Monkeypox: What a Local Health Emergency Means

London Breed
4 min readJul 28, 2022

SF reported its first case of monkeypox on June 3 and cases have continued to increase since then. The risk to the general population from this virus is believed to be low as this is not a disease that spreads easily through the air like COVID. However, this is the first time it has spread in so many countries at once and we are seeing rising rates of cases in San Francisco. This past weekend, the World Health Organization (WHO) declared it a Global Health Emergency. Today, our Department of Public Health is taking action to declare a Local Public Health Emergency to help us better prepare for the spread of this virus.

We know that this virus impacts everyone equally — but we also know that those in our LGBTQ community are at greater risk right now. Our Department of Public Health has been working with community leaders to raise awareness and distributed our limited vaccines for those most at-risk in the community. Our LGBTQ elected leaders like Senator Scott Wiener, Supervisor Rafael Mandelman, and Supervisor Matt Dorsey have been leading efforts calling for more support. They’ve been joined by Speaker Nancy Pelosi, who has always been a champion for public health, as well as community groups like the San Francisco AIDS Foundation and so many others.

The most critical need right now is for more vaccines. The federal government distributes vaccine to state health departments and then the California Department of Public Health allocates to counties, such as San Francisco. We have no control over the vaccine amount we receive. San Francisco needs more support, and we need more action. That’s why we are declaring a Local Emergency.

Current State of Monkeypox in SF

Right now, with 261 diagnosed cases of monkeypox, San Francisco has more cases than most states and is one of the epicenters of this virus.

While this virus impacts everyone equally, right now there is an increased risk for exposure in our LGBTQ community, which is accounting for nearly 90% of cases in San Francisco. Additionally, our Latino community is accounting for 30% of cases, even though Latinos are only 15% of our population. So we know where the most at-risk people are, and we know what we need to do — which is get them more vaccines.

A few weeks ago, the San Francisco Department of Public Health requested 35,000 vaccines to start to get at those most at risk for contracting the virus. So far, in the last three weeks, we’ve barely received a 1/3 of that request. That is not nearly enough, and the reality is we are going to need far more then 35,000 vaccines to protect our LGBTQ community and to slow the spread of this virus.

We are aware that there is a vaccine shortage across the country, but despite that, these vaccines need to be distributed quickly to places like San Francisco that have a disproportionate share of cases. This is not only to protect the health of our community — but also to slow the spread to other communities. Last week, I wrote a letter to Health and Human Services Secretary Xavier Becerra asking for more support. Since that time, our case count has nearly doubled.

Local Health Emergency — and what it means

So while we continue to push for vaccines, we know there is more we can do. Which is why we are declaring a Local Health Emergency for monkeypox.

The declaration of a Local Health Emergency will strengthen the City’s preparedness to respond to the rising cases of monkeypox. It is a legal document that will:

  • mobilize City resources
  • accelerate emergency planning
  • streamline staffing
  • coordinate agencies across the city
  • support future requests for reimbursement by the state and federal governments
  • raise awareness throughout San Francisco about how everyone can stop the spread of monkeypox in our community

I also want to be clear about what this Local Health Emergency does not mean. We are not implementing behavior restrictions or other measures like we did under COVID. This is all about having the resources and ability to move quickly to deploy these resources. During COVID, we used our Local Emergency to pop up emergency vaccine sites. To deploy workers to immediate needs. To enter into emergency contracts. To be able to move government bureaucracy nimbly to confront the virus. That’s the kind of actions this Local Emergency will allow us to do.

Next steps

This Local Health Emergency goes into effect on August 1st, and must be adopted by the Board of Supervisors within a week. The Board of Supervisors has agreed to convene an emergency meeting next week to consider this emergency, and I’m confident they understand the urgency of this matter.

You can track City updates on vaccines and other developments here.

San Francisco showed during COVID that early action is essential for protecting public health. We are ready to do whatever it takes to protect our communities, especially those who are most at risk for this virus.