SF leaders demand stronger monkeypox response

  • by Liz Highleyman, BAR Contributor
  • Wednesday July 13, 2022
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San Francisco AIDS Foundation CEO Tyler TerMeer, Ph.D., speaks about the inadequate federal and state response to the monkeypox virus during a July 12 news conference on the steps of City Hall as District 8 Supervisor Rafael Mandelman stands at left. Photo: Rick Gerharter<br>
San Francisco AIDS Foundation CEO Tyler TerMeer, Ph.D., speaks about the inadequate federal and state response to the monkeypox virus during a July 12 news conference on the steps of City Hall as District 8 Supervisor Rafael Mandelman stands at left. Photo: Rick Gerharter

Gay District 8 Supervisor Rafael Mandelman, health officials, and community advocates called on the federal government to do more to address the ongoing monkeypox outbreak at a July 12 news conference on the steps of City Hall.

On July 13, the San Francisco Department of Public Health updated its monkeypox case count to 68 and the Centers for Disease Control and Prevention raised its tally to 1,053, including 161 cases in California. While anyone can get monkeypox through close personal contact, the vast majority of cases in the current outbreak have been men who have sex with men.

"Gay and bisexual men and trans folks in San Francisco and across the United States are once again being failed by our public health institutions," Mandelman said. "Local officials, health care providers, and community activists like us are left to beg for an adequate response, and that begs the question, would monkeypox have received a stronger response if it were not primarily affecting queer folks?"

The monkeypox virus spreads through close personal contact, including skin-to-skin contact, kissing, and respiratory droplets at close range, but it is not transmitted through the air over longer distances like the coronavirus that causes COVID-19. It is not yet known whether monkeypox is transmitted in semen, but it does spread through contact with sores during sex.

Related to smallpox but less severe, monkeypox causes flu-like symptoms, swollen lymph nodes, and a rash. The sores, which may resemble common sexually transmitted infections such as herpes or syphilis, can appear anywhere on the body, including the throat, genitals, and anal area. Most people recover without treatment after a few weeks, but the sores can cause scars and some patients have reported severe pain. An antiviral drug called TPOXX (tecovirimat) is used to treat severe cases, but it is currently difficult to get.

Vaccines in short supply

Speakers at the news conference were particularly concerned about the shortage of monkeypox vaccines.

"We are literally begging our federal partners to provide more vaccine so we can get it into the arms of people who need it most," said gay San Francisco Health Director Dr. Grant Colfax.

Smallpox vaccines prevent monkeypox too. Because the monkeypox virus has a long incubation period, vaccines can be used as both post-exposure prophylaxis for several days after exposure and as pre-exposure prophylaxis for individuals at risk.

The newer Jynneos vaccine, which involves two injections given a month apart, is currently in short supply, although the Biden administration has recently taken steps to provide more. The Department of Health and Human Services expects approximately 1.9 million Jynneos doses to be available this year, with an additional 2.2 million doses available during the first half of 2023, according to a July 7 statement. The federal government allocates the vaccine to states, which in turn distribute it to local jurisdictions. The U.S. holds a larger supply of an older smallpox vaccine called ACAM2000, but it can cause side effects and isn't safe for everyone.

Colfax said San Francisco has received just under 2,900 Jynneos doses since the beginning of June, most of which just arrived in the past week. The city has requested an additional 35,000 doses from the state to meet the burgeoning demand.

"These small and inadequate allocations of vaccine make it nearly impossible to beat the curve of new infections," said SF AIDS Foundation CEO Tyler TerMeer, Ph.D., a gay man who is living with HIV.

On the evening of July 12, SFAF hosted a virtual town hall to discuss the city's monkeypox outbreak.

Ahead of Tuesday's briefing, Mandelman unveiled a resolution that calls on the CDC and DHHS to accelerate the purchase and distribution of vaccines and to streamline testing and treatment by eliminating bureaucratic barriers. It asks DHHS to provide enough doses to vaccinate everyone at high risk for contracting monkeypox, including all gay and bi men, trans people, and sex workers.

"Preventing monkeypox from becoming another endemic sexually transmitted infection should be a top public health priority," Mandelman said in a statement. "The insufficient response thus far is reflective of an institutional callousness to issues that disproportionately affect gay and bisexual men and trans people."

New District 6 Supervisor Matt Dorsey, who is gay and living with HIV, has signed on as a co-sponsor of the resolution. "Our queer, BIPOC, and HIV-positive residents know all too well the impacts of misguided, lax, or slow-moving public health responses," he stated in Mandelman's release, referring to Black, Indigenous, and people of color. "The CDC must expand access to our high-risk and vulnerable populations now, and the Health and Human Services Department must do all it can to speed up vaccine distribution."

Dr. Monica Gandhi, director of the Ward 86 HIV clinic at Zuckerberg San Francisco General Hospital and Trauma Center, one of the first city sites to offer the vaccine, added, "We remain poised on the ground to administer the vaccine but need greater supply and attention to the outbreak."

Representatives from SFAF, St. James Infirmary for sex workers, the Castro LGBTQ Cultural District, the Transgender District, and the Harvey Milk and Alice B. Toklas LGBTQ Democratic clubs, also expressed support for the resolution.

Health officials urge anyone with a rash or other possible monkeypox symptoms to seek medical care and get tested. Those who don't have a regular provider can contact City Clinic on 7th Street or SFAF's Magnet sexual health clinic in the Castro. Refrain from sex and other close physical contact until the results are known. People who test positive should avoid close contact until their sores heal completely, which takes about three weeks.

For the latest updates on vaccine eligibility and locations, click here.

To contact City Clinic, click here or call its new phone number, 628-217-6600. To contact SFAF's Magnet clinic at Strut, click here or call 415-581-1600.

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