SUBJECT
Title
RATIFY DECLARATION OF LOCAL HEALTH EMERGENCY REGARDING MONKEYPOX (DISTRICTS: ALL)
Body
OVERVIEW
On July 23, 2022, the World Health Organization (WHO) declared the multi-country spread of monkeypox to be a Public Health Emergency of International Concern, which constitutes its highest alert level. On August 1, 2022, Governor Newsom declared a State of Emergency as part of California’s response to the monkeypox outbreak. On August 2, 2022, the San Diego County Public Health Officer issued a Declaration of Local Health Emergency, pursuant to California Health and Safety Code Section 101080, as a result of the global outbreak of monkeypox and the local impacts to public health. Today’s recommended actions will provide the County of San Diego (County) additional powers to coordinate local efforts and identify resources that may be necessary to fully address this evolving situation.
Monkeypox is an unusual disease caused by infection with the monkeypox virus. It is spread through prolonged skin-to-skin contact and symptoms of monkeypox include rash, fever, muscle aches, and respiratory symptoms. Although most cases of monkeypox resolve within a few weeks, monkeypox can cause serious symptoms, including severe pain, hospitalization and, in rare cases, death.
State law requires the Declaration of Local Health Emergency to be ratified by the San Diego County Board of Supervisors (Board) within seven days of issuance. Today’s action requests the Board to ratify and find that there is a continuing need for the Declaration of Local Health Emergency.
This item supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by protecting the health of residents against the monkeypox outbreak.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Ratify the attached Declaration of Local Health Emergency made by the San Diego County Public Health Officer on August 2, 2022.
2. Find that there is a continuing need for the local health emergency until no longer needed, subject to the California Health and Safety Code Section 101080 requirements.
EQUITY IMPACT STATEMENT
In order to support the most vulnerable, an equity lens/risk-based approach was used to prioritize, when appropriate, the distribution of monkeypox vaccine and other resources. Response efforts are based on a data-driven approach, identifying communities that have the highest need for support in relation to the number of positive monkeypox cases. In any outbreak response, the County of San Diego’s approach is to recognize the risk factors for infection and specific communities where the infection is being seen. This is done without stigmatizing those affected. Helping people make the best-informed decisions to protect their health and the health of their community from monkeypox requires providing key health promotion and harm reduction prevention information to the public and working with partners and trusted messengers to ensure information reaches affected communities.
FISCAL IMPACT
The County of San Diego Health and Human Services Agency (HHSA) is assessing the fiscal impact and funding needs for responding to the monkeypox outbreak. HHSA will use existing appropriations funded by General Fund fund balance, Realignment, and General Purpose Revenue to support the current costs associated with the response efforts until funding sources are identified. HHSA will pursue federal and State revenue and other funding sources to cover response costs. HHSA may return to the San Diego County Board of Supervisors at a future date to seek further authority and request additional resources as needed. There is no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
N/A
BACKGROUND
On July 23, 2022, the World Health Organization declared the multi-country spread of monkeypox to be a Public Health Emergency of International Concern, which constitutes its highest alert level. On August 1, 2022, Governor Newsom declared a State of Emergency as part of California’s response to the monkeypox outbreak. On August 2, 2022, the San Diego County Public Health Officer issued a Declaration of Local Health Emergency as a result of the global outbreak and the local impacts to public health.
In May 2022, clusters of monkeypox cases were identified in multiple countries. The first case of monkeypox in the U.S. was confirmed in Massachusetts on May 20, 2022, and the first case in California was confirmed on May 27, 2022. The first case of monkeypox in San Diego County was reported on June 15, 2022. The global outbreak of monkeypox is rapidly changing day-to-day. As of August 2, 2022, globally there have been over 25,000 cases associated with monkeypox, and nationwide there have been 6,617 confirmed or probable cases in the U.S., including 1,135 confirmed or probable cases in California, and 54 confirmed or probable cases of monkeypox in San Diego County.
Monkeypox is an unusual disease caused by infection with the monkeypox virus. It is spread through prolonged skin-to-skin contact and symptoms of monkeypox include rash, fever, muscle aches, and respiratory symptoms. Although most cases of monkeypox resolve within a few weeks, monkeypox can cause serious symptoms, including severe pain, hospitalization and, in rare cases, death.
There is a limited supply of the JYNNEOS® vaccine, which is approved by the U.S. Food & Drug Administration for the prevention of smallpox and monkeypox disease. Due to the limited supply of vaccine, the large population and geographic location of San Diego County, combined with the worldwide spread of monkeypox and confirmed or probable cases, there is an imminent threat from the introduction of monkeypox in the San Diego County community at-large. Given the limited vaccine availability, the County of San Diego (County) has made significant efforts to slow down the spread of the virus, through the activation of community leaders and trusted messengers, enhanced contracted services to provide person-centered messaging and foot teams in communities most impacted, increased contact tracers with training in sexual health interviewing, enhanced communication with healthcare providers for testing and treatment, and additional health promotion and harm reduction communication, education, and outreach to other communities that are at risk for monkeypox outbreaks.
Based on the circumstances described above, on August 2, 2022, the County’s Public Health Officer found that the introduction of monkeypox into San Diego County is a threat to the public health within the meaning of California Health and Safety Code Section 101080, and thus issued a Declaration of Local Health Emergency. This local health emergency declaration will help bring additional vaccines and other resources to the region and will support with enhanced community awareness as the County continues its monkeypox response efforts.
Under California Health and Safety Code Section 101080, the local health emergency may only remain in effect for seven days unless ratified by the San Diego County Board of Supervisors (Board). If ratified, the Board must review the need for continuing the local health emergency at least every 30 days until the earliest possible date that conditions warrant the termination of the local health emergency. Today’s action requests the Board to ratify the Declaration of Local Health Emergency and find that there is a need to continue the local health emergency until no longer needed subject to statutory review requirements.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Equity (Health) and Community (Safety) initiatives in the County of San Diego’s 2022-2027 Strategic Plan, as well as the regional Live Well San Diego vision, by protecting the population from the global outbreak of monkeypox virus.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Chief Administrative Officer
ATTACHMENT(S)
Attachment A: Declaration of Local Health Emergency, dated August 2, 2022