Inside Provincetown’s ‘Herculean’ Effort to Save Summer from Monkeypox

Jonathan Wiggs/Globe Staff

Crowds of people visited Commercial Street in Provincetown last week. The community is making efforts to control the monkeypox virus as the summer season is in full swing. Jonathan Wiggs/The Boston Globe

PROVINCETOWN – Dr. Andy Jorgensen knew he was in a race against time.

In early June, it was clear that the outbreak of monkeypox, a relative of smallpox that is rarely fatal but causes a painful rash that can last for weeks, was spreading through the gay community. First, there were reports of it in the Canary Islands. Then the UK. Then Montreal.

Jorgensen, the Outer Cape Health Services Chief Medical Officer, feared Provincetown could be next. And it was only a matter of weeks before the first real crowds of summer would pile in from the freeway and the ferry dock into the packed bars and nightclubs of Commercial Street for the weekend of The Independence Day.

With memories still fresh from the COVID outbreak that made headlines last summer, Jorgensen knew the community needed to act quickly.

A poster on Commercial Street in Provincetown addresses the issue of monkeypox. –Jonathan Wiggs/The Boston Globe

Although Provincetown is vulnerable to monkeypox, public health officials and advocates say the LGBTQ+ paradise is also uniquely prepared to handle public health threats by reactivating the networks built during the AIDS epidemic and brought to life. the ordeal during the coronavirus pandemic, when the Delta variant sparked the first known major outbreak of COVID-19 among a group of highly vaccinated people last summer.

“It’s not our first day at the rodeo,” said Christopher Casale, Jorgensen’s colleague at the Outer Cape Clinic.

Although cases of monkeypox continue to be overwhelmingly concentrated in men who have sex with men, experts point out that sexual orientation is not linked to the virus; everyone is sensitive. The first transmission event probably happened by chance at a party attended by homosexuals. Since the virus was mainly spread through intimate contact, it mostly stayed in that community.

Under clear blue skies last week, Casale emerged from the health center in shades, a leopard-print shirt and matching shoes to guide four patients through the vaccination process in the clinic’s back parking lot.

He was running Provincetown’s sixth vaccination clinic in a week. During this period, they had given the first 700 doses of the Jynneos monkeypox vaccine, which consists of two doses given four weeks apart, and another 140 appointments were scheduled for that day. It was a “herculean” feat, Casale said.

Dan Gates, CEO of the AIDS Support Group of Cape Cod, is part of community efforts to control the monkeypox virus. –Jonathan Wiggs/The Boston Globe

Gates had been scouring Instagram, sending one-on-one messages to people inviting them to town halls and getting vaccinated. Community leaders enlisted bartenders and drag queens to spread more information, Gates said.

Now, during Bear Week, when thousands descended on Provincetown to celebrate the culture of burly, bearded gay men known as “bears,” officials and activists exuded a clear-headed calm and said they could keep everyone safe.

Meanwhile, cases continue to rise across the country. The Centers for Disease Control and Prevention said Friday that 1,814 people had tested positive for monkeypox. In the Commonwealth, the total was 51, according to the CDC.

Those numbers are likely underestimates, said Dr. Cassandra Pierre, associate hospital epidemiologist and medical director of public health programs at Boston Medical Center, who began vaccinating against monkeypox two weeks ago.

In the early days of the outbreak, testing was slow and scarce. But on Friday, the CDC announced it had increased testing capacity from 6,000 per week to 70,000. CDC Director Rochelle Walensky said the federal government had delivered 156,000 doses of Jynneos to states and made another 131,000 immediately available for order. Seven million doses will be available by next year, she said.

Last week, Massachusetts nearly tripled the number of sites that will offer the monkeypox vaccine, from four to a total of 11 sites stretching from Provincetown to Springfield. The Massachusetts Department of Public Health said that by the end of the day Thursday, 1,600 vaccine doses had been administered by the first four clinics open – three in Boston and one in Provincetown.

Close contacts of someone with monkeypox and those who have had multiple sexual partners in a jurisdiction known to have had monkeypox transmission are eligible for the vaccine. Injections work even in the early stages of infection.

Although monkeypox is not considered a sexually transmitted infection, it is largely spread through intimate contact at this time. Pierre of the Boston Medical Center said the number of sexually transmitted diseases reported among men who have sex with men is typically highest in July and August, making them “not only a high-risk population, but a high-risk time of year”.

Doctors at the three Boston sites said each clinic was inundated with hundreds of calls a day to get the shots.

“It reminds me of the early days of the COVID vaccination in that people are so grateful to be here and get this vaccine,” said Dr. Kevin Ard, director of the Massachusetts General Sexual Health Clinic. Hospital and Assistant Professor of Medicine at Harvard. Medicine School. “The atmosphere is very positive.”

Fenway Health in Boston, which received 250 doses of the monkeypox vaccine on July 7, had run out of supply by the time its second shipment, of 400, arrived six days later.

Meanwhile, in Provincetown, the summer season and many residents’ livelihoods are at stake.

Most businesses make 80 to 90 percent of their revenue during the ten-week summer season, and many residents earn a large chunk of their income during the same period, State Sen. Julian Cyr said.

Trevor Pittinger is the Associate Director of the Provincetown Business Guild. –Jonathan Wiggs/The Boston Globe

“It was kind of our season of glittering hope,” said Trevor Pittinger, associate director of the Provincetown Business Guild. “I think it’s going to be okay, but it’s scary for companies that have struggled for the past three, four years.”

A Provincetown man in his 30s, who works in the entertainment industry and asked not to be named for confidentiality reasons, has already lost income due to illness. He tested positive for monkeypox after sleeping with someone who later tested positive for the virus.

His symptoms started with a sore throat, but when he noticed an unusual pimple, he ordered a monkeypox test. Since the positive result, painful lesions have spread all over his body and he has been in quarantine for weeks, waiting for them to heal. Recently, she was prescribed tecovirimat, an FDA-approved antiviral also known as TPOXX. The medicine was hard to find and the patient had to go through a long process to get it.

“I feel much better than when I was in the height of monkeypox hell,” he said. At one point, his lymph nodes became so swollen that he could barely breathe for three nights.

Provincetown is suffering from a severe staff shortage brought on by a housing crisis, so losing even one employee to a long quarantine can have serious consequences for workers and businesses.

Monkeypox hasn’t kept visitors away from Provincetown just yet. Many hotels in the city are full again, Pittinger said.

Crown & Anchor bar and nightclub owners Jonathan Hawkins (left) and Paolo Martini hope proactively tackling monkeypox will help save the summer tourist season –Jonathan Wiggs/The Boston Globe

Sitting by the bar at the Crown and Anchor last Wednesday afternoon, co-owners Jonathan Hawkins and Paolo Martini said that after two virus-tainted seasons they were determined not to let the news ruin a third summer.

The Crown and Anchor hosted the first-ever community meeting about the virus. They trained their employees to spot symptoms and ensured eligible staff were vaccinated. When one of the staff contracted monkeypox they sat everyone down to talk about it.

They too hope that this summer will not be like the previous two. But they cannot afford to rely on hope; they know Provincetown has to be proactive.

“That’s what I appreciate about this community,” Martini said. “It looks like we learned something.”

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