of Health webpage.”
On Thursday, Nina Levine, a Department of Health – Broward spokeswoman, said as cases were diagnosed in Broward County, staff responded by identifying contacts, vaccinating those exposed and securing Tecovirimat antiviral medication for those infected. She said posters and coasters with information on monkeypox also were distributed to Broward county bars, clubs and businesses. In addition, she said, the HIV Prevention Team has participated in and provided information regarding monkeypox, meningococcal disease, Hepatitis A and HIV at various community events.
Florida is at an inflection point
Dr. Stuart Burstin, interim national director of infectious diseases for the AIDS Healthcare Foundation, says it is going to take intense outreach to stop the spread. “There’s a great deal of education that needs to take place in the LGBTQ community, especially with young African Americans who don’t trust the system.”
Yet, Burstin believes relying on vaccines is not enough with the country now reporting more than 2,100 cases and the virus identified in countries across the globe.
The most effective vaccine made by Jynneos is a two-dose regimen taken four weeks apart and becomes fully effective two weeks after the second dose. That means it will take about six weeks for someone to have immunity from monkeypox.
“I think the outbreak will be blunted by vaccines but we need the education to encourage men who have sex with men to cut down on sexual contact, identify when they have lesions and isolate,” Burstin said. “That’s the only way we are not going to have continued spread.”
State Rep. Carlos Guillermo Smith said he organized a Community Health Update last week in Orlando because of the dearth of information locally on monkeypox. With Florida reporting the fourth-largest number of cases in the country, he wants more aggressive action.
“The state and federal response is not where it needs to be,” Smith told the South Florida Sun Sentinel on Wednesday. “We are not seeing much of any communication from the state. There have been one or two mentions on the Department of Health’s social media but that’s not going to cut it. To make people aware of a serious public health issue like this, you really have to be intentional about raising awareness.”
In Fort Lauderdale, Mayor Trantalis believes the state still has the opportunity to contain the outbreak.
“Fortunately, no one has died and no one is in the ICU, and we are fortunate it is not as egregious as COVID when it first appeared in our city,” Trantalis said. “But it’s still a disease that is causing pain and that could mutate into something worse and we need to take it seriously.”
Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com or Twitter @cindykgoodman.
