San Francisco officials declared a state of emergency on Thursday in response to the growing spread of monkeypox cases in the city.
The declaration will enable the Mayor of London Breed and other city officials to mobilize resources and staff to deal with the escalating monkeypox outbreak. On Wednesday, the city reported that 261 people had confirmed or probable monkeypox infections. Health officials said they expect that figure to only rise in the days and weeks to come.
A rapid increase in monkeypox cases in San Francisco has been met with a shortage of available vaccines. To date, city officials said they have received about 8,200 doses of the Jynneos vaccine, intended to prevent monkeypox and smallpox in adults.
“We want the flexibility to be able to use our resources to better serve the public and protect health,” San Francisco health officer Susan Philip said Thursday. “We also want to affirm our commitment to the health of our LGBTQ communities in San Francisco, as we have always done as a city,” she added, referring to the population most affected by monkeypox so far. ‘now.
Philip stressed that she does not plan to call for any closures or restrictions, which distinguishes this emergency declaration from health orders issued throughout the COVID-19 pandemic.
Monkeypox in the Bay Area
Perhaps more worrying than the number of infections was the trajectory, which “continues to rise,” Philip said, “as we know there are more cases that have yet to be diagnosed.” Testing has increased, she said, but not enough to make it universally accessible.
Breed acknowledged in a statement that the virus “affects everyone equally – but we also know that members of our LGBTQ community are at higher risk right now.”
Offering support to members of the LGBTQ community who are “frightened and frustrated”, Breed assured that the local emergency “will allow us to continue supporting our most at risk, while also better preparing for what is to come”.
“This is a very important milestone for San Francisco,” said Sen. Scott Wiener. He urged the city and state to declare a monkeypox-related state of emergency and said he was writing a letter to Sec. Xavier Becerra of the U.S. Department of Health and Human Services, asking states and counties for more flexibility to redirect COVID-19 funds to monkeypox vaccines and treatment.
Wiener expressed frustration with what he saw as an initially slow response from the federal government and the “too complicated” hurdles facing doctors as they attempted to administer smallpox treatment for monkeypox. He said, however, that the federal response had improved.
At the current count, San Francisco and Los Angeles appear to be the two most worrisome hotbeds of the monkeypox outbreak in California, which as of July 21 had the second-highest number of reported cases in the nation, after New York. according to the Centers for Disease Control and Prevention. Currently, the two cities are “neck to neck”, with roughly the same number of infections according to Philip.
The city has requested an initial supply of 35,000 doses and will prioritize vaccines for men and trans people who have sex with men, who are currently the most vulnerable to infection of all populations in the city. Within these communities, Latino men have seen a disproportionate number of cases, a disparity that Philip attributes to the spread of the virus through networks.
She attributed the national vaccine shortage to a limited supply chain generated by a global manufacturer, Jynneos, based in Denmark. It provides vaccines for a federal stock that is distributed to states and then to cities.
The Ministry of Public Health has said it will focus on distributing the first doses of monkeypox vaccines to as many people at risk as possible, postponing appointments for second doses until the city receives enough supplies to accommodate them. New York City adopted this strategy to deal with supply constraints, although the United States Food and Drug Administration and the Centers for Disease Control and Prevention have not endorsed the method.
Declaring a state of emergency allows the city to access state and federal funds earmarked for emergencies and expand public awareness of the outbreak.
The declaration will take effect on August 1, city officials said.
Although monkeypox is not a new disease, it has come to the fore recently after cases spiked in many countries at once. San Francisco reported its first case on June 3 and the number of infections has risen rapidly, prompting concern from health officials still trying to manage the COVID-19 pandemic.
The illness, which causes a rash or sores on the skin that look like blisters or pimples, as well as flu-like symptoms, appears to be spread through intimate contact, including kissing, sharing bedding or clothing, or potentially, nearby breathing. It appears to be much less contagious than COVID-19 and poses less of a risk to the general population. Although many cases resolve on their own, in rare cases monkeypox can become serious.
“It is transmitted by very close skin-to-skin contact, or very close face-to-face contact, so large droplets or saliva can spread it,” Philip said, distinguishing monkeypox from COVID-19. , which can proliferate through the air for a distance.
Tyler TerMeer, chief executive of the San Francisco AIDS Foundation, applauded San Francisco’s quick action but criticized the federal government for its own reluctance to declare a federal state of emergency, in part because monkeypox did not prove fatal.
“Community organizations like the San Francisco AIDS Foundation have been sounding the alarm for many weeks about the crisis our community once again finds itself in,” said TerMeer, noting the resonances between the AIDS epidemic in 1980s and monkeypox epidemics today.
Even though monkeypox is not fatal, the lesions can still cause severe pain, and they have caused fear and panic among people who watch friends get sick or hear about the disease on social media, said TerMeer.
“We are once again in a moment of federal public health failure toward cisgender and transgender men as well as non-binary people who have similar social and sexual networks,” he said.
Given the stumbles at the federal level, health officials in San Francisco have been quite efficient — by comparison — in distributing the vaccines, supervisor Rafael Mandelman said. Nonetheless, he criticized the city for “keeping people waiting for hours and hours” at the Zuckerberg San Francisco General Hospital and Trauma Center, a practice the supervisor called “inhumane.”
Over the past few weeks, Mandelman has held a hearing, a press conference and a room on monkeybox, and drafted a legislative resolution calling on the Centers for Disease Control to step up their vaccine acquisition. He hopes Thursday’s action helps. Mandelman is gay and represents the city’s Castro District, one of the nation’s most prominent LGBTQ enclaves.
“We have seen that there have been benefits in the COVID situation, and in some public health settings around the Tenderloin, that the city is able to move faster – able to move the way I wish we could move all the time — when we declare something an emergency,” Mandelman said, referencing previous statements about COVID-19 and the overdose crisis in the Tenderloin.
The San Francisco AIDS Foundation provided 840 vaccines at its Castro clinic and still has 130 doses on hand, according to TerMeer, who added that the waiting list of 7,300 people far dwarfs the number being served.
Forty years ago, he said, the AIDS Foundation set up a helpline “because people were living in fear and worry about something new happening in their community, and they felt like the public health response was not on their side.”
Now, in a new climate of fear and uncertainty, the foundation has again set up a helpline, this time focusing on monkeypox.
Rachel Swan is a staff writer for the San Francisco Chronicle. Email: rswan@sfchronicle.comTwitter: @rachelswan