For David Watson, no amount of morphine was enough to numb the pain.
Watson had kissed a friend on the cheek on July 8, and by July 21, he had visited the emergency room three times.
The pain from open lesions on his backside made sitting, lying down, and walking an excruciating endeavor, even after he was prescribed a strong opioid medication: Dilaudid.
“The pain was almost indescribable,” Watson said.
Days before the lesions and the pain, Watson developed a cough. Having just recently recovered from Covid, doctors feared that he had developed pneumonia and put him on the antibiotic Doxycycline. This wiped out his gut bacteria and caused gastrointestinal discomfort and a hemorrhoid.
“You’re killing all the bacteria in your intestines,” Watson said.
The next day, his tongue swelled up and his back and neck muscles had tightened, which are symptoms that have frequently appeared in monkeypox patients, according to Watson. Just days after being exposed to monkeypox, a lesion appeared on his cheek. And some time after that, nearly 20 lesions peppered his body.
The lesions and the hemorrhoid caused Watson excruciating pain and brought him to the hospital three times in four days.
On July 19, during Watson’s second emergency room visit, doctors realized that several of his sores, including some on his hands, had become infected with a secondary bacterial infection, requiring yet another course of antibiotics.
That same day, Watson’s care provider applied for Tpoxx on his behalf—it was that drug that was the turning point, according to Watson. Tpoxx had been used to treat smallpox and was only rarely used in treating monkeypox before the current national outbreak. Watson began taking it on July 23 and noticed an immediate difference.
“Within 24 hours, my pain was cut in half, and by 48 hours, it was cut by two-thirds,” Watson said.
But being prescribed the antiviral drug takes a lot more than a doctor’s note.
Watson said that the process involved a lengthy application, more than a dozen pages long. It had to include pictures of his open sores and be filled out by his doctor. It then had to be approved by the CDC, adding days of delay before the drug could be shipped to him overnight.
“As complicated as it sounds, that’s how f****** complicated it was to go through,” Watson said.
A Long Wait for the Vaccine
As he picketed outside the San Francisco Federal Building, holding a sign shaped like a vaccine, Freddy Coronado recalled that it took him 12 hours waiting in line across three visits to San Francisco General Hospital before finally getting his shot last week.
Coronado said that he got most of the information about monkeypox and the vaccine from outreach from local advocacy groups rather than the Department of Public Health directly.
“It almost seems like they don’t want to talk about it, or they’re pretending it's not happening,” Coronado said.
Coronado was part of a protest organized by the Alice B. Toklas Democratic Club, where club members and people from the community called for action from federal and local public health agencies.
Protesters demanded that Tpoxx be cleared for emergency use by the FDA, slashing the red tape involved with the current CDC application process, and that the Department of Health and Human Services (HHS) revise their vaccine allocation strategy to send more shots to the cities that need them most, like San Francisco, which had the highest infection rate in the nation as of Aug. 1.
“We obviously don’t want places like Iowa not getting the vaccine, but they don’t have the high case load that we have in San Francisco or Los Angeles or New York City,” said Gary McCoy, who helped organize the protest. “That could be done through HHS.”
Protesters understood that the city’s hands are mostly tied when it comes to getting more vaccines, since they come from a national stockpile. But the city has already declared monkeypox a health emergency, which the Board of Supervisors ratified during an emergency meeting Monday.
“A lot of hiccups are at the federal level,” said McCoy.
The city, meanwhile, has quietly stopped contact tracing monkeypox cases as victims didn’t want to identify their sexual partners, reports The Mercury News.
For those who haven’t gotten it, Watson’s woes illustrate the urgency to get vaccinated, or ensure available treatment in case they contract it. Health experts say that getting a vaccine is one of the best ways to protect against infection, but limited supply has made getting a shot an arduous task.
Akash Singh said he had issues accessing the vaccine. He said he tried to call his care provider about it in early June but was told by a nurse that she had not received information about it from the Department of Public Health.
Singh later learned through a friend’s Instagram story that monkeypox vaccines were available at Steamworks, a Berkeley bathhouse which primarily serves gay men, through a vaccine pop-up event. The venue recently encountered some controversy for allegedly offering expedited vaccine wait lines for those who paid to use the bathhouse. Singh was unable to get a shot the first visit, but got it the second time, after a four-hour wait.
“Trying to get the vaccine was a complete s***show,” Singh said. “I had no idea the vaccine was happening there…there wasn’t a single communication from a public health department.”
Protesters also complained about delays in getting results from swab tests and asked for help from the city to arrange funding for people who could not otherwise afford to take time off work to quarantine.
The Department of Public Health acknowledged in a statement that nasal and throat swabs for monkeypox are available, but only under pilot evaluations done alongside sore swabbing, and that they are working to make it easier for private health care providers to have access to Tpoxx.
HHS was contacted for comment.
The Standard is closely tracking the outbreak of monkeypox in San Francisco. Click here to get the latest information on case counts in the city and the state.