California waits to declare monkeypox emergency, unlike SF and New York state

  • by Eric Burkett, Assistant Editor
  • Friday July 29, 2022
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California health officials are not ready to declare monkeypox a public health emergency. Photo: Courtesy Krishnia Parker, Assembly Democratic Caucus
California health officials are not ready to declare monkeypox a public health emergency. Photo: Courtesy Krishnia Parker, Assembly Democratic Caucus

Although both San Francisco and the state of New York declared public health emergencies July 28 to help contain the spread of monkeypox, California will not be doing so, according to Dr. Tomás Aragón, director and state public health officer of the California Department of Public Health. At least not yet, he told reporters.

In a live teleconference from Sacramento July 29, Aragón told reporters that the department takes this outbreak very seriously, and has communicated to the federal government that California needs more assistance. However, with a strong infrastructure already in place because of the still ongoing COVID pandemic, he said, California can decide later whether to declare a public health emergency.

"All that infrastructure is really coming into play right now," said Aragón, who added that California is thus in a much better place to handle the monkeypox outbreak.

The state health agency noted that last week, it had called on federal health officials to make more vaccine doses available to California "as quickly as possible," estimating it needs an additional 600,000 to 800,000 JYNNEOS vaccine doses. The Biden administration announced Thursday more doses will be distributed nationwide, leaving California officials "hopeful" their vaccine request can be met.

In a letter they sent Friday, California's two Democratic U.S. Senators - Alex Padilla and Dianne Feinstein - sent a letter to Health and Human Services Secretary Xavier Becerra urging him to provide at least 600,000 additional doses of the monkeypox vaccine to California. It follows their signing onto a letter that urged HHS Assistant Secretary Dawn O'Connell and Centers for Disease Control and Prevention Director Rochelle Walensky to address the inequities in access to vaccines and immediately increase access to the JYNNEOS monkeypox and smallpox vaccine to all communities in the United States.

"Due to limited supplies, only Californians with suspected or confirmed monkeypox exposure are currently eligible for vaccination, and testing has been limited to individuals with a rash. As we learned from the COVID-19 pandemic, a sustained period of limited testing and vaccine availability early in a public health crisis is a recipe for disaster. In the case of monkeypox, it is also largely avoidable, given the availability of an approved vaccine," wrote Padilla and Feinstein. "Therefore, we urge you to fulfill California's request to surge 600,000 — 800,000 vaccine doses to California as quickly as possible in order to halt the transmission of monkeypox, particularly in those communities that have already been disproportionately impacted."

A July 28 statement from Governor Gavin Newsom's office to the Bay Area Reporter emphasized the gravity with which the state is approaching the outbreak.

"California is taking this outbreak very seriously and the state will continue to work with local health departments and community advocates to ensure that we're able to assist in providing care, testing, and information to everyone who needs it," the statement read. "The administration has requested more vaccines from the federal government and contacted the manufacturer directly to ask for more. CDPH is closely monitoring monkeypox transmission in the U.S. and California to assist in case prevention, ensure rapid identification and treatment, and inform our ongoing response. We will continue to evaluate the need for additional measures."

An additional 72,000 JYNNEOS vaccine doses have been allocated to California, plus another 48,000 for Los Angeles County. The state has distributed more than 25,000 vaccine doses to date.

"We continue to approach monkeypox with the utmost urgency to slow its spread in California, distributing scarce vaccine doses to impacted communities, providing prevention information and testing, and doing what we can to increase access to treatment," said Aragón. "This virus has impacted more than 750 Californians to date, and we know that has been incredibly challenging for those individuals and families. We remain focused on doing what we can to reduce risk, increase awareness, and get additional access to vaccines and treatment."

Aragón addressed reporters a day after New York State Commissioner of Health Dr. Mary T. Bassett had declared monkeypox an "Imminent Threat to Public Health" in New York State.

"Based on the ongoing spread of this virus, which has increased rapidly and affected primarily communities that identify as men who have sex with men, and the need for local jurisdictions to administer vaccines, I've declared monkeypox an Imminent Threat to Public Health throughout New York State," stated Bassett. "This declaration means that local health departments engaged in response and prevention activities will be able to access additional State reimbursement, after other Federal and State funding sources are maximized, to protect all New Yorkers and ultimately limit the spread of monkeypox in our communities."

New York City accounts for the lion's share of New York's cases with 1,092 of the state's total of 1,383, as of July 29.

Local vaccine clinics opening next week

San Francisco's public health department declared a public health state of emergency Thursday because of the city's rapidly growing monkeypox outbreak. It also announced it expects to receive 4,220 monkeypox vaccine doses this week, so it's reopening the vaccine clinic at Zuckerberg San Francisco General Hospital and Trauma Center Monday, August 1.

