SF supervisors ratify monkeypox emergency declaration

The San Francisco Board of Supervisors unanimously ratified the city's public health emergency declaration for the monkeypox outbreak at a special meeting August 8, interrupting its August recess.

Health Director Dr. Grant Colfax addressed the board. "As a gay man who came out personally and professionally at the height of the AIDS epidemic" he said he's concerned about stigma and discrimination around the monkeypox virus. "We are committed to ensuring discrimination and stigma are confronted head-on," he said. "Men who have sex with men account for 95% of monkeypox cases in San Francisco."

The emergency declaration, Colfax said, will help the Department of Public Health "have all the tools we need and help the communities at highest risk."

During the meeting, city Health Officer Dr. Susan Philip was asked by gay District 8 Supervisor Rafael Mandelman about an article in the San Jose Mercury News indicating that the Department of Public Health had abandoned contact tracing.

"But San Francisco has never announced publicly whether it is tracing the contacts of infected residents in order to detect and control the spread of a monkeypox outbreak that has affected hundreds, and emails obtained by this news organization indicate that health department officials are reluctant to answer questions about their strategy," the paper reported. "It turns out that for this city, contact tracing — a key endeavor during the early days of the COVID-19 pandemic, and an approach epidemiologists say should work well against monkeypox — plays only a small part."

Philip told the supervisors that when the monkeypox outbreak first appeared in San Francisco this spring "we were reaching out to every individual" and that continued through early summer. "What we found was that people were not willing or able to talk about names of people" they may have been in contact with, she said. Because of that, DPH pivoted to a broader strategy because monkeypox cases were seen that were not specifically tied to travel, as some of the early cases were, she said.

"We have talked to over 72% of people as of August 22," Philip said, adding that DPH wants to target young people and people who may become pregnant, as well as other high-risk groups such as men who have sex with men and their sexual partners.

District 4 Supervisor Gordon Mar also asked about contact tracing, particularly for congregant settings such as the jails, Navigation Centers, and homeless shelters. He said monkeypox has been reported in the jail system. Philip said that case is unconfirmed, "though it is a concern there."

As of August 5, the city had recorded 444 cases, both probable and confirmed, she added.

"Monkeypox impacts all people," Philip said, "but it's spreading in the LGBTQ community at a higher rate. Anyone, regardless of sexual orientation or gender identity, can contract monkeypox."

As health officer, Philip is responsible for issuing public health emergency declarations, which she did for monkeypox July 28. The Board of Supervisors needed to ratify it, which it did Monday by a vote of 10-0, with District 9 Supervisor Hillary Ronen excused. The declaration will enable the city to obtain additional vaccines, now in short supply, and raise awareness and provide education for people. Philip noted that U.S. Health and Human Services Secretary Xavier Becerra issued a national public health emergency August 4 and California Governor Gavin Newsom issued a similar declaration for the state August 1, as the Bay Area Reporter has reported.

Philip also said that the city received 10,000 doses of the Jynneos vaccine August 5, "more than double" the previous allotment, "but we requested 35,000 doses and have only received 22,000, including the 10,000," she said. "DPH will continue to ask for vaccine."

Mandelman also asked Philip about the "incredibly long lines" of people waiting to get vaccinated at Zuckerberg San Francisco General Hospital and Trauma Center. During a Board of Supervisors committee hearing July 21, health department officials were criticized for the length of lines, which has seen people line up in the early morning hours.

"I got my shot and I was the 123rd person in line. It doesn't make sense," he said. "Can we identify a time and sign up, much like we did for COVID? Use the emergency authority to create a system?"