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Public Health Hypocrites

This is not how experts treated recalcitrants during the AIDS crisis.
President Biden Speaks On Administration's Plan To Combat Delta Variant

President Biden yesterday announced his plan to fight the coronavirus by penalizing the unvaccinated. Workers at companies employing more than 100 people will be forced to get vaccinated or else endure weekly testing. Federal workers and contractors will have no testing opt-out; they must get vaccinated. A passport system requiring vaccination for admittance to large entertainment venues was urged.

Public health experts have lined up to commend the Biden plan. This is the height of hypocrisy coming from the same discipline that spent the AIDS crisis telling everyone that the real epidemic was stigma.

The type of measures being applauded today were resisted tooth and nail when applied to AIDS, a much deadlier disease. In the 1980s, even mild, noncoercive proposals like contact tracing to identify sexual partners who might have been exposed to the virus were condemned as portents of oppression. “Contact tracing is a euphemism,” warned Thomas Stoddard of the Lambda Legal Defense Fund. “What they want to do is keep a list of sexually active people.”

Back then, the watchword was voluntary. Officials avowed that their job was not to mandate anything but merely to educate at-risk populations to help them make informed choices. If some people persisted in making bad decisions after knowing all the facts, well, that was their right. This doctrine of self-restraint was adhered to even when many gay men announced their intention to keep making the same choices. “I refuse to blight my life in order—supposedly—to preserve it,” wrote one correspondent in the New York Native in 1983 in response to the suggestion that gay men should cut down on casual sex. “Just give me the facts and I’ll decide, thank you.”

The most famous AIDS public health controversy was over the “bathhouses,” as gay sex clubs in New York and San Francisco were euphemistically called. When city officials proposed closing them as hotspots of disease spread, gay activist groups howled in outrage.

The important thing to remember about the bathhouse controversy is that it was not just activists who insisted they stay open. Federal health officials said the same. James Curran of the Centers for Disease Control was careful to explain that, while he personally hoped that the bathhouses would close for lack of business when patrons came to understand the risks, state intervention would be going too far.

Even more egregious, because a greater corruption of science, was a 1984 study by CDC researcher William Darrow purporting to show no correlation between the bathhouses and AIDS. “Although numbers of partners and AIDS are significantly related, and men who go to bathhouses tend to have greater numbers of partners, bathhouse attendance [itself] is not significantly associated with AIDS,” his paper concluded. The sophistry was so transparent that his superiors commissioned a second study to confirm the obvious, that hubs of anonymous sex did indeed contribute to the spread of AIDS. Proponents continued to cite Darrow’s study as scientific proof that bathhouses were fine.

The establishment’s emphasis on education and letting adults make their own decisions would have been easier to credit as sincere if their messaging on AIDS had been honest and informative, but it was not. The glib slogans were the worst. “Sex does not cause AIDS, a virus does.” “There are no risk groups, only risky behaviors.” “It’s not who you have sex with, it’s what you do.” “AIDS doesn’t discriminate.” Everyone from Oprah to the Clinton White House parroted these slogans to discourage any possible victim-blaming.

These slogans live on today in fossilized form. Pick up any book by someone with a degree in public health and you will see what passes for expert orthodoxy on AIDS. “The actions that fueled the epidemic were not condom-less sex acts or shared syringes but the laws passed and stigma dispensed by members of society who despised homosexuals,” writes Emily Bass in her new book To End a Plague. “Although sexual practices of gay men did play a role in the disease’s spread…if HIV had initially started in heterosexual men and women, gay men would have seemed to be relatively immune, at least at the outset,” writes Nicholas Christakis (MPH, Harvard) in a book published last year.

In fact, we know that AIDS struck the gay community not because of homophobia or happenstance but because, circa 1980, the majority of gay men had more than a hundred lifetime sex partners and a third had more than a thousand. The only reasons for pretending otherwise were, and are, political.

And that is the point. The dilemmas arising from Covid and AIDS are analogous in public health terms, and the establishment comes down on different sides in each case based entirely on which groups are politically favored or disfavored. Gays lean Democratic, therefore they will be politely requested to wear condoms. Vaccine holdouts lean Republican, therefore we will revoke their right to hold a job until they comply.

Ironically, the one coercive measure that experts did embrace during the AIDS epidemic is one that is now more favored by Covid doves than hawks. Employees with AIDS often lost their jobs when their status became known, just as unvaccinated workers are losing their jobs now, and for similar reasons, the perception that they posed a threat to coworkers and customers. States and municipalities responded by extending anti-discrimination protections to HIV status, making it illegal to fire a person or exclude them from public accommodations for having AIDS. Florida and California banned employers from even giving their workers antibody tests.

“The whole point of such laws is to say this: It may indeed cause you psychological distress to mix with others whom you irrationally dislike or fear. Too bad,” explained Charles Krauthammer in a column that was cited when he won the Pulitzer Prize for commentary in 1987. “These particular prejudices are destructive and irrational. Therefore the state will prohibit you—even in ‘private sector’ transactions such as hiring and firing or serving people in your own luncheonette—from acting upon your groundless prejudices.”

Stemming irrational hysteria is a good use of state power. But the modern analogue to those laws is not anything in President Biden’s six-pronged strategy. It is the vaccine passport bans in states like Texas and Florida.



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