Why It Was Easier to Curb Monkeypox Than Covid
Good morning. It’s Friday. We’ll look at why the monkeypox outbreak is subsiding in New York City. And, an election follow-up: Did Mayor Eric Adams’s focus on crime hurt Democratic candidates last week?
Credit…Kholood Eid for The New York Times
A dangerous virus, monkeypox, arrived in New York City in May, shortly before the World Health Organization declared it a “public health emergency of international concern.” That designation that had been in effect for only two other diseases, Covid-19 and polio. But the monkeypox outbreak has subsided, and New York City has stopped sending vaccine vans to community centers and nightclubs. It has also closed mass vaccination sites that were set up in the summer. I asked Sharon Otterman, who covers health care and the pandemic for the Metro desk, to assess where things stand.
You write that the city and the state have quietly ended their monkeypox states of emergency, but the federal government has not. Is it too early, or were the vaccination efforts in New York so much more successful than in other parts of the country that New Yorkers no longer need to be concerned about monkeypox?
Monkeypox is not Covid. It’s not as contagious as Covid. We were unable to get herd immunity with Covid because that virus mutates and because our vaccines turned out not to protect completely against infection.
But monkeypox tends to be less infectious than Covid, so it was possible to approach herd immunity with monkeypox. And through infection, vaccination and behavior change by those most at risk — mainly men who have sex with other men — we were able to bend the curve, not just in New York but nationally.
In New York, we now have only two or three cases a day, compared with more than 70 at the peak of this outbreak, so it hasn’t gone away completely.
The federal government is continuing its state of emergency because it’s dealing with areas of the country like Texas, where there are places where monkeypox is either stable or increasing slightly — in other words, not declining. But here in New York, health officials felt there was enough evidence of low transmission that there no longer had to be an all-out effort.
You write that the city’s mobile vaccination program for monkeypox lost its funding. Why? And where can people go if they received the first dose of a two-shot regimen but still need the second dose?
In a perfect world, the city might have continued the outreach on monkeypox because the job is not done yet. They’ve vaccinated 100,000 people with a first dose and half as many with a second dose, but originally health officials said they believed there were 150,000 people at high risk in New York City.
The vans that took the vaccine to those who were most vulnerable really had an impact. Some of the most at-risk people work at night, in clubs. Or they might go to commercial sex parties that run from 10 p.m. on and might not be able to make a 9 a.m. appointment at a clinic.
We are in a belt-tightening time now, and the federal government did not allot specific money for monkeypox prevention, so the city is moving its monkeypox vaccination sites to its sexual health clinics around the city, run by the Health and Hospitals Corporation. There are also nonprofit clinics and some urgent care centers that will have vaccines.
When they started giving vaccines at the end of June and the beginning of July, there was enormous demand. It was sort of like winning a radio contest to get an appointment. There’s no supply issue anymore. You might have to make an effort to get that appointment, and it might not be right around the corner, but it’s available.
What about racial disparities among those who’ve been vaccinated? And how many people who are at high risk for monkeypox remain unvaccinated?
As with Covid, people with the most access to information, computers and time during the workday were able to make those first appointments.
Now, according to available city data, Black people have received 13 percent of vaccine doses but account for 27 percent of the cases. White people have gotten about 50 percent of vaccine doses but make up 23 percent of the cases. So disparities remain.
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The mayor and the midterms
Some Democrats criticized Mayor Eric Adams for lending legitimacy to Republicans who played up fears of crime in their campaigns. Adams, a former police officer, is not backing down.
He says Democrats should consider the midterms a teachable moment and acknowledge that they let Republicans steer the narrative. “We’re strong on crime,” he said. “We voted for sensible gun laws. We voted to fund police officers, which the president has done, and yet we’ve allowed others to state that we’re just the opposite.”
Adams also said that simply not talking about crime, as he said some Democrats suggested, “was an insult to Black and brown communities where a lot of this crime was playing out.”
My colleagues Emma G. Fitzsimmons and Jeffery C. Mays write that heightened fear about crime in the city is a chicken-and-egg conundrum: Are people more worried because Adams calls attention to nearly every high-profile crime and focuses on offenders who return to the streets? Or are New Yorkers more scared because of their experiences, and is Adams responding to that?
Either way, Adams has made public safety a recurring theme in his first year in office. He called on state lawmakers to tighten laws that, as revised in 2019, made it easier for suspects to be released from jail when they cannot afford to post bail. That — and a crime uptick as the pandemic ground on — at times put him closer to Representative Lee Zeldin, the Republican candidate for governor, on bail reform than to Gov. Kathy Hochul, whom Adams campaigned for.
Zeldin made crime a centerpiece of his attacks on her, and while she won, her margin of victory was narrower than that of any governor in three decades. Zeldin won 55 percent of the vote in the Long Island suburbs, and Democrats lost four congressional seats statewide.
Many Democrats support the mayor’s approach. Representative Adriano Espaillat, a Democrat from northern Manhattan, credited Adams with sending more police officers to violent sections in his district. “The No. 1 issue people came up to me about was crime,” Espaillat said. “He’s doing the right thing to address it.”
Left-leaning Democrats like Jumaane Williams, the city’s public advocate, worry that Adams and other Democrats will seek additional changes in bail laws when the State Legislature convenes in January. Adams said that he and Hochul discussed legislative initiatives for January when they met privately during a Democratic gathering in Puerto Rico after the election. He would not say whether the bail laws came up in the conversation. But he said that he and she were closer than ever, even after Zeldin’s relentless attacks on her.
“People who supported him used everything they could to create wedge between Kathy and Eric,” the mayor said, lapsing briefly into the third person. “Thank goodness the two of us didn’t bite. We didn’t fall into the trap.”
onto the dark side
of dead Daylight Saving Time
When the land folds black into shadows
an ordinary moon waxes high and bright
in this season of oncoming gloom
when clocks betray us
and a rusty wrench is taken to
— Arthur Gatti
Illustrated by Agnes Lee. Send submissions here and read more Metropolitan Diary here.
Glad we could get together here. See you Monday. — J.B.
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Melissa Guerrero and Ed Shanahan contributed to New York Today. You can reach the team at [email protected].