Located at 1001 Potrero, Building 30, the clinic will welcome walk-ins from 8.a.m to Noon. It will be open each weekday during those hours until the vaccines run out. At previous clinics, lines began forming well before 6 a.m.

Marin County's LGBTQ community center, the Spahr Center, also announced that North Bay health officials will be hosting an LGBTQ+ Monkeypox Vaccination Clinic on August 6. The center is teaming up with Marin County Health and Human Services to offer it, but it reported only having 48 vaccines available.

Thus, only Marin County residents age 18 years or older are eligible to be vaccinated and must meet any of three criteria: they are gay or bisexual men or a transgender person who has had multiple sexual partners in the last 14 days; is a sex worker of any gender; or anyone who knows they have been exposed to someone who has monkeypox.

Appointments can be made online here.

Adrian Shanker, executive director of The Spahr Center in Corte Madera, was critical of the small number of vaccines allotted to Marin County.

"The ability to access a vaccine that our bodies need should be fair across California and across the Bay Area," Shanker said in a statement. "Unfortunately, Marin County has not yet received a fair allocation of doses and our community members have mostly been unable to access the monkeypox vaccine as a result. Marin County is seven minutes from San Francisco, and needs an appropriate number of doses to support our community members."

Despite San Francisco's emergency declaration, others are criticizing the city for not responding to the outbreak quickly enough. Ande Stone, senior community mobilization manager for San Francisco AIDS Foundation, announced a town hall August 1 to "learn more about the current outbreak and what actions you can take to force the federal government to address these bottlenecks," according to a press release from SFAF.

The town hall, at 1035 Market Street, third floor, Room 3D, which will be both in-person and virtual, begins at 6 p.m. Reserve a seat here.

San Francisco leaders demand stronger response

Hours after San Francisco health officials issued their emergency declaration Thursday, Mayor London Breed held a press conference at City Hall where, alongside leaders of the Department of Public Health, she recalled the AIDS pandemic and its impact on the city some 40 years ago, while decrying the federal government's slow response to the monkeypox outbreak.

Noting that, despite having five sites set aside for vaccinations against the monkeypox virus, the mayor said the city had had to close them earlier in the week after running out of vaccine supplies, which were already low to begin with.

"So we're all here today because we know the importance of this, we know the challenges of what happens in San Francisco when we put public health on the backburner," Breed said. "We've seen this happen before in history during the AIDS crisis when San Francisco was virtually left on its own to fend for itself to address what became a real pandemic in this country. And we use the examples of the work that we did when we came together during the AIDS crisis to fight against discrimination, against the hate, to focus on public health because this is about the public health of the residents of our city."

Joining the city leaders were a number of LGBTQ advocates, including Tyler TerMeer, a gay man who is chief executive officer of the San Francisco AIDS Foundation; gay state Senator Scott Wiener (D-San Francisco), and gay Supervisors Matt Dorsey (District 6) and Rafael Mandelman (District 8). Board of Supervisors President Shamann Walton (District 10, a straight ally, also took part in the press conference.

Monkeypox, a member of the orthopoxvirus genus that includes now-eradicated smallpox, is less serious than smallpox. But for some, it can still be potentially deadly and, for many, an outbreak of the virus can be quite serious and very painful, with the potential of leaving victims with lifetime scars. In San Francisco, as of July 28, there have been 281 documented cases. Statewide, there have been 786 confirmed cases, according to the California Department of Public Health.

The city's declaration followed an earlier call by Wiener to do just that, after he criticized the slow federal response to the growing outbreak.

"Unfortunately, because our federal government failed to act quickly to acquire the vaccine supplies needed to prevent an outbreak, we are now in a public health emergency that is only going to escalate," Wiener had stated. "Given that gay and bi men and trans people are the most impacted, it's sadly becoming clear that we are being left behind once again."

The city's declaration July 29 seeks to remedy that. Dr. Grant Colfax, a gay man who leads DPH, and San Francisco Public Health Officer Dr. Susan Philip said the declaration would help the city in its efforts to gather needed resources.

Calling it "imperative" for the city to "mobilize rapidly," Colfax said the declaration would help ensure the tools necessary to increase testing services and vaccinations, particularly in the city's outreach to the LGBTQ community.

Noting that, so far, there have been no deaths in San Francisco stemming from monkeypox — which has an historically low fatality rate of about 3 to 6%, according to the World Health Organization — Philip said the physical suffering is another matter.

"Even though no one has died of monkeypox in San Francisco, it is causing severe suffering and pain for many individuals," Philip said. "There are people who are unable to eat due to pain. There are people who are unable to urinate or have a bowel movement. I know these are strong words but this is the reason we must act now to preserve the health and reduce the suffering of our fellow San Franciscans."

For more information about monkeypox in San Francisco, go to or

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