AIDS BASIC THEMES DURING EPIDEMICS Jonathon Erlen

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AIDSBASIC THEMES DURING EPIDEMICSJonathon
Erlen
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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
1970s 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.
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1. the same errors in handling epidemics are
repeated over and over.2. there is an
ecological perspective to all epidemicsa
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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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 danger-1950-1981 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.