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AIDS
BASIC THEMES DURING
EPIDEMICS
Jonathon Erlen
Define terms epidemic, pandemic, and endemic.
Give beginning story of AIDS epidemic:
1981 cases at L.A. General Hospital-first called
GRID-Robert Gallo made initial breakthrough in
diagnosising this disease along with a French
medical scientist-there were some earlier cases
(1968 in St. Louis and late 1970’s prostitutes)
United Nations figures recently released
estimate 50 million AIDS cases world wide in
1999 and 16.4 million deaths since the start of
this epidemic-there are no accurate world wide
figures on HIV cases. 70% of the AIDS cases are
in subSaharan African.
1. the same errors in handling epidemics are
repeated over and over.
2. there is an ecological perspective to all
epidemics=a combination of biological
causes and social responses.
3. there are political issues raised by
epidemics ie: the creation of government
administrative units and government
responsibilities during an epidemic ie:
additional funding,quarantine measures and
mass screening.
4. scapegoating specific groups in
society-using an epidemic as an
excuse to attack socially unacceptable
groups ie: Jews during the Plague,
poor and immigrants during cholera
(1832, 1849), prostitutes with the VD
epidemic, homosexuals and IV drug
users during AIDS.
5. individuals are blamed for bringing the
epidemic on themselves (victim blaming) by
bad behavior ie: laziness and drunkenness
and poverty during cholera (1832, 1849),
until after WWII cancer carried this type of
social stigma, improper sexual behavior
and drug abuse for AIDS; in these cases
the epidemic was not seen as an equal
opportunity disease-you had to misbehave
to get it so there was a strong social stigma
attached to these epidemics.
6. existing health facilities were either
unable or unwilling to care for those
struck by the epidemic ie: creation of
leprosariums to care for the lepers
during the Middle Ages and
sanatoriums for TB victims in late 19th
and early 20th centuries, refusal to
treat cholera victims in 1832 and 1849
in regular hospitals, concerns over
overcrowding and the need to isolate
patients on separate floors in AIDS
epidemic.
7. physicians and other health
professionals reactions to epidemics ie:
many ran away and there was frustration
with their inability to help the sick during
an epidemic-both lowered the doctors'
public image and raised ethical concerns
ie: plague and yellow fever (late 18th and
19th centuries) and need for AMA policy
to force physicians to treat AIDS
patients, Pitt Medical School policy on
AIDS patients.
8. massive economic damage done to
communities by epidemics and economic
opposition to dealing with epidemics ie:
quarantine during the plague and yellow fever
outbreaks, 1918 influenza epidemic in
Pittsburgh with the closing of bars and movies,
who pays the costs for care of AIDS patients
and research on this disease?
9. epidemics are blamed on outsiders bringing
disease into a community ie: quarantine
measures during the plague, yellow fever was
called the "strangers' disease", influenza was
called the "Spanish flu", Haitians and Africans
blamed for AIDS.
10. public reactions to an epidemic center
on ignorance of the cause of the disease and
the nature of the epidemic leading to
irrational fear bordering on panic-the public
looses confidence in traditional societal
institutions ie: government, church,
medicine ie: plague, cancer, AIDS.
11. the politically weaker an affected group
is the harsher will be the public health
measures used against them during an
epidemic ie: poor and immigrants treated
differently than middle and upper class
victims or the "innocent victims.”
12. society has always found it difficult
to confront the lifestyle issues which are
seen as leading up the epidemic ie:
poverty during the cholera and TB
epidemics, social isolation of minority
groups (plague in Chinatown 1900-01),
homosexuality and IV drug abuse during
AIDS epidemic-human nature has been
to react to an epidemic with fear + blame
+ denial.
13. during an epidemic the individual's
rights are abridged or ignored for what is
considered the public's good ie: property
is seized and destroyed, people are
quarantined (imprisoned) in their own
homes or in pest houses, mass screening
are initiated.
14. public education about the causes and
nature of an epidemic does not stem the tide
of fear and repression toward certain groups
in society and often raises public fears
based on misinformation ie: 1916 polio
epidemic in N.Y.C., AIDS.
15. public health policies during an
epidemic are strongly supported by the
majority of the public and used to buttress
already existing social divisions and
prejudices.
16. in mass epidemics quarantine has not
been effective but public fear and ignorance
has raised this issue time and again: cholera
(1832 and 1849), TB, AIDS.
17. AIDS now is being viewed using the
chronic disease model rather than as an
epidemic-impact of this change?
18. AIDS is not the “new plague”-it is not an
equal opportunity disease like the plague
and other major past epidemics.
19. There is little hope in the short run for a
“magic bullett” cure for AIDS because of the
rapid mutation rate of this retro-virus.
20. AIDS has changed the nature of the
medical school population-no longer can
students enter medicine without concern
that their work will place them in danger1950-1981 period doctors not concerned
about health risks but AIDS changed this
reality so some potential applicants
decided not to go to medical school and
chose other career paths.