To the editor:
Forty years ago this June. It does not seem possible.
It has been 40 years since the Centers for Disease Control identified the first cases of a bizarre and deadly syndrome among otherwise seemingly healthy, young, gay men in a sleepy little California surfing town called Laguna.
Although most people associate what became known as the AIDS pandemic with large U.S. cities like New York, San Francisco and Los Angeles, it was in Laguna Beach where what came to be called the “worst death in medicine” first reared its ugly head -- here in the U.S. anyway.
We now know the syndrome was showing up in other parts of the world even before the first U.S. cases in Laguna, but very few saw any connections between what was happening in southern California and in far off places like sub-Saharan Africa.
A few years before the emergence of the syndrome in Laguna, a Danish doctor named Grethe Rask, who was working with Doctors Without Borders in Africa, fell so ill that she returned home for treatment.
She died just days later from a rare form of pneumonia called pneumocystis carinii pneumonia -- PCP for short.
Doctors were baffled because PCP was seen almost exclusively in cancer patients whose immune systems had been ravaged by chemo and radiation treatments.
In between Dr. Rask’s death and the events in Laguna, doctors in Europe and Africa began seeing patients presenting with bizarre infections and symptoms including PCP, but had no clue as to the cause.
The events in Laguna, where several of the young gay men also died from PCP, brought epidemiologists and researchers from around the world together to try and figure out what was going on.
For a couple of years, the cause of the strange syndrome remained a mystery.
But epidemiologists and infectious disease specialists, like Dr. Anthony Fauci at the Institutes of Allergic and Infectious Diseases, Dr. Don Francis at the CDC and Dr. Luc Montagnier at the Pasteur Institute in Paris, increasingly suspected an unidentified virus was likely the causative agent of the “worst deaths in medicine.”
In the U.S., because the syndrome initially appeared in gay men, it was erroneously dubbed GRIDS -- Gay Related Immune Deficiency Syndrome.”
However, by early 1983, as the syndrome appeared in injection drug users, their sex partners, their children and a small number of hemophiliacs being treated with a blood based clotting agent known as Factor-8, the acronym GRIDS was changed to AIDS - Acquired Immune Deficiency Syndrome.
But the actual cause of the syndrome remained a mystery.
Then, later that year, Dr. Francis at the CDC got a call from an orthopedic surgeon at San Francisco General Hospital about a recent hip replacement surgery patient who had full blown AIDS and was just days away from death.
The only problem was the patient was a 68-year-old long-married grandmother of six with no history of intravenous drug use, hemophilia or sex with gay men.
Francis flew immediately to San Francisco to interview the woman.
Eight weeks earlier, during her relatively routine surgery, she had received several blood transfusions.
As soon as Francis heard that, any doubts he had the mysterious syndrome was caused by a virus evaporated.
He immediately reported his findings to Dr. Fauci and the two began to urge the blood supply be universally screened for hepatitis B.
The new agent remained unidentified for several more months, but it was clearly spreading in populations long known to be at risk for hep-B infection -- gay men via sex, intravenous drug users via needle sharing, hemophiliacs via Factor-8, and recipients of blood transfusions.
Believe it or not, the U.S. blood banking industry did not universally screen the blood supply for a common blood borne virus like hep-B until 1984 or 1985.
Don Francis became so angry and frustrated by the for-profit and nonprofit blood banking industry’s refusal to universally screen the blood for hep-B, he publicly accused them, including the Red Cross, of putting money ahead of human life.
His outrage very nearly cost him his job.
President Ronald Reagan came out on the side of the blood banking industry, saying any mandated hep-B screening would amount to “...unnecessary governmental interference in the private sector”.
As a result, the infection and death rates from what was soon known as HIV in the U.S. soared until, in September of 1985, when Reagan uttered the acronym AIDS for the first time in public, more Americans were dead or dying from AIDS than had died in Vietnam.
But enough of history.
With the second year of the global COVID-19 catastrophe upon us, and 40 years after the dawn of the ongoing AIDS pandemic, the lesson we all should have learned is that when facing a public health calamity of unprecedented proportions, the last thing the nation needs is an incompetent, ignorant, faux Christian, science denying, right wing, Republican, whether his name is Ronnie or Donnie, sitting in the White House.