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Official monkeypox discussion thread (1 Viewer)

I actually don't have a problem with giving gay men priority for limited vaccine supplies.  If that's the population where the virus is circulating, it seems to make the most pragmatic sense to target your doses to that community.  I don't see that as social justice activism -- if a virus was attacking middle-aged white male Midwesterner community I would argue for vaccines to be delivered to my front door.  

 
I actually don't have a problem with giving gay men priority for limited vaccine supplies.  If that's the population where the virus is circulating, it seems to make the most pragmatic sense to target your doses to that community.  I don't see that as social justice activism -- if a virus was attacking middle-aged white male Midwesterner community I would argue for vaccines to be delivered to my front door.  
I’m this example I think it makes sense.  I do think the dilemma is more difficult when more contagious and involves self induced co-morbidities. 

 
It’s a bit odd they included all transgender, gender non-conforming and non-binary people. It’s not like those groups are guaranteed to be practicing high risk activities.

They could have simplified it to MSM who have had multiple recent sexual partners.

 
I actually don't have a problem with giving gay men priority for limited vaccine supplies.  If that's the population where the virus is circulating, it seems to make the most pragmatic sense to target your doses to that community.  I don't see that as social justice activism -- if a virus was attacking middle-aged white male Midwesterner community I would argue for vaccines to be delivered to my front door.  


The social justice warriors in this scenario arent arguing for this. They are arguing against it.

 
It’s a bit odd they included all transgender, gender non-conforming and non-binary people. It’s not like those groups are guaranteed to be practicing high risk activities.

They could have simplified it to MSM who have had multiple recent sexual partners.
I was listening to Dr. Campbell's podcast on the way in and he was citing a recent report from the NEJM (I think), but it highlighted that 42% of known cases of monkeypox in June were in the immunocompromised.  IF transgender, and similar fall heavier in that field it could explain it.  Or they could have also simplified it as being immunocompromised, so who knows...

 
It’s a bit odd they included all transgender, gender non-conforming and non-binary people. It’s not like those groups are guaranteed to be practicing high risk activities.

They could have simplified it to MSM who have had multiple recent sexual partners.
Pretty sure they just worded that poorly. I think the original language was in fact just the first part and what you are saying. But then I think people brought up that some trans men are gay or non binary etc so they arent included in such a statement and that would be trans exclusionary. 

 
I was listening to Dr. Campbell's podcast on the way in and he was citing a recent report from the NEJM (I think), but it highlighted that 42% of known cases of monkeypox in June were in the immunocompromised.  IF transgender, and similar fall heavier in that field it could explain it.  Or they could have also simplified it as being immunocompromised, so who knows...
Transgender do have higher rates of HIV,  but still, most aren’t immunocompromised. Here’s the NEJM summary of cases:

We report 528 infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries. Overall, 98% of the persons with infection were gay or bisexual men, 75% were White, and 41% had human immunodeficiency virus infection; the median age was 38 years. Transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. In this case series, 95% of the persons presented with a rash (with 64% having <10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion). Common systemic features preceding the rash included fever (62%), lethargy (41%), myalgia (31%), and headache (27%); lymphadenopathy was also common (reported in 56%). Concomitant sexually transmitted infections were reported in 109 of 377 persons (29%) who were tested. Among the 23 persons with a clear exposure history, the median incubation period was 7 days (range, 3 to 20). Monkeypox virus DNA was detected in 29 of the 32 persons in whom seminal fluid was analyzed. Antiviral treatment was given to 5% of the persons overall, and 70 (13%) were hospitalized; the reasons for hospitalization were pain management, mostly for severe anorectal pain (21 persons); soft-tissue superinfection (18); pharyngitis limiting oral intake (5); eye lesions (2); acute kidney injury (2); myocarditis (2); and infection-control purposes (13). No deaths were reported.

 
Pretty sure they just worded that poorly. I think the original language was in fact just the first part and what you are saying. But then I think people brought up that some trans men are gay or non binary etc so they arent included in such a statement and that would be trans exclusionary. 
Figured. Silly word choice.

