The city of San Francisco and the state of New York declared public health emergencies on Thursday amid the growing outbreak of monkeypox.

San Francisco Mayor London Breed said that the risk of monkeypox to the general population remained low but that declaring a public health emergency would allow the city to mobilize resources and accelerate emergency plans to respond to rising case numbers. Monkeypox infections in the city have nearly doubled over the past week, she noted.

“We know that this virus impacts everyone equally — but we also know that those in our LGBTQ community are at greater risk right now,” Breed said in a Medium post. “The most critical need right now is for more vaccines. The federal government distributes vaccine to state health departments and then the California Department of Public Health allocates to counties, such as San Francisco. We have no control over the vaccine amount we receive.”

“San Francisco needs more support, and we need more action,” she added. “That’s why we are declaring a Local Emergency.”

In New York, which has recorded 1,251 cases of monkeypox so far, Health Commissioner Mary Bassett said it represented an imminent threat to public health across the state.

“This declaration means that local health departments engaged in response and prevention activities will be able to access additional State reimbursement, after other Federal and State funding sources are maximized, to protect all New Yorkers and ultimately limit the spread of monkeypox in our communities,” she said in a statement.

The declarations came after the World Health Organization said the growing monkeypox outbreak was an “extraordinary” event that qualified as a global emergency, saying it had spread to more than 70 countries. The disease spreads mainly through close physical contact with an infected person, and almost all known cases so far have been in men who have sex with men.

Dr. Anthony Fauci has stressed the U.S. should work to reduce the stigma surrounding monkeypox, noting it can circulate in any community.

Monkeypox has been confirmed in almost every state, but the U.S. Centers for Disease Control and Prevention noted that more than 40% of cases have occurred so far in New York and California. There have been no deaths attributed to the outbreak, but some people report serious pain after being infected.

The Biden administration has considered declaring monkeypox a public health emergency and may tap a coordinator in the White House to oversee the federal government’s response. The Food and Drug Administration said this week it had cleared an extra 800,000 doses of vaccines to distribute around the country, greatly expanding the supply for vulnerable communities. But those figures still concern some public health experts who worry there’s not enough to meet high demand.

“We will weigh any decision on declaring a public health emergency based off the response we’re seeing throughout the country,” Health and Human Services Secretary Xavier Becerra said Thursday. “Bottom line is: We need to stay ahead of this and be able to end this outbreak.”

In New York state, where demand has far outstripped available vaccines, gay and bisexual men have been confronted with a slow rollout of shots that has drawn comparisons to the early days of the HIV/AIDS epidemic.

The state is set to receive an additional 110,000 monkeypox vaccine doses amid the latest FDA rollout, 80,000 of which will go to New York City.