AIDS | Joe Jots

Karl Marx was being somewhat reductionist when he said that history repeats itself, first and tragedy, then as farce. And I won’t be the first person to suggest that the Corvid-19 tragedy in the US is a repeat of the AIDS crisis of the 1980s. The earlier was (for those of us in the West) a great tragedy, and what’s affecting us now surely isn’t farce – it’s a tragedy on a larger, faster scale. One of the reasons it’s such a tragedy is that many people learned from the AIDS crisis, President Trump just isn’t one of them.

This probably isn’t the first time I’ve mentioned on this blog the travesty of the Reagan administration in not acknowledging the toll AIDS was taking on a couple of communities in the United States, even when it took the life of his friend Rock Hudson. He refused even to name the disease until well into his second term. That the hardest hit communities were the gays and the intravenous drug users might have had something to do with this. I initially wrote that Reagan was handily reelected even with ACT-UP protests in the capital, but ACT-UP wasn’t formed until 1987. As long as the communities were demonized, though, there was no need to worry. It didn’t hurt Reagan that his opponent in ‘84 was the relatively uncharismatic Walter Mondale.

But the fact is that over the first 20 years of the epidemic, 774,467 people in the US were diagnosed with HIV. 448,060 died of its related ailments. (HIV is still the cause of approximately 1 million deaths per year, mostly in sub-Saharan Africa and Asia.)

The disease wasn’t discussed in US political circles, except in reference to the innocent victims. Remember the Ryan White Act? Innocent meaning not gay, not a drug user. Comics used it as a punch line. Sometimes the entertainment industry stepped up (Philadelphia), generally not. But eventually there was movement in the research and the disease became less of a death sentence, at least in the West. Africa? Still a different story. Standard Precautions also evolved out of the AIDS epidemic. Previously there had been precautions associated with whatever diagnosed illness the patient presented with. First Universal Precautions (1986 or so), which referred specifically to blood and blood-related bodily fluids, and then Standard Precautions superseded those with a set of practices for all those who had patient (and especially body fluid) contact and weren’t dependent on the patient presenting symptoms. When I was working in healthcare in the 90s (as a secretary in home health for a major HMO), I had to be familiar with these, even though it wasn’t in my daily routine to practice them.

Read that WHO doc on standard precautions, or this one from the CDC. That’s okay. I’ll wait.

Did you note the bits about cough safety and hand washing? Yeah, those ring bells because we’re coughing into our elbows now and washing our hands eighteen times a day. What about PPE, sterilization, and infection prevention? Yeah. We’ve had rules in place about those things for decades.

Which brings us to the current repetition.

We know just about when this outbreak came to the US. And we’ve listened to the president and his cohort lie, cheat, steal, brag, and generally screw over those most in need: those suffering from this dreadful flu and the health professionals doing their utmost to help those patients. If the AIDS crisis was itself a tragedy, what can we say about the sheer numbers of this pandemic and the madness of the federal response?

In United States of America, from Jan 20 to 2:00am CEST, 15 April 2020, there have been 578,268 confirmed cases of COVID-19 with 23,476 deaths. (https://covid19.who.int/region/amro/country/us)

I’m not really sure how to address this. In less than a week, we will see the number of cases of COVID-19 in the US in three months exceed the number of AIDS cases recorded in 20 years. And we knew how to prevent the outbreak, or at least lessen its effects, and we knew what was needed to safely take care of those suffering. (In fairness, we knew how to do those things relatively early on in the AIDS crisis, too.) And we didn’t. Not only were we as a nation unable to meet this crisis in a unified way, we were undermined from the outset by the avarice of those who should have been setting sane policy.

