Monday, November 10, 2014
A Different Virus Causes Similar Reactions: AIDS and Ebola
by Kathleen Goodwin
Currently, Ebola hysteria in the United States is at a low simmer compared to the fever pitch of a few weeks prior. In the lull following the peak of the hysteria as Americans in Dallas and New York City tested positive for the virus, a number of activists, physicians, and journalists have reflected on the similarities between the Ebola epidemic and the emergence of AIDS in the 1980s. There are important differences, as a trending internet meme explains, more Americans have been married to Kim Kardashian than have died of Ebola. Yet, Ebola has captured thousands of headlines and is a constant source of discussion, speculation and fear. In stark comparison, it took until May 1983, when 558 AIDS deaths had been reported to the Center for Disease Control, for the New York Times to make AIDS front page news. In today's internet/ social media age, a fascination with the dramatically contagious, fast-acting, and horrific virus ensured that Ebola immediately became a significant news item in a sensationalist media culture where "if it bleeds it leads". Americans were able to keep their fears of Ebola purely theoretical over the spring and summer even as the death toll rose in West Africa, but on September 29 when Thomas Eric Duncan was diagnosed in Dallas, panic erupted across the U.S. and the accompanying flawed reporting, political overreaction, and public health nightmare made Ebola a reality rather than a curiosity from a distant continent.
Here, some of the similarities to AIDS began to emerge. In mid-October, a Haitian woman vomited at the Massachusetts Avenue MBTA station in the middle of Boston. The MBTA immediately suspended service from the station after a 911 call reported "a Liberian woman" may have Ebola. Based solely on the color of her skin, the woman was covered in a white sheath from head to toe by emergency responders and transported to Boston Medical Center where medical professionals deemed her unlikely to be suffering from Ebola. Of course, many will remember how less than thirty years ago the woman's Haitian lineage, rather than mistaken West African origin, would have been cause for discrimination. In the '80s Haitians, homosexuals, heroin users, and hemophiliacs were the 4 "Hs" Americans feared because of their presumed proclivity for contracting HIV. The episode in Boston betrays the precise issues with maintaining order in the midst of a public health scare— it is always deemed prudent by public officials to be safe rather than sorry when it comes to containing a lethal and contagious disease, even at the risk of violating the rights and dignity of citizens.
The most obvious example is in New York and New Jersey where governors Cuomo and Christie enacted mandatory 21 day quarantines for those returning from West Africa who have had contact with an Ebola patient, regardless of their being symptomatic for a disease that is scientifically proven to be contagious only when the carrier is showing symptoms. As Gregg Gonsalves and Peter Staley recently wrote eloquently in the New England Journal of Medicine:
"…we believe that by rejecting scientific evidence, substituting unsubstantiated claims for facts, and undermining the credibility and authority of both the CDC and the National Institutes of Health, these quarantine protocols risk damaging our country's ability to respond quickly and efficiently to serious public health threats in the future."
Gonsalves, an HIV positive AIDS activist, is co-director of the Yale Global Health Justice Partnership and sees salient similarities between the attitudes of the media and politicians in response to AIDS and Ebola. He views the Ebola response to be discriminatory to healthcare workers, exactly the population that disregarded widespread fears in the '80s and heroically cared for AIDS patients, even before effective protocols to prevent the spread of the virus were implemented, much the same as with Ebola today. Gonsalves also points out that immigrants and the children of immigrants from West Africa are being unfairly and erroneously targeted as a source of fear related to Ebola. In addition to situations like the one that befell the Haitian woman in Boston, there is also the seven year old girl who was barred from her elementary school in Connecticut after returning from a family wedding in Nigeria. The "ad hoc" state by state nature of the response to Ebola is allowing some public officials to exploit a few brave healthcare workers or innocent Africans in order to give the appearance of prioritizing the health of the public at large.
In much the same way that fear of AIDS became justification for homophobia, xenophobia, and other forms of discrimination, Ebola has revealed the American public's tendency to target populations that are already at risk of bigotry. In 1986 William Buckley, a conservative commentator, wrote in a New York Times Op-Ed that "Everyone detected with AIDS should be tatooed in the upper forearm, to protect common-needle users, and on the buttocks, to prevent the victimization of other homosexuals." Even more astounding than the fact that Buckley wrote these words is that the Times chose to publish it less than thirty years ago. It is opinions like these that perpetuated the stigma attached to AIDS that made—and continue to make—combating the disease a torturously uphill battle worldwide. Similarly, when people believe that their basic rights will be violated because of an association with Ebola there are countless adverse effects. This attitude prevents much needed healthcare workers from traveling to West Africa to help treat and prevent the spread of the epidemic, despite the fact that containment of the virus is the most effective way to prevent outbreaks from spreading abroad. It also encourages those who may think themselves to be suffering from Ebola to avoid treatment, as a quarantine and the subsequent stigma attached to themselves and their family may seem a fate worse than a horrible death.
The small bit of good news is that it does seem that some lessons are being learned from the botched public health responses of the past. One of the original AIDS activist organizations, ACT UP, has launched a campaign to ACT UP Against Ebola, calling for public officials to use science based evidence to plan a response to the virus rather than attempting to appease frenzied constituents with overblown restrictions on freedom. Hopefully Americans will soon recognize the absurdity of the mass hysteria surrounding Ebola in the U.S. and focus on the imperative task at hand—helping the thousands in West Africa who are suffering from or at high risk of contracting the virus.
Posted by Kathleen Goodwin at 12:05 AM | Permalink