August 10, 2022
A Message From The Supervisor:

Sincerely,

On July 28, 2022, the San Francisco Public Health Director issued a local public health emergency for Monkeypox to harness resources, including efforts to obtain additional vaccine supply. This will also allow DPH and other health providers to prepare for an increase in cases and direct resources to testing, treatment, vaccination, and community awareness.

Declaration of Local Health Emergency Regarding the Outbreak of the Monkeypox Virus

San Francisco to Declare Local Public Health Emergency for Monkeypox

Symptoms

Monkeypox often begins as flu-like symptoms. It also appears as a distinctive rash or sores or spots that can look like pimples or blisters on the skin anywhere on the body, especially in the genital area. Spots can also be inside the rectum or butt, on fingers, or in the mouth or eyes.
 
Generally, the spots start as red, flat spots, and then become bumps. Those bumps then become filled with fluid which turns to pus. The pus bump then breaks and crusts over into a scab. The scabs may be itchy.
 
Some people never get a rash. They may have a fever, or swollen glands or muscle aches. Some people get a rash and other symptoms together. Or one after the other.  And for some people, symptoms start with a fever and only two or three spots.   
 
Some people have also reported pain or discomfort inside their rectum.    

How it Spreads

Monkeypox spreads through prolonged skin to skin contact. Contact includes:

• sex
• kissing
• breathing at very close range
• sharing bedding and clothing

If you have sex or close physical contact with many people you have a higher chance of getting monkeypox.

Monkeypox can be serious, though most cases resolve on their own. You should see a doctor right away if you think you have been exposed. 

Staying Safe

If you think you might be at risk you can:

• Cover exposed skin in crowds
• Don’t share bedding or clothing
• Talk to anyone you've had sex or close contact with about their health
• Stay aware if traveling

If you have symptoms:

• 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
• Talk to a healthcare provider as soon as possible
• Stay away from other people
• Let sex partners know about any symptoms you have

Monkeypox Vaccine

Vaccine supplies are limited. Get more information on the monkeypox vaccine. 

Notice of Exposure

If you got a notice that you might have been exposed, think about your contact with other people at the event.

If you had close, physical contact with others at an event (like kissing or sex) you are at high risk of direct exposure. You should get a monkeypox vaccine within 14 days to prevent an infection (the sooner the better!).   

If you were at the event and did not have close, physical contact with others, you may not need a vaccine. Look for symptoms of monkeypox and talk to your healthcare provider.

Testing

If you have a rash, or spots, your heathcare provider or a clinic an test you for monkeypox. They will rub a swab on the spots and send the swab to a lab for testing.

Your healthcare provider may also do blood tests at the same time.  We run a blood test to look for infections that can look like monkeypox, like syphilis. 

While you are waiting for your test results you should:

• Stay away from other people
• Don't use public transportation
• Get in touch with people you've had sex or close contact with and ask them to get tested

Treatment

Most people get well from monkeypox without needing any medicines or other treatment.

There is no medicine that the FDA has approved for monkeypox infection treatment.  

However, there is one medicine that is used for severe monkeypox, called tecovirimat, or TPOXX. It is allowed as an “investigation” drug for special circumstances for people who have severe monkeypox. 

Right now, we only have a few TPOXX pills available. Talk to your doctor if you think you might need TPOXX because of a special condition or severe disease.

If you need TPOXX, your doctor will work with the health department, or other providers to get you TPOXX.

Healthcare

If you do not have a healthcare provider, or can't get an appointment, go to either:

• SF City Clinic at 7th Street San Francisco (628-217-6600)
• Strut located 470 Castro Street (415-581-1600)

• Click HERE for San Francisco guidance, updates and outreach materials
• Click HERE for Q&A from CDPH
• Click HERE for information on monkeypox from the CDC
• Click HERE for guidance on social gatherings and safer sex from the CDC 

1. Most importantly: stay up to date on your COVID-19 vaccinations (vaccination plus booster, if eligible). This is your first layer of defense against the virus, preventing serious illness and hospitalization. 
2. Keep rapid COVID-19 test kits on hand. There are options to receive free test kits from the federal program, through health systems and community organizations, or be reimbursed by insurance.  
3. Keep masks handy – you may need them during times of high community spread, or when the situation requires. N95s/KN95s or double mask, cloth over surgical, are best.  
4. Plan ahead in case you or a loved one becomes infected. For example, you may need a care plan for a child, or a work plan to cover your work duties.  
5. Know how to reach a doctor. If you are at high risk for serious illness, you may be eligible for COVID-19 medicine, but you must take it within days of onset of symptoms.  
6. Stay informed. Follow COVID news updates and health guidance through reliable and trusted sources of information, such as your local health department (SFDPH) and other government websites 

• Age 65 or older 
• Pregnant 
• Unvaccinated or partially vaccinated
• 12 or older and have these common medical conditions  
  
  Read more about COVID medicines and resources available here. 

