>> thank you very much for being here everyone. good evening san francisco mayor london breed joined here today by department of public health, dr. grant colfax as well as dr. susan phillips, and members of the board of surprisers including the president of the board walton, members mandalten, dorsey and our state sin scott wiener. we are here because we as a city and county of san francisco

officially are declaring a state of emergency for a public health crisis in san francisco involving monkeypox and more clearly, we want to make it known that san francisco has one of the highest case rates already of monkeypox of any other major city in the country. and just to put that into perspective recollect we saw over the past couple weeks the numbers begin to increase. at one point there was 60 and 80 and 140 and when there was 140 on july 20 i sent a letter to the secretary of the department of health and human service expressing significant concern and urgency for the need of vaccine in san francisco and we are at a very scary place and

we dont want to be ignored by the federal government in our need. so many leaders of the lgbt community weeks ago asked for additional help and support and assistance and this was july 20 and now here we are. july july 28 and double the number at 281 cases of monkeypox and desperate need of vaccines and to put that into perspectives we received about 12 thousand vaccines to date. we really need 70 thousand we sent a letter asking for 35 thousand because we want to prevent the numbers increasing. we have a solution in the

vaccines and we want to make sure that everyone who is requesting a vaccine gets one. we had 5 sites identified in san francisco and have to close many of those sites because we run out of vaccines. so we are all here today because we know the importance of this. we know the challenges of what happens in san francisco with we put public health on the back-burner and seen this happen 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 the country and we use the example what we did when we came together to fight against it discrimination, against the hate, to focus on

public health because this is about public health of the residents of our city. and so by sounding the alarm what we are saying is this is not going to be ignored, this is a public health crisis, that we are in desperate need of vaccines to support the people of san francisco. here to talk specifically about what it is that is happening in the department of public health and what we are going to continue to push for and fight for and what the declaration of emergency will do and represent and help with in san francisco is the director of the department of public health dr. grant colfax. >> good evening everybody and thank you mayor breed for your leadership: i really want to thank senator wiener, president walter and supervisors

mandelman and dorsey joining us today. today announcement is a critical piece of our city response to the monkeypox outbreak. by declaring this is a local helths emergency we are making sure everyone that everyone understands that this is a threat to our entire community. and as the mayor has mentioned, our city has a rich history of elevating celebrating and advocating for the lives of the lgbtq plus community. we have always as a city as a community been at the forefront of advocacy, treatment, research, for medical conditions disproportionately impact the lgbtq plus commune ity. this is personal to me. as a gay man who came out and

did medical training during the peak of the aids pandemic i experienced the difference, the home phobia and stigma by the medical and public health institutions with regard to prioritizing hiv prevention and care. but san francisco community driven and responsive care system were a notable exception and today we seek to immolate that history by elevating our response to this disease. this declaration will allow us to serve the city and the residents better. our covid-19 response taught us that it is imperative that we mobilize city resources rapidly and this declaration helps insure that we have the tools available to augment our outreach, testing, vaccines and

treatment, particularly and especially in the lgbtq plus community. thank you. and my pleasure to introduce dr. susan phillips our public health officer. >> thank you so much mayor breed and dr. colfax for your words. good afternoon, my name is dr. susan phillips. the health officer for the city and county of san francisco. as health officer issuing the declaration to affirm our commitment to the wellbeing of the communities that dr. colfax mentioned, the lgbtq xhungties. to alloy us to move more quickly, to obtain and distribute the resources needed to help those who are disproportionly impacted and within the lgbtq community we

know latino men who are gay many bisexual men, other men who have sex with men and trans individuals are impacted so happy to work with community based organizations such as dr. tyler (inaudible) here today with the san francisco aids foundation and amazing team and partners who have particular expertise and work in from within and for latino communities in san francisco. san francisco will not leave anyone behind in this crittle moment. we understand the difficulties and trying to get vaccinated. and let's make no mistake, even though one died of monkeypox in san francisco it is causing severe suffering and pain for many individuals. there are people who are unable to eat due to pain, there are people unable to urinate or have a bowel movement. these are strong words but this is the reason why we must act now to preserve the health reduce suffering of our

fellow san franciscans. this declaration will help us ease the process of vaccine distribution. it will also send a message to the federal government that san francisco is in dire need of more vaccines. we had to prioritize first doses of vack cine to get vaccine is to as many people who benefit from it and we will differ, not cancel but differ the second deployment. we will notify the communities when our supply is sufficient to schedule the second doses. this is the best strategy at the moment to keep san franciscans as protected as possible while supplies are limited. and i want to no introduce senator scott wiener who is a strong champion for the health of gay men and all our lgbtq communities in san francisco during the

outbreak of monkeypox. - >> public health is about. just like the city did and mayor and department of public health did so quickly at the beginning of covid pandemic and adjust like the city did 40 plus years ago when the federal government completely and utterly abandoned our community when gay and bi men