 
FTR, gay men were (and are) horribly stigmatized for HIV/AIDS, and people absolutely believed it was a disease of gays and drug users, despite most cases occurring outside those communities.  
I dont think this is true.

I guess I dont know the historical stats year by year going back through the 90's but gay men make up over half of HIV cases for a very long time and i know that % was even higher in the beginning. Add in drug users and you have a large majority.

Unless you are talking worldwide maybe? Africa really changes the data on a global scale. I dont think people realize how rampant it is there. 

But i am guessing thats on purpose. 

 
The point is that they are putting out bad medical information to the masses. I thought this type of thing was frowned upon.

Its literally medical misinformation on the mainstream media.
It’s Good Morning America.  This is like asking the dumbest person in your family for medical advice and then pretending you asked an expert.

 
I actually don't have a problem with giving gay men priority for limited vaccine supplies.  If that's the population where the virus is circulating, it seems to make the most pragmatic sense to target your doses to that community.  I don't see that as social justice activism -- if a virus was attacking middle-aged white male Midwesterner community I would argue for vaccines to be delivered to my front door.  
Ditto.  It’s just rational. 

 
Without looking anything up I wonder what the perception of the HIV demographics are here in america. 
I looked this up last week when we were talking about the history of AIDS in the US.  Sometimes I go looking for data and I'm surprised by what I find.  This isn't one of those times.

 
It’s Good Morning America.  This is like asking the dumbest person in your family for medical advice and then pretending you asked an expert.
And ABC news posted the article claiming monkeypox can spread through droplets and they haven't ruled out asymptomatic spread. The whole point of the rant was how and why people might be misinformed.  

 
The R0 of omicron is estimated to be at 8.  The R0 of Monkeypox is estimated to be under 1.  This shouldn’t be a difficult thing to control.  

 
Ok I didn’t see that. This seems like the way to go with this at the moment (first piece of advice is safer sexual practices).
OF COURSE!

But a loud minority of folks have a problem with a targeted approach at this point for fear it might add to the stigma the MSM community already endures. 

I think stamping this out before it spreads to other portions of society in meaningful ways is an absolute no brainer. It's less PC, but so be it.

 
Did I miss a memo on "gay" falling out of favor?  We have a nice, one-syllable word for men who have sex with men: gay.  

What is it with progressives and their desire to make language worse?

 
OF COURSE!

But a loud minority of folks have a problem with a targeted approach at this point for fear it might add to the stigma the MSM community already endures. 

I think stamping this out before it spreads to other portions of society in meaningful ways is an absolute no brainer. It's less PC, but so be it.
I guess I have missed this. I feel like this has been pretty well covered so far considering how every issue can become polarized these days. 

It’s been pretty clear in stuff I have read why people are getting it and why.

 
I guess I have missed this. I feel like this has been pretty well covered so far considering how every issue can become polarized these days. 

It’s been pretty clear in stuff I have read why people are getting it and why.
You replied to a post that specifically brought this point up and had a link to a twitter thread making this point. 

Maybe Ivan is wrong. Maybe it isnt intentional and people just dont pay any attention when they post. 

 
You replied to a post that specifically brought this point up and had a link to a twitter thread making this point. 

Maybe Ivan is wrong. Maybe it isnt intentional and people just dont pay any attention when they post. 
I responded to a tweet showing NYC’s current guidelines for the vax.

 
I responded to a tweet showing NYC’s current guidelines for the vax.
In fairness, unless you looked through the responses to the NYC's post (scrolled down to the replies) you could easily miss the fact that people had a problem with it and were virtue signaling about it.

 
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In fairness, unless you looked through the responses to the NYC's post (scrolled down to the replies) you could easily miss the fact that people had a problem with it and were virtue signaling about it.
You literally have to ignore the sentence the link was provided in and then only look at the OP's first tweet. It wasnt posted as a hey everybody here is a link to the vaccine requirements. 

And not only not pay any attention to any of that, but reply in agreement? 

Lol. Nope. He either wasnt paying any attention at all or he made an assumption that i was arguing gay men shouldnt be given priority for vaccine distribution and then his blinders came on. 

Eta: reading his replies again it is almost certainly the latter. 