• ZSFG (1001 Potrero Ave, Bldg 30)  
• Southeast Health Center (2401 Keith Street) 
• Chinese Hospital (845 Jackson Street)
• Kaiser Clinic (2350 Geary Blvd)
• Mission Wellness Pharmacy (2424 Mission St.)
• HealthRight 360 (Ages 18+, 1563 Mission St.) 
• All DPH neighborhood events and sites

M Oceanview Transit and Safety Project

We offer our deepest sympathies to the victims and their families who are suffering right now.  

While these recent incidents appear to be an anomaly and instances of isolated, targeted confrontations, we are working resolutely to make sure all Muni riders are safe and can be confident riding our buses and trains. We were already increasing security and safety across our system and are taking additional steps in response to the recent incidents. 

• Increased staff presence on our vehicles:
  Having uniformed personnel present on Muni vehicles is a visual deterrent against crime and other problematic behavior. 
  • Our Muni Transit Ambassadors are San Francisco community members with deep ties to their neighborhoods. Many of them grew up riding Muni. They ride specific Muni routes to assist customers, defuse and deter any conflicts, prevent acts of vandalism and assist bus operators. We currently have 21 Muni Transit Ambassadors in the field and are hiring an additional 20 ambassadors. 
  • Our Transit Fare Inspectors also ride Muni routes, and they do more than make sure our riders comply with our fare policies. They also provide riders with service information and information about fare programs and kiosk locations.  
  • We’ve been informed by the SFPD that they will be providing an increased presence on Muni in the coming weeks. 
  • At Muni stations, station agents are monitoring video footage from cameras that are set up throughout the station and will take action if there’s an emergency, either by going to the scene or by contacting emergency personnel. Any time you’re concerned about a safety issue or have a question, you can walk up to the booth and talk with the station agent.
• Extensive and effective video surveillance program: 
  • We’ve installed high-quality video cameras throughout our system to be able to document crimes and provide the documentation to the police. In multiple instances, this video footage enabled the police to identify and arrest people who perpetrated crimes.  
  • Each bus is equipped with at least 11 cameras that are recording any time the bus is running. The footage is monitored by staff in our video surveillance unit. 
  • We are constantly upgrading and improving our video system. Currently we are hiring more team members to support this work.
• New Equity Safety Initiative: 
  • All forms of gender-based and race-based harassment, assault and sexual violence are strictly prohibited throughout the SFMTA system including on vehicles and at stops and facilities. Threatening, harming or harassing passengers or SFMTA employees is illegal and will not be tolerated.  
  • We recently implemented an initiative to prevent this type of harassment and violence on Muni. Later in August, announcements will be posted throughout the Muni system making it clear that this behavior is not tolerated. Riders can now report gender-based harassment and violence using the Muni Feedback form  (SFMTA.com/MuniFeedback) or by calling 3-1-1. Non-English speakers should call 3-1-1 for language-assisted reporting.   
  • We will be tracking this data to determine where more resources should be directed to make sure none of our riders ever have to tolerate gender-based harassment or violence. Learn more about our Safety Equity Initiative (SFMTA.com/SafetyEquity) 

The safety of our customers and staff is a top priority for the SFMTA. We will continue our efforts to make sure Muni is a safe and welcoming environment and update you with our progress. In the meantime, if you need to report an incident you see happening on Muni, please follow these steps. 

• What to do in the event of a crime on Muni 
  • First and foremost, stay safe: Try to remain calm and exit the vehicle if necessary and safe to do so. Never put yourself in danger. 
  • Alert authorities and your Muni operator: Call 911 to report the crime as soon as it's safe to do so. Alert the Muni operator if the operator doesn't seem to be aware so they can take steps to keep everyone safe. You can also alert any other SFMTA staff member you see (they’ll be wearing a Muni vest). 
  • Remember and report helpful details: When reporting an incident, accurate details can make all the difference in enabling police and Muni staff to respond effectively. When a crime occurs, note details like the time, location and Muni vehicle number. If safe, also note a physical description of any suspects.