But any older gay San Franciscan recognizes all too well some elements of this country's response to Ebola. There's a terrible "here we go again" feeling watching the US flub the emerging pandemic. Once again, instead of responding to a disease threat by implementing and refining practical, science-based measures, politicians dither and citizens panic. We've seen this before: almost a decade into the AIDS crisis, North Carolina Senator Jesse Helms led the charge for quarantine for persons with the markers of AIDS. The disease becomes an excuse for preexisting prejudices against gay people and anyone considered "other" to manifest. There are too many true tales of AIDS panic like the North Yorkshire health department that buried an AIDS patient in a concrete coffin; the child confined to a glass booth in her school room; and the motorist who ran over a pedestrian and asked an AIDS service agency whether he should decontaminate his car.
Today, people who have spent a lifetime working to change HIV/AIDS from a death sentence to chronic health condition are begging New York Governor Andrew Cuomo and New Jersey Governor Chris Christie to back off from abetting panic with their ill-considered quarantines.
Ebola is not AIDS repeated. These days, it is hard to remember that for nearly a decade, we simply didn't know what caused AIDS (the HIV virus) or precisely how the disease was transmitted. And even once the virus was identified, testing "positive" -- showing the signs of an immune response to the virus -- was simply a death sentence. There were therapies that sometimes prolonged life, but people with HIV were going to die of it. (Actually there turned out to be a few very rare people who lived on with HIV, but we did not know that then.) And then -- it felt very sudden to those of us living in centers of the epidemic -- drug therapies were invented that made survival possible. Response to AIDS shifted to identifying persons who are infected and ensuring they receive and can afford the drugs.
The Ebola crisis is different from the AIDS crisis. Public health authorities come into this epidemic way further along in their competence. Scientists know what causes Ebola; there's a test that identifies its virus. The incubation period (21 days) and the onset of the infectious stage (visible symptoms) have been pinpointed. And although the death rate is horrendous, most especially in extremely poor West Africa where there are no modern medical facilities, everyone who gets Ebola does not die. World Health Organization estimates an average fatality rate of 50 percent.
Dr. Paul Farmer, chief strategist and co-founder of Partners in Health, warns of the special horror of Ebola in just the sort of place the current outbreak has been concentrated:
Farmer offers a mantra for what is needed to contain the epidemic: "staff, stuff, space and systems." (By stuff he means protective equipment for health workers and basic medical supplies.) And he makes a bold claim:
My emphasis. I'm ready to believe Farmer. Just today, the second nurse who caught the disease from the Liberian victim who brought Ebola to Dallas has been released from the hospital, cured. (In the picture, President Obama shows genuine leadership by hugging the first Dallas nurse declared cured. If only posturing pols would stop trying to drown him out!)
If we don't want to live with Ebola popping up all over the world, causing havoc and misery in the poor countries where it can seed itself, we need to offer the wealth of this country to stopping it now in West Africa -- whatever that takes. Blustering for political points isn't going to serve anyone. Diseases don't respond to hot air.