An internet friend, a Berlin artist, sent me a WhatsApp message in May: "Excited we'll finally meet. But a little worried for you — you've heard about this, right? Happening all over the venues I think you'll be interested in."
She linked to a report about monkeypox, a virus once endemic to parts of Central and West Africa now getting some international buzz as cases started showing up among gay men from more privileged and media-connected countries. I laughed it off, but I also knew she was right: I was headed to Berlin for a month to study the formation of urban subcultures around sexual behavior. With only a few reported cases at the time, contact with the virus seemed an abstract and improbable concept, but it hung in my mind.
My first week in Berlin, I got it. Another internet friend, a gay student and porn actor, took me out with his boyfriend in Berlin's gay district. We went to a naked bar night. Thursday was a little lifeless, so the three of us got to know each other more intimately. Four days later, my friend — let's call him Ernst — called to say he'd had a terrible fever the previous night. His tonsils had swollen up intolerably. The clinic suspected monkeypox and advised him to isolate with his boyfriend pending test results. I thanked him, offered my condolences, and began a weird waiting game.
Unlike COVID, there's no evidence monkeypox spreads asymptomatically. And the incubation period is relatively lengthy, as long as 21 days, although most people experience symptoms between seven and 14 days after contact. This set off a mental crime-scene-reconstruction of my contact with Ernst. He hadn't had obvious symptoms when we'd gotten closest. But he said he'd felt oddly exhausted that day I kissed him hello. And, now I remembered, that first night he'd complained of an inexplicable backache.
When Ernst's test came back positive, German public health officials interviewed him and his boyfriend, cheerfully and efficiently, and then, just as cheerfully and efficiently, informed them there wasn't much they could do. The hulking machinery of German bureaucracy hadn't figured out how to distribute vaccines yet, so any close contacts would have to wait and see, and there wasn't any treatment available for Ernst, either.
Two doctor friends, an American and a German, agreed: with treatments tied up, the only thing contact with the health system was likely to do was entangle me in that bureaucratic bondage. It might be hard to leave the country if my status was registered officially. So they said to lay low and examine myself carefully.
For 10 days, I thought maybe I'd had my intimate contact before Ernst was contagious. Like Ernst's backache, my first symptoms weren't distinctive enough for me to take note. Was I tired just because I'd been up till 5 a.m. with a cute kilted bear? Were the nightsweats because I was ill, or because it was 90�F in a country that doesn't believe in air conditioning? Finally, two mosquito-bite-esque red spots on my forearm raised my alarms. I took a photo and went to bed. Next morning, they'd grown, and I felt a new bump on my ass.
That night, the lymph nodes in my neck were sore enough to wake me once or twice. I was lucky: I never developed a fever, and in total about 15 or 20 sores appeared over the 12 or 13 days before the scabs fell off, marking the end of contagiousness. I know at least one guy whose symptoms lasted longer than the 21-day quarantine guideline. Even my relatively mild experience was not one I'd recommend: while the lesions were mostly itchy, they cause inflammation when they appear on mucous membranes, and they cluster at the site of entry. Acetaminophen took care of the pain, but there were three days where the inflammation kept my bowels from moving. And for another month after the sores, the new skin there was rather tender. I was still able to conduct my research in isolation, but the length of the infectious period could cost many wage workers their jobs. I dearly wish vaccines had been available to those who were exposed, as they are now in well-populated areas of the United States.
While the rollout in the U.S. has been embarrassingly slow, I'm heartened to see San Francisco's strong LGBTQ health care system springing into action. Most of my friends — though, glaringly, it's the ones who work professional jobs with self-set schedules — have gotten the first dose of the vaccine. The virus' physical characteristics take advantage of gay culture's greater comfort with touch, and I have my fingers crossed that a targeted vaccination campaign could stop the chains of transmission before we have a new pandemic.
But public health communicators are in an impossible bind. Stating straightforwardly that nearly all the cases so far have been found in the context of men having sex with men, often at public venues like the bar I went to in Berlin, could help target the vaccines. But in a country like ours, where gay men are tolerated only at our most sexless, that could bring a wave of retaliation against gay men, businesses, institutions, and sexuality.
I do think the efforts of San Francisco institutions like Strut are our best bet: frank communications about sex and risk, by and for LGBTQ people who understand and participate in our communities, away from the Sauron-eye of national culture wars. But Strut, operated by the San Francisco AIDS Foundation, is the result of decades of hyperlocal politics, and viruses are an international problem. Instead of the well-coordinated government-and-local-community action that could forestall a pandemic, I fear we'll have that well-worn American response to a crisis: "Save yourself, if you can."
Kevin Stone is a Ph.D. candidate in comparative literature and critical theory at UC Berkeley. He lives in the Castro with his partner and friends from the community.
Help keep the Bay Area Reporter going in these tough times. To support local, independent, LGBTQ journalism, consider becoming a BAR member.