City declares state of emergency

San Francisco officials declared a state of emergency Thursday in response to the growing spread of monkeypox cases across the city.

The declaration will allow Mayor London Breed and other city officials to marshal resources and personnel to confront the intensifying monkeypox outbreak. As of Wednesday, the city reported that 261 people had confirmed or probable monkeypox infections. Health officials said they anticipate that figure will only grow in the coming days and weeks.

A rapid surge of monkeypox cases in San Francisco has collided with a scarcity of available vaccines. To date, city officials said they’ve received about 8,200 doses of the Jynneos vaccine, which is intended to prevent monkeypox and smallpox in adults.

“We want the flexibility to be able to use our resources to best 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 historically always done as a city,” she added, referring to the population most impacted by monkeypox so far.

Philip emphasized that she was not planning to call for any closures or restrictions, which distinguishes this emergency declaration from the health orders issued throughout the COVID-19 pandemic.

Monkeypox in the Bay Area

Perhaps more worrying than the sheer amount of infections was the trajectory, which “continues to go up,” Philip said, “as we know there are more cases that have yet to be diagnosed.” Testing has increased, she indicated, but not enough to make it universally accessible.

Breed acknowledged in a statement that the virus “impacts everyone equally – but we also know that those in our LGBTQ community are at greater risk right now.”

Offering support for LGBTQ community members who are “scared and frustrated,” Breed assured that the local emergency “will allow us to continue to support our most at-risk, while also better preparing for what’s to come.”

“This is a very important step by San Francisco,” said Sen. Scott Wiener said. He has pushed the city and state to declare a state of emergency related to monkeypox, and said he is writing a letter to Sec. Xavier Becerra of the US Dept. of Health and Human Services, asking for more flexibility for states and counties to redirect COVID-19 funds toward monkeypox vaccines and treatment.

Wiener expressed frustration with what he viewed as an initially sluggish response from the federal government, and with the “overly complicated” barriers burdening physicians as they try to administer a smallpox treatment for monkeypox. He said, however, that the federal response had improved.

With 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-in-neck,” with roughly the same number of infections according to Philip.

The city requested an initial supply of 35,000 doses and will prioritize vaccines for men and trans people who have sex with men, who at present are the most vulnerable to infection of any population in the city. Within those communities Latino men have seen a disproportionate number of cases, a disparity that Philip attributes to the virus spreading through networks.

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