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Making sense of monkeypox and California’s state of emergency

Recently, the U.S. Department of Health and Human Services declared the monkeypox outbreak a national public health emergency. This follows emergency declarations in California, Illinois and New York. In California, as of this writing, San Francisco, Los Angeles, and San Diego counties have also released local emergency declarations. The words "state of emergency" can naturally make you feel worried. You might be wondering if this will turn into another pandemic. What does a state of emergency declaration mean, and will it happen in other places? How can you protect yourselves and your loved ones from monkeypox?


Monkeypox is not easily spread through the air. Monkeypox is a serious and painful disease, but it is rarely fatal. We have a vaccine that can protect people from monkeypox, even after exposure to the virus, and local public health agencies are working to prioritize vaccines for those at highest risk of contracting the virus. According to the Centers for Disease Control and Prevention (CDC), monkeypox is a virus that is generally spread through close or intimate contact. 

What does the state of emergency mean? Will we shut down again?

Declaring a state of emergency is a tool that gives state and local officials flexibility to address the monkeypox outbreak more quickly, for example unlocking emergency funding. Monkeypox is a very different disease than COVID-19 in how it is spread and in its lethality. There are no indications that shutdowns would help or be required. We will likely see other states and counties taking similar actions to California if their numbers of monkeypox continue to climb. We have already seen New York City follow San Francisco’s lead with calling a state of emergency. 

Now is the time to take the necessary steps to protect ourselves. 

How can I prevent infection?

Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.

  • Do not touch the rash or scabs of a person with monkeypox.

  • Do not kiss, hug, cuddle or have sex with someone with monkeypox.

Avoid contact with objects and materials that a person with monkeypox has used.

  • Do not share eating utensils or cups with a person with monkeypox.

  • Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.

Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

Do I need to get vaccinated for monkeypox?

Widespread monkeypox vaccination is not recommended or available at this time. The U.S. government is working with local public health agencies to get the vaccine to those most at risk. 

The CDC is currently recommending the vaccines be allocated to the following groups:

  • Known contacts who are identified by public health via case investigation, contact tracing, and risk exposure assessments

Presumed contacts who may meet the following criteria:

  • Known sexual partner in the past 14 days was diagnosed with monkeypox

  • Had multiple sexual partners in the past 14 days in a jurisdiction with known monkeypox

What should I do if I’m eligible for the monkeypox vaccine?

Currently, the monkeypox vaccine is being allocated to communities at highest risk. Contact your local public health department to find out where and how to get the vaccine. A list of local health services/offices can be found here. The California Department of Public Health also has information here. San Francisco, Los Angeles, and San Diego counties have additional eligibility guidelines and information on how to get the vaccine on their websites.

Are providers prepared to diagnose monkeypox?

Monkeypox is not a disease that providers in the U.S. are used to seeing, so it is possible that cases will be misdiagnosed. A diagnostic test is available through doctor’s offices involving swabbing lesions. Not every lab is equipped to read the test, so results may take more time. 

As more cases present themselves, doctors are becoming more knowledgeable about the disease. The CDC is updating their website with clinical guidance on a regular basis and local health departments are doing their best to stop outbreaks. That is exactly why San Francisco declared a state of emergency. If there’s one thing I know, it’s that our providers will do all that they can to get up to speed on this emerging virus as quickly as they can. 

For more information on how Monkeypox is spread, its symptoms and how to prevent infection, please visit the CDC website: How it Spreads | Monkeypox | Poxvirus | CDC


Dr. Susan Fleischman is the chief medical officer at Blue Shield of California.