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Monkeypox treatment Tpoxx: Where to find the elusive drug in San Francisco as cases hit 501

Signs depicting syringes, scissors and TPOXX, a pill being used to treat monkeypox, lays flat at a protest outside the San Francisco Federal Building advocating the government take immediate action to defend against the monkeypox outbreak in San Francisco Calif., on Monday, Aug. 8, 2022. The actions advocates are pressing for include increased testing, vaccinations and treatment. | Benjamin Fanjoy for The Standard

San Francisco’s monkeypox crisis continues to grow as the total number of cases hit 501 as of 5 p.m. Monday according to the city’s monkeypox dashboard.

But access to vaccines and treatment is proving difficult for many in the city.

Monkeypox victim David Watson told The Standard that he had to visit the emergency room three times after contracting the virus by kissing a friend on the cheek in early July.

He then went through a lengthy application process that required a doctor and the CDC to sign off on before he was prescribed Tecovirimat—or Tpoxx—an antiviral drug that he said greatly improved his condition.

Since The Standard’s coverage of the issue the San Francisco Department of Public Health (SFDPH) has now released information on where the drug is being prescribed.

David Watson shows the pills he has been taking for Monkeypox during a portrait shoot outside of his apartment in San Francisco Calif., on Monday, Aug. 8, 2022. Watson and his husband have been quarantining at the apartment while recovering from monkeypox. | Benjamin Fanjoy for The Standard

The following locations are all able to prescribe Tecovirimat (Tpoxx):

    “SF City Clinic, an SFDPH facility, has been serving as a safety net site and has provided Tecovirimat to over 150 patients, including many who were unable to access it through their regular system of care,” SFDPH said in an email statement.

    In that statement, the health department noted that the drug is only used in some severe monkeypox cases.

    “Tecovirimat (Tpoxx) is allowed as an ‘investigation’ drug used for special circumstances for people who have a severe monkeypox infection,” a spokesperson for the department said. “And requires providers to go through a burdensome federal regulatory process for clearance and approval.”

    This includes a lengthy application with photos of monkeypox lesions and follow-up visits. Many health care providers do not have the infrastructure needed to complete all of these steps, so the number of health providers who can dispense Tpoxx in San Francisco is limited, according to the health department.

    “DPH is advocating for the federal government to make the process less burdensome, and in the meantime in an effort to facilitate more providers being able to dispense the medication is providing technical assistance and guidance on the regulatory requirements for prescribing Tpoxx,” SFDPH said.