In Illness as Metaphor, Susan Sontag discusses the different ways in which tuberculosis and cancer were treated by the medical profession and by family members of those suffering those diseases. TB had an odd romance about it, but in both cases, even the mention of the disease was thought to add another burden to the patient. One of several dozen key points she makes is that, ‘All this lying to and by cancer patients is a measure of how much harder it has become in advanced industrial societies to come to terms with death. (Ch. 1)’

This speaks volumes to how much we as a society really want to believe that getting back to normal, opening the markets, and so forth is preferable to addressing the massive numbers of suffering on our doorsteps. I’ll be honest, I’ve only finished two chapters of Illness and haven’t gotten to the second volume, AIDS and Its Metaphors. But I think Sontag will have a lot to say that speaks to our current condition.

The main reason I’m bringing Sontag’s points into this discussion is that we don’t have the time to be either romantic or blithely quiet about COVID-19. We should be studying and learning and financing the science and the health to get to the other side of this. And doing the work to protect one another. But instead we have the anti-science coming out of the White House and folks like the protesters in Michigan demanding society be reopened so they can shop and have their hair done.

I grieve.

(ETA: My friend Kevin added the following: ‘I am somewhat surprised you limited this to those affected by his ignoring AIDS. His policies in Central America, both under Reagan and on his own, went far further than was revealed in Iran Contra and resulted in untold deaths, mass impoverishment, and the overthrow of legitimate governments by USA backed and armed narco cartels who persist to this day. Lastly we can point out that Bush and William Casey were responsible for the perpetuation of the Iranian hostage crisis, which cost Carter the election.’ These things are absolutely true, and any one of them could have earned another 500 words. The AIDS crisis struck closest to home at the time and is much in my thoughts these days for other reasons.)

I’ve been thinking about the death of George Herbert Walker Bush and why I won’t ‘dignify’ his memory by keeping silent. By 1988, HIV had been identified as the source of AIDS and AIDS had been named for three and five years respectively. Bush had remained silent the entire time, as had his predecessor, Ronald Reagan. (Reagan’s silence, even as friends of his such as Rock Hudson died, was despicable enough.) When ACT-UP and other gay groups protested in forms of extreme street theatre and were arrested for it, they were working in the same realm as the Freedom Riders two decades before, and playing for similar stakes. The people who risked and suffered violence and arrest at the hands of police forces coast to coast in many cases could have lived relatively quiet closeted lives, but as soon as they put themselves on the line for queer causes, they risked being disowned by their families (as the price of coming out had always included), firing, often their entire livelihoods. (This is why Harvey Milk pushed for all gays and lesbians to come out – to make it impossible to ignore that we were everywhere.)

s-e-d This was a fair risk because their friends were dying. (I would so love to be able to say that I took the risks, but I lived safely then and rarely demonstrated, and generally only when it was safe. I won’t rewrite my own history.) Friends and lovers were dying horrible, lonely, painful deaths. Let’s not forget that the opportunistic infections associated with AIDS were slow and had few treatments. And there was no cure on the horizon.

As the leader of the free world, Bush had the responsibility and the duty to speak out, But, I hear you say, it wasn’t politically expedient to do so.

No, butt the crimes and death that result from political expedience are unforgivable. Instead of standing up and saying These are our brothers, sisters, sons, and daughters, he declared a whole segment of the population ‘Other’, a nuisance, and therefore disposable. That nuisance continued to die on his watch at an alarming rate. When he took office over 82,000 cases of AIDS had been reported in the US and almost 62,000 had died of it. When he left office in 1993, those numbers had increased threefold in the US alone. In his time in office, and in the succeeding quarter century, Bush has always been unwilling to stand up and own up and repent and do some kind of good work in this regard.

When his own Department of Health and Human Services produced a report on teen suicide that included the specific risks of gay and lesbian youth, Bush caved to far right groups and suppressed the report. The report was only released when its findings were leaked.

Bush’s successors have blood on their hands too, and I’m not willing to give them a pass, either, but in this moment of hagiography, I must say no. The man was not a saint of any kind. When the crisis was in its infancy, and leadership was required, he continued to do what was expedient. Were I the sort who believed in such things, I’d say that Hell had prepared a room.

ETA: The Rude Pundit has a column on this matter that’s a whole lot less nice than mine.

This is not a metaphor, this is not a test

Why I don’t mourn George HW Bush

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