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What the Early AIDS Epidemic Can Teach Us About COVID-19

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When it comes to handling an outbreak, Reagan was bad, but Trump may be worse.

The panic and fear surrounding COVID-19 is a place we've been before. The media is literally inundated with almost exclusive coverage of the pandemic. There are distinct similarities and differences between what is going on right now with COVID-19 and what we experienced in the early AIDS epidemic.

An inept administrative response is a key component of creating public panic. One thing about COVID-19 that is distinctly similar to the '80s and '90s is public ignorance and confusion accelerated by an administration that does a poor job at dispelling fears and conveying realities. What are the distinct lessons we can learn from the early AIDS epidemic that we can apply to the current issues we face?

In 1981, a doctor in San Francisco began seeing Kaposi sarcoma and Pneumocystis Pneumonia in young, primarily gay men. This was noted in the CDC's Morbidity and Mortality report as young, otherwise healthy men with a rare form of cancer and a very rare infection caused by fungi that a person's immune system, if healthy, should be able to fight off on its own. The media soon dubbed this condition GRID or Gay Related Immune Deficiency, or "gay cancer."

Later this same year, a doctor in Florida began seeing similar symptoms in Haitian patients who were both male and female, and primarily reported as heterosexual. When the doctor told the CDC what she was seeing, they told her they didn't believe it, but later began investigating. Their investigations consisted of looking into the nature of voodoo rituals and also the sexual histories of these individuals (i.e. did any of them have "homosexual contact?")

In 1984, scientists found the cause of HIV and came up with a test for it, which brought up a whole new set of questions about what people were supposed to do after they tested positive in an era when there was no treatment and mortality was nearly 100 percent.

The AIDS epidemic began in the first months of the Reagan years, an administration that promised to reduce government and cut taxes. A disease centered around sex and homosexuality got almost zero airtime in this administration. In Reagan's two terms, he held one single press conference on AIDS. At this time, Reagan's administration was surrounded by an evangelical revival. Jesse Helms, a Republican senator from North Carolina, vehemently condemned any possibility of facilitating HIV/AIDS education and prevention, purely on the basis of alleged morality. While Reagan was silent about the science of HIV and did nothing to quell mass hysteria, evangelical pundits like Jerry Falwell and Pat Robertson often gave speeches about how people with AIDS "bring it on themselves" with their "ungodly" behavior.

Reagan and his administration, very much influenced by Helms, put profit -- and re-election politics -- over people and didn't want to rock the boat of public opinion by putting money into a disease they perceived as being only a problem for "homosexuals" and "drug addicts."

On Monday, March 9, 2020, the Dow Jones dropped a record 2,000 points, putting a complete halt to trading on Wall Street for the day. Trump had just returned from a golf trip in Florida and that morning tweeted, "So last year 37,000 Americans died from the common flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life and the economy go on. At this moment, there are 546 confirmed cases of Coronavirus, with 22 deaths. Think about that!" 

The administration has been highly criticized for their slow pace in rolling out test kits that could be available to the public, which experts believe could greatly help to quell public panic and even buoy the stock market. The idea of expanding paid leave was only just floated yesterday during a press conference in which Trump seemed to do a confusing about-face from this week's earlier tweet.

The COVID-19 outbreak has been traced back to Wuhan, China, but it's important to know that coronaviruses have been identified by scientists, according to the CDC, since the 1960s. The Beta Coronavirus, one of the four most common types of coronavirus, is responsible for SARS -CoV, or more commonly known as Bird Flu. Because of the genesis of the recent outbreak, coronavirus (a new term and concept to most Americans) has become associated with Asia and with people of Asian descent, especially those of Chinese descent. China, who according to The New York Times initially concealed and then was slow to respond to the outbreak in Wuhan, has now taken aggressive and successful measures (some argue extreme) that appear to be bringing down COVID-19 case numbers. The tactics included a lockdown of residents in the affected area and very strict restrictions for domestic and international travel. The result is hospitals are emptying out where they were not so long ago overflowing and reported cases continue to drop.

