Saturday, August 27, 2022

Racial disparities and Monkeypox

If you do an internet search today on "Racial disparities monkeypox vaccine" you will learn that African-Americans and Hispanics (aka, People-of-Color) are over-represented in terms of the per-capita rate of MPX cases...over-represented by about a factor of two. They are also under-represented in terms of the number of people who received MPX vaccine...under-represented by 50% on a per-capita basis and 75% on a per-case basis.

My understanding is that MPX patient are asked to produce a list of people who have been exposed and efforts are made to find those people and offer them vaccine.

In a similar way, if somebody learns that they were involved in a, ahem, "sporting event" where they might have been exposed then can present themselves to a clinic and they will be offered vaccine.

As a visual, public-health officials are attempting to construct a rings of immune patients around patients diagnosed with MPX.

Possible reasons for the disparity include:

  • P-o-C are actively denied vaccine even though they claim exposure.
  • P-o-C who are identified by MPX cases are not contacted by healthcare providers.
  • P-o-C who engage in "sporting events" are unaware of the epidemic.
  • P-o-C do not know where to go to declare exposure and get vaccinated.
  • P-o-C do not have transportation to clinics with vaccine.
  • P-o-C might be vaccine-hesitant in general and not be fully trusting of Authorities.
  • The true names of P-o-C who engage in "sporting events" are not always shared with other contestants at the "sporting events".
  • P-o-C might be more hesitant to come out of the closet with regard to their participation in "sporting events".
  • Non-P-o-C MPX cases might be hesitant to identify P-o-C that they attend "sporting events" with and thus might not identify them to healthcare providers.
  • Many STDs are characterized by skin lesions that make it easier for pathogens to enter the body

  • There might be non-"sporting event" modes of transmission that are higher for P-o-C than for non-P-o-C and the CDC is blind to those modes. For example: it might be that other STDs make patients more vulnerable to virus transmission and that the P-o-C (who might have higher rates of STDs) can catch MPX at a tailgate party and not even have to enter the stadium of the "sporting event". Obviously, this hypothesis might make some people angry.

Clearly, MPX is getting away from efforts to contain it. The CDC and State Health teams better sharpen up their game.

They are missing something.

4 comments:

  1. The most effective action would be to cancel all events AND locations where "sporting events" are rampant, enforced with arrest of any attendees who ignore the orders with forced full isolation quarantine for 30 days. The AdSeg unit in the local jail comes to mind as a location.

    But that would offend a protected group, so it can never even be proposed.

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  2. As usual they’re playing with the figures.

    Yes the rates are higher than both the percentage of PoC’s in the general population, and the rate of Gay’s within the PoC population too, but … they’re deliberately ignoring the fact that within certain areas those higher rates are reflective of reality of the demographics there.

    It’s much like the Irish. Ireland has a much lower (drastically so) level of gay men than any other western nation. Why? Because as soon as they are able, they leave for London or The US (London has rates of both Irish and gays way above normal, that skew the whole nations figures. Ditto with alcoholism, drugs and mental health issues). Ever wonder why the BBC acts like the population is 50% gay, because within the small areas the staff live … it is.

    Certain cities, and specifically areas within those cities, have considerably higher gay populations. That those populations are also majority PoC’s and Hispanics is easily understood when you note the general macho and openly anti-gay attitudes in both those cultures (white gays are more likely to remain in their home town, so the white figures reflect local numbers, with much fewer ‘immigrants’ but some outside ‘visitors’. The numbers make it seem like the rates of being gay are higher in black/hispanic populations, it's not, they're merely more concentrated in the affected areas).

    Then there’s the reality of gay ‘hook-up’ culture. Hard as it is to consider but most will not even know who, or where, they have had “intimate’ contact with. “Anonymous sex” is what they want, and get.

    So? Only specific areas have infected individuals. Those areas are predominantly populated by PoC and Hispanic gays. Most have multiple ‘encounters’ weekly, often with multiple ‘partners’, so they simply don’t know who they have had contact with. The results are consistent with that unfortunate reality.

    As for some mythical exclusion and/or avoidance … sexual health units are staffed by uber left partisans on the whole (and a massively higher rate of gays/lesbians than even the high rates within general nursing), and specific exclusive ‘gay only’ units exist everywhere courtesy of the vast AIDS monies. Nope, they receive better care in such specialist areas, and numbers show access is common and regular.

    That it will be seen as “evidence” of this or that is predictable, as is the fact they will demand even more privilege and money, but it’s unwarranted. 'If' this were any other demographic, restrictions and actions would be implemented that 'could'(maybe/possibly) contain this, but (just as with AIDS) they wont, because to do so makes anyone who even thinks, let alone suggests, it both an ist and an ia as per normal. So it will continue, and spread.

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  3. I see you understand then why mail in balloting is so.important.

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  4. All behaviour has consequences.

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