Delays and incorrect info: N.L.'s first monkeypox cases say health system wasn't ready

·6 min read
Newfoundland and Labrador's first two cases of monkeypox weren't tested in time because they were incorrectly told by health-care staff that there was no testing in the province. (National Institute of Allergy and Infectious Diseases - image credit)
Newfoundland and Labrador's first two cases of monkeypox weren't tested in time because they were incorrectly told by health-care staff that there was no testing in the province. (National Institute of Allergy and Infectious Diseases - image credit)

The first two people diagnosed with monkeypox in Newfoundland and Labrador say incorrect information from the provincial Public Health department prevented them from getting properly tested and delayed access to protection for their close contacts.

Both men — CBC News has agreed not to identify them because they're concerned about the stigma associated with the disease — attended different Pride events outside the province at the end of June.

The 22-year-old man who was the first probable case, which Public Health announced July 28, said he had been at a Pride event at the end of June outside Canada.

He says he started feeling unwell when he returned. At first he thought he had COVID-19. It was only after a friend told him about monkeypox cases identified at parties he attended that he realized he might have it.

811 said no testing available

He called 811, the provincial health line.

"They didn't really have any information for me or an idea of how I could get testing or if the province had testing," he said.

It took two weeks for him to see his family doctor. By then a rash he'd developed along with pustules on his arms had healed.

Instead of being referred to Public Health, he was sent to a dermatologist for the scarring. It wasn't until the dermatologist alerted Public Health that he was told to go to an emergency room for testing.

But by then it was too late to confirm monkeypox because he had recovered. He was told he likely had it, based on his exposure and his symptoms

"If it wasn't for the fact that I took it upon myself to isolate, well, then there could have been lots of community spread, and it's even more frustrating now because I'll never know if I had it or I didn't have it."

Second case, similar experience

His experience isn't unique. CBC News spoke with a second probable case with a similar story.

The 29-year-old man was at a different Pride event and developed symptoms at the end of June.

He told a nurse at 811 he thought he had monkeypox. He asked if he should self-isolate or see his family doctor

"The nurse's response was, 'You can, but there's no tests and no vaccines in the province.'"

That information was wrong. Newfoundland and Labrador is able to test for monkeypox through the national microbiology lab, and had doses of Imvamune, the vaccine given to contacts of cases to reduce their chances of contracting it, and to lessen symptoms.

Peter Cowan/CBC
Peter Cowan/CBC

CBC News asked Public Health for an interview but was given a statement instead.

"The department was made aware of the confusion around some 811 messaging and the issues have since been resolved," said the statement, which didn't provide any details on how any issues were resolved.

The vaccine should be given as soon as possible after exposure, but because Public Health wasn't immediately told about the cases, it wasn't until weeks after the men thought they had the disease that their contacts were given access to the vaccine.

Public Health says those two cases are the only known cases in the province so far, and both men say none of their contacts have developed symptoms.

Men say different treatment 'reeks of homophobia'

It's not just the delay in accessing testing that concerns the men. It's also in how their contacts were treated.

They say their gay friends were asked about their sexual history, while their straight contacts were not.

CBC News talked to one contact, who's gay, who said they were told to self-isolate for four weeks. Another contact, a straight woman, said she was told she had to self-isolate for only two weeks despite having shared drinks and been in the bed of the man who's a presumptive positive.

The 22-year-old says a gay couple, who are friends and were a contact, were told not to have sex, but his parents, who had a similar exposure, weren't.

Monkeypox has been largely circulating among men who have sex with men but is not a sexually transmitted disease. Health officials have said any close contact can spread the disease, like sharing bed sheets or contact with the sores.

It's completely inequitable health care, and it's not fair. - 22-year-old man

But there were other differences that made the two men, and their gay friends, feel they were being treated differently.

While the straight woman was allowed to come into the health clinic in Conception Bay South, gay contacts who went to the Mundy Pond site were told they had to stay in their car and couldn't go in.

"That's infuriating for anybody. It's completely inequitable health care, and it's not fair. It reeks of homophobia, and that's really what it reeks of at the end of the day," said the 22-year-old presumptive case.

"You need to be able to take away those barriers. Queer people already have mistrust on how they handle things like this."

In a statement Eastern Health said vaccines are often delivered in different ways.

"Depending on clinic space and scheduling availability, individuals may also receive a monkeypox vaccination inside a clinic or at curbside," it wrote.

Health Department has 'no way' of predetermining sexual orientation: statement

In its own statement, the provincial Health Department said it can't comment specifically on the concerns over the different treatment of contacts.

"Health professionals would have no way of predetermining an individual's sexual orientation. All individuals are asked questions to assist in identifying close contacts in an effort to reduce spread," says the statement.

The 22-year-old case says he worries there may be other cases who were given similar incorrect information but didn't push to get tested.

"I feel there has got to be people out there that are experiencing this that just aren't getting any care, and I think that's pretty ridiculous, especially when it's something that's being taken so seriously. Then why aren't we treating it seriously," he said.

"Why are we unprepared when we're saying we've been preparing for months?"

The 29-year-old case says he wants an apology for the way he and his gay friends were treated. The 22-year-old says that's not important to him; he just wants the system to be more responsive

"Actions speak way louder than words," he said.

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