Like COVID-19, Monkeypox Is Heavily Affecting Bay Area Latinos. Are We Prepared?

Monkeypox has now been formally declared a public health state of emergency in California. And when the state released initial data on the demographics of confirmed monkeypox infections in July, the numbers revealed that two ethnic groups composed an overwhelming majority of cases: white and Latino residents.

White people represented 40.5% of cases in California, while Latinos formed 37%. The percentages roughly match up with the overall makeup of the state’s population — 35% of Californians are non-Hispanic whites, while 40% consider themselves Latinos.

But in the Bay Area, a different picture is emerging.

As individual counties in the region share their own numbers on monkeypox cases, this more localized data shows that within the Bay Area, it’s the Latino community that’s being disproportionately affected by the virus.

On July 29, the San Francisco Public Health Department confirmed that Latinos made up over 26% of cases — despite representing only 15% of the city’s population. That same week, Santa Clara County released its own data, which showed that over 50% of cases are among Latinos, while this population represents only 26% of the county.

The disproportionate nature of these numbers has alarmed both public health officials and Latino community organizers — some of whom say it’s reminding them of COVID-19, and the asymmetrical impact that virus had on this population in the Bay Area.

The COVID-19 pandemic saw many community-led public health initiatives in predominantly Latino neighborhoods across the region, including San Jose’s Eastside, Fruitvale in Oakland and San Francisco’s Mission District. In the Mission, the Latino Task Force, a coalition of nonprofits and organizers, partnered with UC San Francisco and the city to bring testing and vaccination services to public transport hubs and food banks. These efforts helped make the COVID-19 vaccine easily accessible to essential workers, uninsured residents and immigrant families. So what lessons can be learned for the new public health challenge of monkeypox?

On Wednesday, KQED’s Brian Watt spoke with Dr. Carina Marquez, associate professor of medicine at UCSF and one of the founders of Unidos en Salud — a partnership of the Latino Task Force, UCSF, UC Berkeley and CZ Biohub — to understand what lessons from the coronavirus pandemic can be applied to the way care providers respond to the monkeypox outbreak, and to hear more about monkeypox’s disproportionate impact on Latino and immigrant communities.

The following interview has been edited for length and clarity.

BRIAN WATT: What do you make of these early signs of monkeypox spread among Latinos in parts of the Bay?

DR. CARINA MARQUEZ: This isn’t anything new. I think we saw early disparities by race/ethnicity emerged with the COVID-19 pandemic. We see them in other health conditions.

And so I wasn’t surprised to see these disparities emerge early on. Of course, I was saddened by it.

What are groups like the Latino Task Force doing to help address this?

We’re in a unique situation with monkeypox in that we have a vaccine, but it’s very limited. When we were in COVID-19, we started the COVID-19 pandemic without a vaccine.

So with the monkeypox vaccine, we have to do everything we can to partner with community to get the word out on how to access the vaccine … communities want to know what [the vaccine] is and whether they should trust it.

Education is the first thing and doing it with trusted messengers in the community is extremely important and certainly particularly important with the Latino community.

Then how you structurally access the vaccine is really important. My colleagues at San Francisco General Hospital have set up a really great low-barrier walk-up access clinic, but we know that this is not enough. The lines are really long. You have to know when to show up in line to get it. And then there may be a stigma associated with waiting in line.

As we’re thinking about vaccine distribution, partnering with community and using what we know has worked with the COVID-19 vaccine — in terms of using neighborhood sites or pop-up sites, to bring vaccines out of the health care system to the communities most impacted — I think are going to be a key part of an equitable response to vaccine distribution.

I hear you saying that our experience with COVID-19 should have prepared us better for monkeypox. Do you think we are better prepared now than we would have been without COVID-19?

I think in some ways we are still in our COVID-19 response. In San Francisco, we still have a number of highly used neighborhood vaccination sites, community partnerships, both with [UCSF] and the San Francisco Department of Public Health, where we’re working together to address equity.

We have a lot of room to go, but we can use these relationships and these sites to increase vaccine access. The limiting issue right now is the number of vaccines available, and I hope that that changes quickly. I know many people are advocating for increased vaccine supply.

How can Latinx parents or caregivers talk about monkeypox with kids when they’re talking about sexual health?

I’m a parent of young children. I think that this is part of the bigger conversation about the importance of talking about sexual health with youth in an age-appropriate way. And we have to be very clear about how it transmits, and what it looks like, and when to get tested and who should get vaccinated. But I think just being honest is the best policy.

What conversation should a family have after a loved one tests positive for monkeypox? I’m thinking about the case of a large sort of multigenerational family, living together in the same space.

We hope that these conversations are filled with compassion and love for the family member.

The other big question you’re bringing up is that with monkeypox, the recommended isolation is quite long. It can be, oftentimes, a month. You have to wait until the lesions scab over and new skin grows. So oftentimes, we’re talking about being out of work and having infection control precautions within the house for one month.

We as a society need to think about, as we did with COVID-19, how we support people who have to isolate and who don’t have sick pay. And again, this sick pay comes up over and over again and certainly [is] extremely important for Latino households.