were dying in droves a mass die-off and the federal government completely abandoned us and san francisco stood strong and reprioritized and focused and built public health infrastructure to try to save lives and so i'm so proud to be a san franciscans. what is frustrating is that what is happening now was completely preventable and we need to always remember that because this won't be the last virus that impact us. it was preventable. unlike covid, unlike hiv, monkeypox is not a new mysterious are disease that just appeared. we have known about this virus for more then half century. we knee what it is, we know about the spread and there is a vaccine and a treatment already. and yet, as monkeypox started accelerating

in west africa over the last number of years spreading more and more, the world didn't do anything. instead of flooding africa with vaccines to try to stomp out this outbreak, 3, 4, 5 years ago, the world did nothing because it was africa. unfortunately that is long-history of that. experts were telling us for years that monkeypox was a matter of time before monkeypox spread outside of africa to europe and north america and elsewhere and unfortunately the u.s. did not do enough to prepare. purchased very few dogess doses of vaccine so here we are. the good news is that despite a sluggish start at the

federal level, our local health officials and at the state level sprung into action quickly and now at all levels we are rowing in the same direction. we just need to row a lot faster and we need more vaccines yesterday. we need more manufacturers of the vaccine. one manufacture is not enough. it needs to be licensed that ask manufacture not 5 or 6 million doses for u.s. other wise this will spread out of control. we have a small window of time to control the outbreak and if we dont it might be endemic and have to deal with 2 for ever. i'm very really happy to report that at the state level we is a group of legislators working together with the

administration and making budget request to provide support to our county public health departments. the county are going to have to stand up testing, vaccination sites and do a lot of education and grass roots outreach anded should not let the county do this on their own. they are under funded so the state needs to step up. we have budget surplus and provide resources. finally i want to say that i came of age as gay man in 1987 when i was 17 years old and one of the worse points of the hiv crises and feel this is de javu once again gay men are getting attacked and demonized and blamed as we get sick. that we can never tolerate that. we

need to call out these attacks and homeo phobia and treat this as a health problem and need to act with compassion and strength, make sure everyone has access to what they need to remain healthy. madam mayor, thank you so much. it is now my honor to bring up supervisor mandelman who is also incredibly vocal and tenacious around this outbreak. >> thank you senator wiener. i am very grateful for this declaration of emergency and want to thank our public health officers susan fillip and mayor and director of public hemth. it communicates to different folks a message that needs to be communicated in the face of a slow sluggish federal response, it

communicates the federal government there is a emergency and it is real and it demands immediate response with urgency. we need vaccines, we needed them a month ago. we needed them weeks ago when director colfax asked for 35 thousand as a first installment. pointed out we have gotten 12 thousand at this point. we need 70 thousand. we need more from the federal government and we need it yesterday. it communicates to folks who may be at risk. this is a emergency. monkeypox we hope will not kill you but i have talked to too many doctors and folks who have gotten monkeypox and describe the symptoms. the potentially life long disfigurement that can come from monkeypox. people need to take this seriously. if you can get yourself a vaccination and you are at risk do it. if you are not able yet to access a vaccination, do some serious thinking with yourself about risk

mitigation. this is something that gay, bi have been doing a long time but important to do it now and communicate a important message to everyone in city government who will have something to do with getting vaccinations out and the tools they need to respond. i am again grateful san francisco is taking the step and look forward to other levels of government treating this crisis with the seriousness it deserves and the urgency. thank you. and i think i am introducing my colleague supervisor matt dorsey. >> thank you so much. i want to say thank you to the department of public health, dr. colfax and dr. phillips and mayor breed. this was mentioned san francisco has a long history called the san francisco model for how we

respond to public health crisis. that is how we responded a generation ago to the aids crisis. i think we saw that again how our city responded to covid-192 and a half years ago and seeing it again today so i want to say how grateful i am to the leadership of our city and public health officialess and senator wiener and president walton and (inaudible) i like to hand it off to tyler, the ceo of the san francisco aids foundation. >> public health crisis. a community filled with fear, unanswered questions and valid outrage. resilient people that had to rise up in support of one another to educate each ort and fight for access for resources they need and deserve. a moment in history where a federal public

health response fails a community causing them unnecessary emotional mental and physical harm. no, i'm not talking about chronically hiv policy from the earliest day when the federal government resisted addressing the onset of aids in our country. i reference this very moment in the nation history when all is a lack of urgency during a public health crisis impacting transgender men and non binary folks within the country. how did woe get to this moment? this history of the u.s. government and our action on hiv aids from the past offers important lessens concerning the limits and possibilities of u.s. public health policy and health care delivery. the last

few years should have taught us valuable lessens on how to intentionally and equitably scale up testing, community awareness, vaccination, and how coordinated harm reduction messaging can help prevent the spread of disease. but here we are months after ringing the first alarm to the federal government. weeks after my warning we had a imminent window to prevent the spread of monkeypox in our community and now we arrive at a public health state of emergency. san francisco aids foundation applauds this decision of the city to declare monkeypox a public health emergency. we hope that this decision will bring greater resources and attention to monkeypox response here in san francisco and we are continuing to push the federal government to also declare a similar

public health emergency. we heard one reason the federal government has decided not to declare a public health emergency around monkeypox is because monkeypox is not a fatal disease as we heard. this is true, but what cannot be over-stated is monkeypox is causing extreme distress, fear anxiety and pain to our community. there will be unfortunate lasting consequence to our communities because of the federal government slow inadequate response to this outbreak. even with the public health emergency declared in san francisco today, we cannot let up on demands for a number of things here in our city. we need more vaccines and we need them quickly. we must insure that testing and vaccines are made available to all people at increased risk for monkeypox.