 
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Pretty good primer from NPR

What exactly is monkeypox?

Besides the reference to wildlife, the only similarity between monkeypox and chickenpox is that they're a virus. Instead, monkeypox is most similar to smallpox, which was eradicated through global vaccination efforts in 1980. The two viruses are from the orthopoxvirus family. Monkeypox is not as transmissible or fatal as smallpox. However, some researchers worry that monkeypox could mutate and become a greater threat to humans.

The CDC says the risk of contracting monkeypox in the U.S. is "believed to be low," but anyone who comes into close contact with an individual carrying the disease is at risk of infection.

The current outbreak is spreading from human-to-human contact. You could develop an infection from droplet respiratory particles by spending too much time face-to-face with a monkeypox carrier, the WHO warns. The virus also spreads through physical contact, including touching a lesion, as well as the exchange of some bodily fluids like saliva. An individual could become infected by touching items and surfaces shared with someone exhibiting symptoms.

As the virus can spread through skin-to-skin contact, the CDC advises people to exercise caution in situations where one can't maintain some sense of personal space and bumping into others is impractical. In places where clothing is minimal and you could experience that contact, such as crowded raves and clubs, the risk goes up. Potentially contaminated items like bedding, clothes and towels should be contained until you have time to do your laundry, the CDC recommends. Be sure to frequently wash your hands with soap and water as you're cleaning and dispose of all cleaning materials when you're done.

The good news is the version of monkeypox spreading across the globe — the West African type — isn't particularly deadly. According to the CDC, more than 99% of patients can expect to survive.
CDC Case Counts by state

This is probably the last 5 minutes I'll ever spend on this topic. 

 
Over 1/3 of the U.S.'s cases are in the Northeast, following a corridor joining Boston, NYC, and Philadelphia. Add in Maryland and D.C. and you get close to half the U.S. cases along the upper East Coast.

Beyond that, monkeypox is generally following major airline hubs -- most starkly, Atlanta, giving Georgia a case count of 289 while Alabama, South Carolina, and Tennessee are at 20 or less. Chicago bumps up Illinois in a similar manner.

Washington D.C. might lead the country in cases per square mile (191 cases in the district).

 
You could develop an infection from droplet respiratory particles by spending too much time face-to-face with a monkeypox carrier, the WHO warns. 
I'd love to have better understanding of what prolonged face to face conact really means...

The WHO probably needs to update their factsheet as well.

While close physical contact is a well-known risk factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual transmission routes. Studies are needed to better understand this risk.
Monkeypox (who.int)

 
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I dont think this is true.

I guess I dont know the historical stats year by year going back through the 90's but gay men make up over half of HIV cases for a very long time and i know that % was even higher in the beginning. Add in drug users and you have a large majority.

Unless you are talking worldwide maybe? Africa really changes the data on a global scale. I dont think people realize how rampant it is there. 

But i am guessing thats on purpose. 
Worldwide.

 
OF COURSE!

But a loud minority of folks have a problem with a targeted approach at this point for fear it might add to the stigma the MSM community already endures. 

I think stamping this out before it spreads to other portions of society in meaningful ways is an absolute no brainer. It's less PC, but so be it.
I think you can take a targeted approach without stigmatizing the gay community.

 
Did I miss a memo on "gay" falling out of favor?  We have a nice, one-syllable word for men who have sex with men: gay.  

What is it with progressives and their desire to make language worse?
Gay is fine. MSM is sometimes a better descriptor though, because it includes bisexuals and guys who don’t consider themselves gay, despite participating in same sex anal receptive/insertive intercourse. Although it sounds silly, you’d be surprised how many men are in denial about their sexual proclivities. 

Gender fluid and trans people kinda throw a wrench in the “M” part of that equation, which is why I think the best approach is just defining high risk sexual activity.

 
I guess I have missed this. I feel like this has been pretty well covered so far considering how every issue can become polarized these days. 

It’s been pretty clear in stuff I have read why people are getting it and why.
Yep. Except very early on, pretty every much description of monkeypox has mentioned the role high risk sex seems to be playing in its spread.

These guys just want to be upset about something.

