How monkeypox is playing out in the Bay Area

On August 25, the Bay Area Global Health Alliance, of which IGHS is a founding member, organized a panel of experts and providers to share insights on how monkeypox is affecting the Bay Area. Although the virus was first identified in humans in 1970 – it emerged from rodents, not monkeys, according to Michele Barry, MD, senior associate dean for global health at Stanford – the current epidemic represents the first time that cases have emerged in multiple geographically disparate areas.

Virtually all of those infected have been men who have sex with men. The United States has more monkeypox cases than any other country, and California has more than any other U.S. state. Though Los Angeles edges out the Bay Area in total cases, our case rates are nearly twice as high.

The panel participants were:

  • Sara Cody, MD, Santa Clara County’s public health director;
  • George Rutherford, MD, acting director of IGHS;
  • Peter Chin-Hong, MD, a UCSF infectious disease doctor;
  • Michele Barry, MD, the senior associate dean for global health at Stanford;
  • Brett Andrews, CEO of PRC, which serves San Franciscans affected by HIV/AIDS, substance use, or mental health issues;
  • Clarissa Ospina-Norvell, NP, the interim co-medical director at San Francisco Community Health Center;
  • Huma Abassi, MD, MPH, general manager of health and medicine at Chevron, which is headquartered in the Bay Area; and
  • Mike Steinberg, Chevron’s global public health project team lead.

Cody offered one reason for the higher case rates in the Bay Area: fewer vaccine doses. Due to an historical quirk, she explained, Los Angeles gets its vaccine supplies directly from the federal government, while most other localities get vaccines from the state, which gets it from the federal government. The system, Cody said, “makes not a lick of sense.”

Whether the virus is transmitted through semen, making it biologically transmissible among men who have sex with men – as suggested by Barry – or if the virus is just opportunistically spreading through sexual partners – as suggested by Rutherford – remains uncertain. Several panelists observed that Latinx men are being disproportionately affected in California.

The good news, according to the panelists, is that case rates seem to be starting to fall as men who have sex with men change their behaviors in response to education campaigns. The state also recently adopted MPX, pronounced m-pox, to reduce the simian and homophobic stigmas associated with the virus.

Educating those at risk, despite the stigma, and connecting them with the vaccine as it becomes available remains a challenge, as Chin-Hong described in some detail. Yet knowledge-sharing networks like the Bay Area Global Health Alliance, which connects diverse stakeholders from academia, nonprofits, tech and other private sector companies to advance health equity, give the Bay Area a powerful toolkit with which to contain the outbreak. 

Watch the full session here.