AIDS and COVID-19: Silent Prejudice
Updated: Apr 14, 2020
An ACT UP poster that drew attention to AIDS, which the Reagan administration ignored
The last virus epidemic that touched my life was HIV, the AIDS virus, 40 years ago.
If you lived in San Francisco at any time during that crisis, which struck gay men and intravenous drug users, disproportionately, the virus became a part of your life as COVID-19 has squirmed its way into everyone’s life today.
Four months after the new coronavirus first appeared in China, you probably know someone who has died of complications from it.
When I learned that my best friend, a gay man, had the AIDS virus, I was in shock. Then, I learned that a childhood female friend in New York had it. And then, a gay friend I knew from Long Beach, California. And then, another friend in San Francisco. Shortly on, I felt like, who didn’t have AIDS?
I got tested more than once. I waited days for the results. I remember that excruciating wait. Will I live or won’t I? In the early days, there were no drugs to keep you alive. AIDS killed you.
How can we slow down the spread of a virus if we don’t know who has it?
HIV (Human Immunodeficiency Virus) is transmitted through blood, semen, vaginal fluid, mucus and breast milk, according to the Terence Higgins Trust, a British charity, which focuses on HIV and sexual health. People are encouraged to get tested and use condoms to avoid contracting AIDS (Acquired Immune Deficiency Syndrome).
We had to change our behavior.
The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, according to the World Health Organization. People also may become infected by touching a contaminated surface and, then, their faces. The coronavirus, generally, can survive on surfaces for up to 72 hours. It is most contagious during the first three days after the onset of symptoms, although it may be spread before symptoms appear and in the later stages of the disease.
How can we slow down the spread of a virus if we continue to act in ways that propagate it?
San Francisco acted quickly in the COVID-19 crisis, declaring a state of emergency on February 25, when the city had no cases at all. As of April 10, San Francisco had 857 cases and 13 deaths, much lower than metropolises of comparable size such as New Orleans.
San Francisco Mayor London Breed said: “We’ve been through this before.”
Dr. Grant Colfax, director of the San Francisco Department of Public Health, was the director of HIV prevention and research with the department before then-President Barack Obama appointed him director of the Office of National AIDS Policy.
“We took early action as a city and a region,” Colfax said in The Daily Journal of San Mateo in the San Francisco Bay Area. “The focus has been on data, science and facts – along with vulnerable populations.”
Colfax said that social distancing by the public has proven crucial with the coronavirus.
“You’re literally saving lives,” he said.
Two of the leading members of the Trump Administration’s White House Coronavirus Task Force also worked on the frontline of the AIDS virus. Dr. Anthony Fauci, an immunologist, has been an advisor to every U.S. president since Ronald Reagan. Ambassador-at-Large Deborah Birx, whose title comes from her role as the United States Global AIDS Coordinator, started her career in immunology, eventually focusing on HIV vaccine research. Birx, 64, worked in the lab of Anthony Fauci, 79, from 1983 to 1986, when she completed two fellowships in clinical immunology.
At Birx’s swearing-in as ambassador, Secretary of State John Kerry told of how her foresight and knowledge of AIDS may have saved her own life in 1983, when the condition was still a mystery, according to The Guardian.
Birx was giving birth to her first daughter and had lost a significant amount of blood, Kerry said. The doctor ordered a transfusion, but Birx had read a report about AIDS and the risk of such a process.
“Do not let them give me blood,” she screamed, before passing out in pain.
Her husband followed her orders and stopped a transfusion, which the hospital later revealed would have been contaminated with HIV.
“It made her think hard, not just about the perils of this new disease, but about her responsibility to fight it,” Kerry said.
Birx and Fauci are fighters.
Since the beginning of the AIDS epidemic in the 1980s, according to UNAIDS, 74.9 million people had been infected with HIV; 32 million had died from an AIDS-related illness, and 37.9 were living with the virus at the end of 2018.
In the same period, new HIV infections had been reduced by 40 percent since the peak in 1997. About 1.7 million were newly infected with HIV as compared with 2.9 million in 1997.
In only four months, according to Johns Hopkins University, there were 1,883,119 confirmed cases of COVID-19 and 117,569 deaths worldwide as of April 13.
As with HIV/AIDS, there has been fear and confusion of the new coronavirus. The San Francisco gay community transformed itself into a compassionate one, caring for those afflicted with HIV. But the reaction of much of the rest of the country and the White House was not so kind. It was often informed by a hate and fear of homosexuality. The conservative Christian Moral Majority had elected Ronald Reagan.
At a White House press briefing in 1982, Larry Speakes, President Ronald Reagan’s press secretary, laughed when asked whether the president had any reaction to the U.S. Centers for Disease Control and Prevention announcement that “A-I-D-S” was an epidemic.
