San Francisco officials declare state of emergency for monkeypox

  • by Eric Burkett, Assistant Editor
  • Thursday July 28, 2022
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San Francisco Health Officer Dr. Susan Philip is issuing a state of emergency for monkeypox. Photo: Rick Gerharter
San Francisco Health Officer Dr. Susan Philip is issuing a state of emergency for monkeypox. Photo: Rick Gerharter

Following gay state Senator Scott Wiener's call July 27 for a state of emergency to help handle the quickly growing monkeypox outbreak, San Francisco Public Health Officer Dr. Susan Philip has done just that less than 24 hours later.

With monkeypox on the rise throughout California, and particularly in San Francisco, Wiener (D-San Francisco) called upon officials for both polities to declare a state of emergency to help combat the virus. The city's action comes less than a week after the World Health Organization designated the virus a public health emergency of international concern, its highest level of alert.

Monkeypox, which is a member of the orthopoxvirus genus that includes now-eradicated smallpox, is generally regarded as significantly less serious than smallpox. For some, however, it can still be potentially deadly and, for many, an outbreak of the virus can be quite serious and painful. In San Francisco, as of July 28, there have been 261 documented cases, an increase of 39 cases from the day prior.

Statewide, there have been 646 confirmed cases, according to the California Department of Public Health. Los Angeles, as of July 28, has 279 confirmed cases, while Santa Clara County has identified 46 cases as of the same date. In Alameda County, as of July 25, there have been 50 confirmed cases.

The declaration allows the city to mobilize resources, accelerate emergency planning, streamline staffing, coordinate agencies across the city, allow for future reimbursement by the state and federal governments, and raise awareness among the public. The declaration goes into effect August 1.

San Francisco Mayor London Breed likened the current outbreak to the city's experience with COVID back in 2020, and which is still ongoing.

"San Francisco showed during COVID that early action is essential for protecting public health," said Breed. "We know that this virus impacts everyone equally — but we also know that those in our LGBTQ community are at greater risk right now. Many people in our LGBTQ community are scared and frustrated. This local emergency will allow us to continue to support our most at-risk, while also better preparing for what's to come."

City health officials weighed in, as well.

"We need to be prepared and this declaration will allow us to serve the city better," said gay Director of Health Dr. Grant Colfax. "Our COVID-19 response has taught us that it is imperative that we mobilize city resources. The declaration helps us ensure we have all the tools available to augment our outreach, testing and treatment, especially to the LGBTQ+ who remain at highest risk for Monkeypox."

Philip, who is actually responsible for issuing the declaration, said, "San Francisco is an epicenter for the country. Thirty percent of all cases in California are in San Francisco. We have always been on the forefront of advocacy and action for LGBTQ+ health and I'm issuing this declaration to reaffirm our commitment to the wellbeing of these communities and to allow us to move more quickly to obtain and distribute the resources needed to help those disproportionately impacted."

In his call a day earlier for the city to take this action, Wiener urged officials to act quickly. Quoted in the statement from the mayor's office, the senator said, "I'm grateful that San Francisco, under the leadership of Mayor Breed, understands the deep public health threat that Monkeypox poses. San Francisco was at the forefront of the public health responses to HIV and COVID-19, and we will be at the forefront when it comes to monkeypox. We can't and won't leave the LGTBQ community out to dry.

"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 continued. "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."

Declaring a state of emergency will allow local health officials to utilize a broader range of resources to help in combating the outbreak. At this point, Wiener said, neither San Francisco nor California have enough of the vaccine or the ability to test on the scale needed to effectively meet the challenge.

"We have no time to waste: this is happening now, it's serious, and we need to do everything we can to contain it," Wiener said.

World Health Organization director-general Dr. Tedros Adhanom Ghebreyesus declared July 23 that monkeypox is a public health emergency of international concern — the global agency's highest level of alarm — as cases continue to rise steeply in the United States and worldwide, as the Bay Area Reporter has reported. Worldwide, there have been more than 16,000 confirmed cases of monkeypox this year in more than 75 countries, according to a report by the United Nations. In the U.S. cases now number 4,639, as of July 27.

Following Wiener's call for a state of emergency yesterday, gay District 8 Supervisor Rafael Mandelman retweeted the senator's statements, and told the B.A.R. he agreed with Wiener's actions. With today's declaration, Mandelman elaborated in a texted statement, saying, "The real failure here continues to be the federal government's lack of urgency around the acquisition and distribution of vaccine doses to stop the uncontrolled spread of monkeypox. That said, declaring a state of emergency at the local level will help San Francisco get vaccines out as quickly and equitably as the supply allows."

At a July 21 hearing led by Mandelman, the city's public health agency came under criticism from members of the Board of Supervisors for communications failures about monkeypox and its drop-in vaccine clinic that had left people waiting in line for hours. Due to a lack of vaccine supply, the city had to close the clinic this week.

Gay District 6 Supervisor Matt Dorsey said he strongly supported the decision to declare a public health emergency.

"I think it's important for San Franciscans to understand that this isn't about alarmism but preparedness," said Dorsey. "It's a prudent step, which aligns with recent moves by the World Health Organization and the U.S. Department of Health and Human Services. I think it also reflects the 'San Francisco Model' of care, which is rooted in our city's early response to the AIDS crisis a generation ago, and which put us far ahead of other cities' response to COVID-19 in 2020. It prioritizes the health and safety of at-risk populations in San Francisco, and I'll be supporting it at the Board of Supervisors."

The San Francisco Department of Public Health has issued a list of guidelines for protecting yourself, and others, from monkeypox. It comes as hundreds of people are expected in the city this weekend for the leather and kink focused Up Your Alley fair on Sunday.

"Monkeypox is spread from person to person during skin-to-skin contact with a person who has a rash (like during sex, or dancing), or contact with body fluids, including saliva, spit and respiratory droplets," according to the statement.

In order to protect yourself from the virus, DPH recommends the following: If you don't feel well — stay at home and encourage your friends to do the same; when in crowds, consider ways to cover?exposed skin; consider limiting opportunities that put you into physical contact with others, especially skin-to-skin contact with those you do not know.

The agency also advises people stay home from social events if they have a rash or sores; and talk to their potential sexual partners because "now is not the time to be shy about important sexual health discussions; you may even consider reducing the number of partners until we have more access to vaccination," it stated.

The advisory said that condoms can reduce the risk of monkeypox by limiting contact with sores people may not be able to see if they are internal, but they will not eliminate risk entirely, since monkeypox rashes/lesions can show up anywhere on the body.

"If you see a bump or a rash cover it up with a Band-Aid or clothing before you go out. If you feel like it may be monkeypox, stay home and wait on going out until you can see a healthcare provider," stated the health advisory.

For anyone who has symptoms, DPH recommends that they cover the area of the rash with clean, dry, loose-fitting clothing; wear a well-fitted mask; avoid skin-to-skin, or close contact with others; avoid sharing their bed while having the rash; and talk to a healthcare provider as soon as possible, as they can run tests and help determine what care may need.

"Do your best to distance yourself from other people until your sores have fully healed; and let sex partners know about any symptoms you have," the agency urged.

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

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