In comparison, the U.S. looks woefully incompetent as case numbers only continue to rise, especially in the U.S. epicenter of the Seattle metro area. No quarantines have been put in place except voluntary ones in which the government asks people to stay home if feeling ill and to telecommute if they can. But to do so, Trump and his administration needs to create a boost to fiscal programs like unemployment, state benefits, and paid sick leave, but we have yet to see these changes addressed, says Jason Furman, head of the Council of Economic Advisors to the Obama administration.

One of the biggest lessons we can learn from the AIDS epidemic is the cost of a slow response to a pandemic by the president and his administration. Though there are marked differences between HIV/AIDS and coronavirus -- mortality, method of transmission, and HIV as a perceived "moral issue" -- one thing that is eerily similar is the degree to which the government has and is demonstrating an inept response to a potential pandemic. With Reagan in the 1980s, he was given the opportunity many times to talk about HIV and dispel public misconceptions and give people a sense of direction, and he failed miserably. With the current administration, we are getting information, but it often is conflicting, vague, and unclear. One minute Trump is tweeting that COVID-19 is not a big deal and we already have it under control, and the next he's telling the public to stay home and avoid public places if you can. One big point of criticism against Trump's administration is that test kits are still not available to the public. Many experts believe this is unacceptable and that testing is key to helping give the public a sense of control and restoring faith in the market.

Asian people of all nationalities are being scapegoated in the U.S. and the issue of racism facilitated by the origins of COVID-19 have not been addressed publicly by government leaders in Trump's corner. The ironic part is that U.S. nationals are probably more likely at this point to have ​COVID-19 than Chinese nationals, mostly due to China's aggressive response to the disease and the U.S.'s lack of cohesive response.

As Jenny G. Zhang writes for Eater, "the outbreak has had a decidedly dehumanizing effect, reigniting old strains of racism and xenophobia tha frame Chinese people as uncivilized, barbaric 'others' who bring with them dangerous, contagious diseases and an appetite for dogs, cats, and other animals outside the norms of other Occidental diets." Media has played a huge role in this, as Vox reports, often using Asian faces in their clips of coronavirus coverage. Additionally, there have been several COVID-19- related assaults against persons of Asian descent and as Vox also reports, Chinatowns across the country have emptied out and businesses flounder as people use the disease as an excuse for racism and xenophobia.

This is much like the story of Ryan White, a 14-year-old boy from Indiana who was a hemophiliac that contracted HIV through a blood transfusion and was subsequently forced to leave his school due to public hysteria and ignorance about HIV. We can also see this with HIV in terms of the public's continuing association between male homosexuality and HIV. This is also just like what happened to people of Haitian descent in this country after the CDC added Haitians as an official HIV risk group, using racism, xenophobia and cultural ignorance to scapegoat a population for a pandemic and sidelining a whole community at a time when there was no testing, treatment, or legal protections in place.

We now know that we need to be careful with labeling "risk groups," because in reality HIV is a highly sophisticated virus that does not discriminate and can affect people in every country and of every race, gender, and sexual identity.

What we can learn from the days of the early AIDS epidemic is fear, panic and hysteria -- particularly when it's targeted at a certain population or group of people -- is not just pointless but actually helps a pandemic to spread. Fear and ignorance are a dangerous combination. Part of this is on the public and part is on our government to give us concise and clear information, direction and options, which it has not. But people also can't just inundate themselves with the news coverage, because it too is biased. We need to be listening to the scientists right now, much like Reagan should have in the 1980s when he gave a press conference saying he couldn't say "unequivocally" that AIDS wasn't transmitted by casual contact. We have to be responsible consumers of media and the government has to do a better job at responding quickly and impactfully to this outbreak.

What we know is that a slow and lazy response to a potential pandemic and to the economy, which is in turn affected, only guarantees an outbreak turns into an epidemic, then a pandemic. The government needs to make swift and corrective action in the interests of public health and economic stability -- no more wishy-washy messaging, no more tweets, no more golf retreats at Mar-a-Lago; just action.

Laura LeMoon is the founder/CEO of LeMoon Public Health Consulting, LLC. Follow her on Twitter @laura_lemoon.

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