As my governor closes all schools and public libraries here in Seattle, I think back to 1981 – the year New York and Los Angeles newspapers reported that a strange new virus was killing healthy young men.
As of March 15, Seattle had recorded 420 confirmed cases of COVID-19 and 37 deaths. As a historian of 20th century queer and trans politics, I know that’s nothing compared to the toll that HIV, the virus that causes AIDS, has taken on our city. But these are the early days.
The United States made serious mistakes when the HIV virus and AIDS emerged. These mistakes cost many lives. But our nation has also learned a few things.
Act fast and think big
HIV is very different from the new coronavirus, in ways that might have made it easier to slow down. Since HIV is more difficult to transmit and has a much longer incubation period, a rapid response could have prevented many infections.
But the response has been slow. It took decades for health experts to notice HIV. Studies have shown that HIV jumped from animals to humans in the 1920s and had already killed many people by 1981, but doctors believed those patients had died of other things.
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Even so, once HIV was recognized as a new infectious agent in 1981, quick action and massive investment in research would have saved lives. Instead, government officials sat on their hands. In 1982, White House press secretary Larry Speakes turned a reporter’s question about AIDS into a homophobic joke. It took four years to develop a blood test for HIV.
This fatal inaction stems from the mistaken assumption that only some people have AIDS and that those people don’t really matter. Instead of major research efforts to develop a test and drugs, there were nonsensical suggestions for the forced quarantine of gay men and an actual forced quarantine of Haitians.
After a slow start, things have improved. In the 1990s, even before the development of today’s magic bullets – antiretroviral drugs, the preventive drug PREP and the post-exposure prophylactic drug PEP – public health agencies were advocating ways to slow the transmission of HIV that also protected individuals, such as using condoms, testing and contacting sexual partners. If only they had had these measures in 1982.
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The new coronavirus already exists all over the world, but public health officials already have ways to prevent transmission. They hammer home essential actions to slow transmission: wash your hands, stay home if you’re sick, cancel big events and limit your activities if you’re over 60 or have health problems. health.
A new study now being studied shows that people are more likely to transmit a novel coronavirus right after contracting it and before they have symptoms. It’s like HIV too. For coronavirus, that means “social distancing” is important, even for people who don’t appear sick. Scientists estimate that social distancing, including the cancellation of major events and school closures, along with widespread testing, could save hundreds of thousands of lives.
It’s everybody’s disease
In the early years of HIV, the discussion focused on ‘risk groups’. Even public health officials claimed that only gay people, Haitians or Haitian-Americans, hemophiliacs, intravenous drug users, and sex workers were at risk. Then, straight, white, wealthy American women also began to die.
Today, some Americans seem to believe that not everyone has to be careful because not everyone will get seriously ill.
It is true that older people and those of all ages with underlying health conditions are at greater risk, as are pregnant women. But if health systems are overwhelmed, as has happened in Wuhan and Italy, anyone who needs medical attention will be affected. And people sick with COVID-19 will do much worse.
The HIV crisis has also shown that the concept of ‘risk groups’ is dangerous. When public health officials must take invasive and drastic measures, such as quarantine or travel restrictions, they must be based on real science and implemented transparently, without recycling biases against “groups at risk”. Otherwise, people quite rationally assume that public health is biased and unscientific, and resist.
In the 1980s, gay activists debated whether to ask city health departments to close bathhouses and sex clubs, while the United States Centers for Disease Control warned that it were places where the risk of transmission was high because people met there for sex. Some gay activists have called for bathhouses to be closed to save lives.
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But many homosexuals had the opposite reaction. Amid vitriolic homophobia and AIDS stigma – people losing their jobs, family members banning gay relatives from living in their homes, lifelong quarantine for HIV-positive people – the closing of public baths seemed to them like a stage on a slippery slope towards the concentration camps. Gay communities resisted and bathhouses remained open. In retrospect, for someone who studies gay politics and HIV, it’s shocking that New York City left its baths open until 1985.
Today, racism has attached itself to the new coronavirus as the first reports of infection came from China. As the World Health Organization has pointed out, calling it the “Wuhan virus” or “Chinese coronavirus” could lead people to mask their symptoms and avoid seeking health care. This will increase the risk for everyone. It is also misleading and stigmatizing because it doesn’t matter where the virus jumped from animals to humans, and the virus is not confined to any one country.
Investing in research and public health pays off
It has taken far too long for the United States to make HIV a public health priority, develop life-saving drugs and deliver them to those who need them. Partly because of this slowness, nearly a million people die of AIDS each year. Even today, not enough HIV-positive people have access to medication.
But there is hope. After antiretroviral therapy for HIV began in 1996, and the rich world finally took major steps in 2004 to share these wonder drugs with the rest of the world, the story of HIV shows what science and public health can accomplish.
Especially in rich countries, substantial research funding and public action have transformed AIDS from a devastating epidemic into a manageable chronic disease. And even for people who don’t live in wealthy countries, the results are much better than they were. Global deaths from AIDS were halved in 2017.
Here is the hope for a response to the novel coronavirus that is smarter and faster.
Laurie Marhoefer is an associate professor of history at the Washington University.
This article is republished from The conversation under Creative Commons license. Read the original article.
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