“It’s known as the gay plague,” explained radio journalist Lester Kinsolving, who was asking the first public question about AIDS. Many people laughed in the room. “No, it is. It’s a pretty serious thing. One out of 3 people who get this die, and I wonder if the president is aware of it.”
Speakes made a joke of it.
“I don’t have it, do you?” which solicited more laughter.
The White House knew nothing about AIDS, said Speakes.
In 1985, three years after the press conference, Reagan finally spoke the word “AIDS”. More than 12,000 Americans had died, and the virus had begun to spread swiftly through hemophiliac populations and injection drug users. In 1987, he made his first major speech about AIDS.
In the face of government silence and inactivity, the activist group, Act Up (The Aids Coalition to Unleash Power) formed and publicized AIDS with eye-catching posters and crowded demonstrations. Gay organizations, human rights groups and celebrities added their voices to the cry for research of the condition and support for patients.
Randy Shilts of the San Francisco Chronicle, who became the first openly gay reporter at a major U.S. newspaper in 1981, was at the journalistic forefront of AIDS coverage. He lambasted the political and scientific bureaucracies for impeding information to the public and called for more medical research funding. Shilts’ And the Band Played On: Politics, People and the AIDS Epidemic was published in 1987. The historian Gary Wills assessed And the Band Played On:
“This book will be to gay liberation what Betty Friedan was to early feminism and Rachel Carson’s Silent Spring was to environmentalism.”
In 1994, Shilts died of an AIDS-related illness at age 42.
The COVID-19 crisis has not suffered outspoken prejudice, but there has been some. The virus was first publicized as being most deadly to those who have serious illnesses and to the old, even as we see more and more young people hospitalized with it. In late March, for example, for 2,449 patients, 18 percent were between ages 45 and 54, and 29 percent were between 20 and 44. Among those who were hospitalized, 18 percent were between 45 and 54, and 20 percent were ages 20 to 44, according to the U.S. Centers for Disease Control and Prevention.
There has been a call from one man for the sacrifice of the elderly for the economic well-being of the young. Texas Lieutenant Governor Dan Patrick told a Fox News host:
“No one reached out to me and said, ’As a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that all America loves for your children and grandchildren?’
“But if they had?
“If that is the exchange, I’ll all in.
“So, my message is: let’s get back to work. Let’s get back to living. Let’s be smart about it and those who are 70-plus, we’ll take care of ourselves. But don’t sacrifice the country. Don’t do that. Don’t ruin this great America.”
Media broadcasted strong reaction against Patrick’s plea, strong enough to silence anyone else who supported his view. Patrick’s thinking has been countered by New York Governor Andrew Cuomo, who has been championing the fight against the virus in his state, which has been hardest hit, in the United States, now the virus’ epicenter.
“My mother is not expendable,” Cuomo said, in one of his daily briefings.
Prejudice in the new coronavirus crisis will be a silent one because it is, like all prejudice, morally reprehensible and, unlike all prejudice, widely recognized as such. It will reveal itself in premature relaxing of lockdowns against the advice of doctors and scientists. It will explain itself in terms of the rescue of jobs and businesses.
I am reminded of the science fiction novel Logan’s Run, in which people were killed at age 21, and the movie, in which the age was pushed up to 30. The story depicts a utopian future society on the surface, which is revealed as a dystopia where the population and the consumption of resources are maintained in equilibrium by these sanctioned killings. The old are sacrificed for the good of the young and for the larger community.
I was in my 30s when my friends were dying and dead from complications arising from AIDS. I attended countless “celebrations” in San Francisco. We all mourned the unspent youth of the dead.
Now, in my 60s, I learned that a college classmate died of COVID-19 in Westchester, New York, a coronavirus hotspot. Four years ago, I met him at our 40th reunion at Williams College. He was a large unforgettable character. Also, a high school classmate lost her father to the coronavirus. Two others have died with no cause of death. As in San Francisco in the 1980s and 1990s, I wondered whether they had the virus.
I edited many obituaries at the San Francisco Chronicle then. A missing cause of death usually indicated that it was AIDS-related. Some families considered AIDS a stigma, so they did not mention it, just as a partner often was tagged on to the list of survivors as a “friend”. Perhaps, families are not mentioning COVID-19 because the virus would take away focus from their dead. It would.
Forty years on, there is no cure for HIV/AIDS. There is no licensed vaccine to prevent the condition or treat those who have AIDS. However, there are many medications that can control it and prevent complications. These medications are called antiretroviral therapy (ART).
Four months on, there is no vaccine or medicine to prevent or treat COVID-19. Possible vaccines and drug treatments are under investigation. The World Health Organization is coordinating research efforts.
I was in shock by the AIDS epidemic.
Forty years later, I am still in shock.