Health
SF largely abandons monkeypox contact tracing
in San Francisco demanded more vaccines and treatment options for escalating monkeypox cases — but the city has largely abandoned contact tracing, an age-old method of containing outbreaks.
US health officials declare monkeypox a subspecies national health emergency Last week, like officials in California and the city of San Francisco, no one wants to infect a close relative of smallpox, who has painful lesions that lead to scarring, although it’s usually not fatal.
With 472 cases — 36% of the state’s 1,310 cases — city public health officials believe San Francisco has the highest per capita rate in the nation.
At first, the practice of tracking and isolating or treating people exposed to the rapidly spreading disease seemed like a good idea. depended on.
But public health officials in San Francisco tried to track down everyone who had been exposed to monkeypox, most of them men who had sex with men, but it didn’t work.
“Many were unwilling or unable to share their partners’ names and contact information,” health officials said in a statement.
So about a month ago, health officials changed tactics and began encouraging monkeypox patients to do their own contact tracing. The city’s health department hastened to say it’s still doing contact tracing for monkeypox, but it’s largely limited to children under 18 and pregnant women.
In contrast, a study of several Bay Area counties, including Alameda, Santa Clara, San Mateo, Contra Costa, and Marin, continued to track contact with all who tested positive for monkeypox. I understand.
But the number of cases there is in the single or double digits compared to the hundreds in San Francisco.
With up to seven cases reported in Marin County, no matter how softly public health officials asked, or how adamantly they explained they would keep the information private, they would never reveal their partners’ identities. Only about half had the will. The highest-ranking officer in the county public health department.
“This is always the case with STD contact tracing,” Willis told the Chronicle. “We’re asking about sex and the kind of sex they’re having.”
According to Willis, people are often happy to talk about their most intimate moments. “But when you actually try to name your partner, there are often moments when it becomes clear that you have conflicting feelings about having any more conversation,” he said.
One common approach to making people more comfortable is for health officials to role-play conversations with an infected person’s partner, and that can work. But that’s not always the case, Willis said, and usually people just say they want to contact the partner themselves.
Still, contact tracers can provide appointments and information, if not treatment, so they can better help reaching partners. In some cases, others can be vaccinated. But drugs are in short supply.
Arnab Mukherjea, a public health expert at the University of California, East Bay, expressed surprise that San Francisco would suspend contact tracing no matter how low the number of cases was.
“If someone refuses to give the name of another person, we can’t force it,” Mukherjea said. If it is, it’s better than leaving it alone.”
He said contact tracing could be more effective for monkeypox than for COVID, which is transmitted by air droplets. Unlike coronavirus, it is not possible to be sure who infected you.
Nevertheless, tracking down all the partners of someone with monkeypox can take hours, especially if they don’t answer the phone, Willis said.
“So if you have close to 500 cases, like San Francisco, and you’re not getting high yields anyway, you know you’d be better off putting your resources elsewhere,” he said.
Still, the fact that the San Francisco Department of Public Health has largely given up on contact tracing wasn’t something officials would easily acknowledge, according to an East Bay Times article this week. He revealed that he was confused about telling the whole story to the public.
According to the paper, San Francisco health official Susan Phillippe approved the public response that “we are doing contact tracing for monkeypox,” but how little they were doing. “It puts too much emphasis on contact tracing,” countered Stephanie Cohen, medical director of the San Francisco City Clinic.
A statement sent by SF officials to The Chronicle on Monday acknowledged that they had been focusing on young people and pregnant people.
Nanette Asimov is a staff writer for the San Francisco Chronicle. Email: [email protected] twitter: @Nanette Asimov
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