 
Yep. Except very early on, pretty every much description of monkeypox has mentioned the role high risk sex seems to be playing in its spread.

These guys just want to be upset about something.
You mean very early on when it could have stopped the spread? 

To be clear, people such as myself are NOT upset that warnings are now pointing out that MSM are by far most at risk. The people now upset are those who still think it's not worth pointing that out because of the dangers of increased stigmatization of the MSM community. 

If less tap dancing around the facts had happened from jump street, there would be far less chances of this spreading to all parts of society. 

 
Battersbox said:
You mean very early on when it could have stopped the spread? 

To be clear, people such as myself are NOT upset that warnings are now pointing out that MSM are by far most at risk. The people now upset are those who still think it's not worth pointing that out because of the dangers of increased stigmatization of the MSM community. 

If less tap dancing around the facts had happened from jump street, there would be far less chances of this spreading to all parts of society. 
No, early on, when public health officials were still piecing things together. 

The current outbreak has only been around a couple months, and prior, smaller outbreaks didn’t involve MSM. Still, this is the Mass DOH release after the first US monkeypox case in May:

Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. In parts of central and west Africa where monkeypox occurs, people can be exposed through bites or scratches from rodents and small mammals, preparing wild game, or having contact with an infected animal or possibly animal products. The virus does not spread easily between people; transmission can occur through contact with body fluids, monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact. 

No monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria. Since early May 2022, the United Kingdom has identified 9 cases of monkeypox; the first case had recently traveled to Nigeria. None of the other cases have reported recent travel. UK health officials report that the most recent cases in the UK are in men who have sex with men. 

Based on findings of the Massachusetts case and the recent cases in the UK, clinicians should consider a diagnosis of monkeypox in people who present with an otherwise unexplained rash and 1) traveled, in the last 30 days, to a country that has recently had confirmed or suspected cases of monkeypox 2) report contact with a person or people with confirmed or suspected monkeypox, or 3) is a man who reports sexual contact with other men. This clinical guidance is consistent with recommendations from UK health officials and US federal health officials, based on identified cases.

Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts. Illness could be clinically confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus. The CDC plans to issue public information soon on poxvirus infections which, when available, will be found here.
Doesn’t seem like much tap dancing to me. Can you provide an example of what you’re talking about, from a reputable, scientific/public health source? 

 
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"San Francisco showed during COVID that early action is essential for protecting public health,” Breed said in a statement. "We know that this virus impacts everyone equally – but we also know that those in our LGBTQ community are at greater risk right now. Many people in our LGBTQ community are scared and frustrated. This local emergency will allow us to continue to support our most at-risk, while also better preparing for what’s to come."

 
No, early on, when public health officials were still piecing things together. 

The current outbreak has only been around a couple months, and prior, smaller outbreaks didn’t involve MSM. Still, this is the Mass DOH release after the first US monkeypox case in May:

Doesn’t seem like much tap dancing to me. Can you provide an example of what you’re talking about, from a reputable, scientific/public health source? 
Just yesterday, from the Commissioner of Chicago Public Health (where I live). Maybe she's unaware that 95% of cases are in MSM??

Dr. Allison Arwady

@DrArwady

MPV is not a ‘gay disease’. There’s nothing inherent in the biology of the virus that limits it to men who have sex with men. The virus spreads through tight-knit social networks. It does not discriminate.

 
Just yesterday, from the Commissioner of Chicago Public Health (where I live). Maybe she's unaware that 95% of cases are in MSM??

Dr. Allison Arwady

@DrArwady

MPV is not a ‘gay disease’. There’s nothing inherent in the biology of the virus that limits it to men who have sex with men. The virus spreads through tight-knit social networks. It does not discriminate.
Meh, nothing she said is inaccurate.

She’s pushing back (appropriately IMO) on the concept of a “gay disease.” While “tight knit social network” is a bit much, I dont think that verbiage is impeding the message reaching the MSM community.

 
Meh, nothing she said is inaccurate.

She’s pushing back (appropriately IMO) on the concept of a “gay disease.” While “tight knit social network” is a bit much, I dont think that verbiage is impeding the message reaching the MSM community.
Tight knit social network is known to be the sciencey definition of having sex with 38 dudes in a weekend. 

