Three months after San Francisco declared a state of emergency for the monkeypox outbreak, the first government in the country to do so, it's now winding down. The San Francisco Department of Health will let the declaration expire October 31, officials said Thursday.
The health department had been renewing the public health emergency monthly since this spring, when the MPX outbreak hit San Francisco, primarily affecting men who have sex with men. At that time, there was a scramble for vaccines, which were in short supply from the federal government. The Bay Area Reporter and other outlets reported on long lines at Zuckerberg San Francisco General Hospital and Trauma Center as men waited hours for the first of two shots of the Jynneos vaccine.
Now, nearly six months later, health department officials said the city's response, particularly that of the public, had played a major role in San Francisco's ability to let the declaration expire at the end of the month.
"The overwhelming community support and advocacy for critical resources such as vaccines from the federal government, coupled with early and strong action, drove San Francisco's successful public health response and enabled the city to reach this milestone," read a statement from DPH.
MPX cases in San Francisco started to decline about a month ago, according to DPH figures. As of October 11, the department's seven-day rolling average is at 0.3 cases per day, a remarkable drop from a few months ago when there were between 20 and 30 new cases per day. As of October 14, DPH reported 828 cumulative cases.
The California Department of Public Health has reported one death that occurred in September in Los Angeles County.
One aspect of San Francisco's success in meeting the challenge of the outbreak has been a drop in demand for the vaccine. Two doses are required for maximum prevention, administered about a month apart. In August, the federal government increased vaccine supply by pivoting to split dosing whereby a single dose of Jynneos could be used to immunize five people.
"The reality is the demand has dropped off," Dr. Susan Philip, San Francisco health officer, told the B.A.R. October 20, but the need for vaccination is still there. "MPX is still with us, and is still a threat to public health."
Philip acknowledged that this "was sending a complicated message," particularly as the need for ongoing vaccinations hasn't ended but "I think as health officer, I always want to be looking at the data to determine that it no longer requires the same levels of recognition."
That said, and despite the success of outreach efforts by DPH in San Francisco, Philip said MPX is likely to be present for the foreseeable future.
In talking with federal coordinators and White House leaders, she said, "we really have seen that its unlikely MPX will be removed from the U.S. very quickly."
The city, on the other hand, has plenty of vaccine to continue its drive to inoculate as many people as possible, Philip said. The city recently expanded eligibility for the vaccine to include people who received notice from a venue or event of a potential exposure within the past 14 days, as has long been the case; laboratory workers who routinely perform MPX virus testing; and clinicians who have had a high-risk occupational exposure (i.e., examined MPX lesions or collected monkeypox specimens without using recommended personal protective equipment).
2nd dose needed
A bigger challenge now is convincing the many thousands who have received the first dose of the two-dose regimen to get that vital second dose. For full efficacy, a second dose must be administered no sooner than 28 days after the first dose.
"The data really support a two dose series," Philip said.
Credit for the success of the city's response to the outbreak goes to the community, DPH stated in a release.
"First and foremost were San Franciscans themselves, who have been exceedingly proactive about their health and have sought out vaccines and taken other steps to become informed and protect themselves and others," according to the news release. "SFDPH and community partners directed resources toward people most impacted by MPX in the gay, bisexual, and trans communities, and with a goal of lowering health disparities and barriers to care."
Among the city's various ethnic and racial groups, whites still make up the largest percentage of cases at 46%. Caucasians make up 51% of the city's population, according to U.S. Census estimates for 2021. However, as noted, Latinx and Black individuals are being particularly hard hit with Latinx people accounting for 28% of cases, despite the fact they comprise only 15.7% of the population, while Blacks, at 5.7% of the city's population, comprised 6% of cases. Asians, who account for 37.2% of San Franciscans, made up only 9% of MPX cases.
Help keep the Bay Area Reporter going in these tough times. To support local, independent, LGBTQ journalism, consider becoming a BAR member.