the clinicians need easier access to monkeypox treatment so people diagnosed with monkeypox can receive care quickly and efficiently. we also need to be lifting up vaccine equity in this moment and insuring communities disproportionately impacted by monkeypox have access to the information and resources they need. this evening at 6 p.m. san francisco aids foundation will host a spanish language town hall to provide information to the latin excommunity currently feeling the disproportionate impact of monkeypox in san francisco. it will be virtually streamed from the website. and finally, we must continue to fight stigma by balancing the need for population specific messaging with non stigmatizing sex positive health communication and public health response strategy. for ongeing information visit our website at san franciscoaids

foundation and reach out to the monkeypox hotline if you have questions fear or concerns. thank you so much. >> thank you and i appreciate everyone joining us here today and just to be clear, the message is that if there were any other community that was disproportionate ly impacted by monkeypox the way the gay community is impacted the whole country would be up in arms so lets not treat this community different then we would anyone else and do what we need in order to get the vaccine and get the treatment and get the resources to the cities that need them the most . san francisco clearly is base on the data, the city that needs it the most so our declaration of emergency is sound the alarm and make it very clear we are in desperate need of more vaccines and desperate need of more treatment to support the people of our city who deserve health care just like

anyone else. and i also want to take this opportunity to recognize and thank speaker nancy pelosi (inaudible) but also president of the health commission here in san francisco. all our wonderful speakers and again thanks to president of the board walton being here and members of the board of supervisors expressing just how critical this is to our city and the need to do everything we can. we have the infrastructure, we have the ability to move vaccines to the community quickly. we have the community partners. we can do this, but we definitely need support from the federal partners and we will not let ubuntil we get the resources we need to have a significant impact and to see these numbers decline and get to a point of being non existence and with that we'll open up to

any questions you have for mostly dr. phillips and dr. colfax. >> (inaudible) do you anticipate the state (inaudible) >> i think it is more so we are talking about a issue around public health and think dr. films or colfax should talk about the coordinated effort and some of the misinformation how this disease is transmitted because it isn't attributed being a sexually transmitted disease so i want dr. phillips and dr. colfax to address that specifically. >> thank you very much

for the question. so, as always the county and regions and us as health officers are very coordinated and talk regularly so they are are informed about the actions san francisco is taking and we have talked ways we can mutually support the work happening in san francisco. it is really important, we need more vaccines in san francisco. there are neighboring counties getting less then a hundred vaccines per allocation so it is a regional importance and we are closely communicateic with them but we are taking the first step because it is so incredibly important to san francisco as the mayor and other speakers have said. >> dr. colfax can you speak what challenges might exist given this is running concurrent with it covid pandemic and (inaudible) are there any challenges that exist now with (inaudible)

allocating vaccines as soon as you get them sh? >> i want to follow up on the-there was a question about the everybody is at risk and we have seen 95, 97 percent of the monkeypox cases in san francisco are among men (inaudible) that is the focus prioritizing vaccines. within the people who are infected we have seen the latin ex population has been disproportionately effected. the point is anyone can get monkeypox. now there are disparities ing risk for monkeypox which is why need more vaccine. the egz qu about covid and monkeypox, it is a balance. we have a pandemic and now have the spread of monkeypox to manage. what is helpful about the declaration it allows us to

integrate the efforts. we develop vaccination sites, testing, education and prevention and work wg community partners expangd as covid increased and with this declaration able to be more flexible bought it allows to shorten the burecrotic process so this is a step in the right direction. dr. phillips and her team along with community partners are doing a incredible job. it is a (inaudible) and confident with this declaration it will give more ability to move faster and be more responsive. what we need is more vaccine, we are ready for the 35 thousand doses. we have far more demand then

supply. >> one, (inaudible) how long is that? >> it is a good question and i think we can't-i won't speculate on that. i think what we know is that as has been said we have a vaccine for this disease. we know how to reduce the risk of transmitting the disease and we have treatment for the disease, so as i think the senator said and mayor said, there is no excuse for where we are now. but where the tipping point is, it is just speculative. i think what we are seeing now cases continued to climb faster then the vaccine so we have to get that into a better state. >> (inaudible) >> if it means endemic

it means the disease established in the population and propaligates. there are outbreaks of monkeypox in the past terminated in the united states but this is a endemic disease in other countries and because of the lack of global health response and adequate systems the investment and resources were not made so the disease were terminated in those countries. >> (inaudible) are you afraid people forget about covid and put all the focus on monkeypox? is that a concern of yours? >> we haven't heard that concern. i think it is managing two priorities at once and people are tired of covid and still encouraging people to take the precautions and get vaccinated. but we haven't-we are trying to insure people have all the information they need about both of these