 
"San Francisco showed during COVID that early action is essential for protecting public health,” Breed said in a statement. "We know that this virus impacts everyone equally – but we also know that those in our LGBTQ community are at greater risk right now. Many people in our LGBTQ community are scared and frustrated. This local emergency will allow us to continue to support our most at-risk, while also better preparing for what’s to come."
British medical journal BMJ has published new research on monkeypox in London. All but one of the people with confirmed monkeypox in study are gay or bi men. Nearly all of them reported having sex with a male recently. 

https://www.bmj.com/content/378/bmj-2022-072410

 
Just yesterday, from the Commissioner of Chicago Public Health (where I live). Maybe she's unaware that 95% of cases are in MSM??

Dr. Allison Arwady

@DrArwady

MPV is not a ‘gay disease’. There’s nothing inherent in the biology of the virus that limits it to men who have sex with men. The virus spreads through tight-knit social networks. It does not discriminate.
This is what happens when there are no consequences for the people who mangled the covid-19 pandemic.  Why learn from your mistakes if those mistakes don't affect you personally?

 
Meh, nothing she said is inaccurate.

She’s pushing back (appropriately IMO) on the concept of a “gay disease.” While “tight knit social network” is a bit much, I dont think that verbiage is impeding the message reaching the MSM community.
Technically, it's not a "gay disease" in the sense that the virus that isn't conscious and arguably isn't even alive also is not homophobic.  But if you are walking around thinking that it's a gay disease, your mental model is closer to the truth than "it hits tight-knit social networks."

Or, more specifically, why not just say that it spreads through close personal contact, like unprotected sex, so maybe you should avoid that?  What's this business about tight-knit social networks? 

Just tell people the truth, forthrightly.  Why is this so difficult?  Why do people in public health insist on talking like lizard people when clear, accurate communication is important?  Just tell people that this virus spreads through close physical contact, and maybe through close respiratory contact.  Sex is terrible for this, and anonymous, unprotected sex is especially terrible. I don't honestly even know if there's anything special about gay sex -- why not just say whether that's the case or not?  Why are you people so allergic to just speaking English?

 
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"Hey guys, these anonymous orgies are getting out of control with this whole monkeypox thing."

"Yeah, you're right.  We should say something about the orgy thing, right?"

"Oh god no. That would be homophobic."

"So what do you suggest as a euphemism?"

"Tight-knit communities?"

"Perfect. Everyone will know exactly what we mean by that.  Well done."

 
I live a boring life but don’t straight people still do orgies?  I’m assuming that tight knit anal sex is where this is extra communicative?

 
I live a boring life but don’t straight people still do orgies?  I’m assuming that tight knit anal sex is where this is extra communicative?
I think a certain population of gay guys partake in a lot more of this stuff than anybody else, and that's why these things spread in that community.  To be clear, that's not because they're gay, but because they're guys.  If women were wired the same way that men are, there would be way more orgies.

 
Technically, it's not a "gay disease" in the sense that the virus that isn't conscious and arguably isn't even alive also is not homophobic.  But if you are walking around thinking that it's a gay disease, your mental model is closer to the truth than "it hits tight-knit social networks."

Or, more specifically, why not just say that it spreads through close personal contact, like unprotected sex, so maybe you should avoid that?  What's this business about tight-knit social networks? 

Just tell people the truth, forthrightly.  Why is this so difficult?  Why do people in public health insist on talking like lizard people when clear, accurate communication is important?  Just tell people that this virus spreads through close physical contact, and maybe through close respiratory contact.  Sex is terrible for this, and anonymous, unprotected sex is especially terrible. I don't honestly even know if there's anything special about gay sex -- why not just say whether that's the case or not?  Why are you people so allergic to just speaking English?
I think the CDC’s description, which I posted earlier and is similar to most public health descriptions, is appropriate. I also agree “close knit social groups” is a ridiculous euphemism.

While anonymous, unprotected intimacy is a good way to catch a lot of stuff, being the “catcher” in anal intercourse does put one at higher risk than other positions on the sexual ball field.

 

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