Battle stigma, not just infection

The recent rise in mpox cases in Iloilo City, from one to four in less than a week, should be a warning signal, not a cause for public panic. All four confirmed cases remain stable, isolated, and under medical care. There is no official declaration of an outbreak or confirmed community transmission. But the silence surrounding some of these cases, and the reluctance of others to seek early consultation, reveals an equally urgent threat: the social stigma and misinformation that could fuel mpox’s spread faster than the virus itself.

Unlike COVID-19, mpox is not airborne and is generally less contagious. It is transmitted mainly through prolonged skin-to-skin contact, contaminated objects, or respiratory droplets in close quarters. Most people recover with supportive care, though patients with comorbidities may face added risk. The City Health Office (CHO) has also clarified that there is no need to bring back mandatory masking at this point. These are important facts. Yet, many people remain either unaware or unwilling to talk about mpox due to fear of being ostracized.

This is where public health efforts must now double down: on information, trust-building, and a culture of safe disclosure.

We have seen what stigma can do in past health crises. HIV-AIDS taught us that silence can kill. During the early months of COVID-19, several patients were shamed on social media or refused entry into their own communities. We cannot afford to make the same mistakes with mpox, especially when many people still misunderstand what it is, how it spreads, and who is at risk.

To prevent further transmission, patients and their close contacts must be encouraged—not coerced—to come forward. But they will only do so if the public narrative is one of compassion, not judgment. Local leaders, public officials, and media outlets must lead the way in normalizing health-seeking behavior. People experiencing rashes, swollen lymph nodes, or unexplained fever should not fear being ridiculed for asking for help.

The city government should also implement safeguards to protect patient anonymity, especially in densely populated barangays where word travels fast. Local policies must be clear that patient identities will not be disclosed and that reporting symptoms will lead to care, not condemnation. Barangay health workers and community leaders must be briefed and trained to handle cases with discretion. In addition, medical personnel and LGU officials must remain accessible and responsive to inquiries without feeding paranoia.

This is also the time to revisit and recalibrate our COVID-era lessons. Handwashing, voluntary mask use, avoiding crowded places, and early symptom consultation are still powerful tools in the public health arsenal. The difference today is that we must apply these lessons with greater emotional intelligence and localized messaging.

The city’s plan to seek permission from the Research Institute for Tropical Medicine to conduct local mpox testing is a step in the right direction. Testing delays have always been a bottleneck in controlling outbreaks. If the Uswag Molecular Laboratory in Barangay San Pedro can take on this role, we can expect faster diagnosis, quicker isolation, and better contact tracing. But this effort must also include preemptive planning for additional isolation facilities and trained personnel. If cases rise again in the coming weeks, we must not scramble as we did during the early waves of COVID-19.

While Iloilo City has not yet recorded a sharp uptick in cases, the lack of a clear exposure pattern is concerning. The CHO reported that the new confirmed cases are not close contacts of the first patient, and most had no recent travel history. This points to the possibility of untracked transmission chains within the community. But the national health protocols remain vague on what defines community transmission for mpox. The Department of Health must issue clear, science-based criteria so that cities like Iloilo can make timely decisions without being paralyzed by bureaucratic uncertainty.

Crisis communication must always stay a step ahead of the crisis itself. When people do not know what to believe, they either downplay the threat or react in fear. Both are dangerous. The key is to communicate frequently, factually, and with empathy.

Mpox may not be the next pandemic, but it is certainly a test of whether we have learned anything from the last one. The real danger is not just the virus but the silence, stigma, and slow response that allow it to spread undetected. Iloilo City must speak clearly, act swiftly, and respond with humanity. That is how public trust is built—and how public health is defended.