Not my first global pandemic

Make a list of everyone with whom you’ve had contact, in the last 2 weeks, where you spent more than an hour together and anyone present wasn’t wearing a mask. The reported infection rate in the US, based on tests, is 1.1%. The actual infection rate is somewhere between 6-24 times higher. So, being optimistic, let’s say 6.6% (though it varies by region quite a lot.) Is your list longer than 15 people?

Now consider the lists of all the people on your list. Are any of them social butterflies? Have they been traveling? Have they been working? Are any of them working with COVID-19 patients? Do any of them work at restaurants? How intimate is their level of contact? Are any of them carrying COVID-19? Do you know, or could you even find out?

I’m a gay man. My family is educated, scientific, and liberal. So when I was a teenager, I got involved with my school’s gay/straight alliance, and I learned about the biology of homosexuality, plus history, social issues, politics… and the AIDS crisis. The whole curriculum basically consisted of two things:

  • You’re ok the way you are, and
  • Don’t get HIV.

When someone gets a positive HIV test, they must put together a list of everyone with whom they’ve had sex since their last HIV test plus six months, because all those people need to be tested now. And any of them who test positive need to make that same list for themselves, and all those people need to be tested, etc. One of the most confounding problems of the HIV/AIDS pandemic is that so many people are HIV+ and don’t know.

Most people have the privilege that they get to not think about HIV or AIDS at all; most of them don’t realize that it is a privilege, like being white or male or wealthy. We’re about 8 months into the pandemic, and in all the COVID-19 coverage I’ve seen, not once have I heard a comparison to HIV/AIDS. Why?

Dr. Anthony Fauci, formerly of the Trump administration, has become basically a celebrity expert on COVID-19. It’s pretty well-known that he was working on a vaccine for HIV very early on in the pandemic. I’ve seen a handful of pictures such as this one on a variety of articles I’ve read on the subject. (I wonder if any of these photos have ever graced Fox News…)

HIV/AIDS, by the way, makes SARS-CoV-2 look like the common cold. 38 million people infected, 770 thousand deaths. 35 years. We don’t have a vaccine, we don’t have a cure, and the medications used to manage it… well, I’m very glad that I don’t have to take them.

Despite our scientific understanding of the HIV virus, we still see another ~1.7 million infections every year. If we did everything perfectly from now on–universal testing and contact tracing, everyone practicing safe sex, no more needle re-use, no breastfeeding for HIV+ mothers, etc., we could get the infection rate very close to zero.

And if everyone wore a mask, kept their distance, and stayed home, COVID-19 could be over in a month. It could be over. it could have been over months ago.

We made a lot of mistakes with HIV. The Reagan administration refused to acknowledge it. The gay community opposed safe sex mandates early on. Funding for AIDS research was hard to come by. The second big wave of infections happened in a part of the world where science has very little say in public policy, even less than the current US government. Some African governments bought into HIV denialist conspiracy theories, providing political cover for not funding research or prevention when it was really just homophobia. To this day, there is massive opposition to comprehensive sex-ed, which we know reduces infection rates for all STIs, as well as teen pregnancy.

With the exception of saying “this is God’s retribution for gays,” we have collectively repeated every single mistake that we made with HIV/AIDS, plus we’ve come up with some new ones. Early antiretroviral medications weren’t the miracles we expected them to be, but they were all better than nothing. There’s no equivalent in the history of HIV/AIDS to the massive cock-up around hydroxychloriquine. We never went backwards on safe practices–there was no “premature re-opening”. Nobody ever said “it’s Memorial Day, go ahead and have your unsafe sex parties,” leading to a taller, second wave of infections.

(There’s a movie I think everyone should watch, especially now, called “And The Band Played On.” It follows the work of American epidemiologist Don Francis from the first hints that AIDS existed, and basically tells the story of how the toothpaste got out of the tube. We’re making the same mistakes.)

Knowing all this historical context makes me all the more frustrated about what’s happening with COVID-19. It is so much easier to fix than HIV. We can get new cases to almost zero any time we want; we just have to wear masks in public spaces and practice social distancing (and KEEP THE SCHOOLS CLOSED YOU CLUELESS FUCKS)

Americans don’t understand, it could be over by now! But since we haven’t been doing things right, it’s going to take longer! Are we so impatient that we aren’t willing to wait 4-8 weeks in order to save months, maybe years of the kind of turmoil that destroys nations?

We know what the right things are to do with a global pandemic. Testing. Contact tracing. Safe contact or no contact. No exceptions, no cheating. And yet. Americans fail the Marshmallow Test so spectacularly, we’re about to re-open schools.

It’s like the United States is trying to die from the common cold.

Why? Just… why?

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