Notes on "And the Band Played On", AIDS and the COVID Pandemic
it’s four years from Covid being declared a pandemic by WHO, so a good time for a bit of pandemic-related writing.
Some time ago back, I managed to finish Randy Shilts' And The Band Played On. In case you don’t know this book, it's about the early phases of the HIV/AIDS pandemic, starting from late 70s and ending in 1985 (the book was published in 1987, with Shilts himself learning that he had HIV only after finishing the book, and dying some years after).
The book was actually written very engagingly. It is no wonder it is probably still the best-well-known "popular" work on HIV/AIDS, something I had seen referenced dozens of times before actually reading it. So popular, in fact, that one of the things that I kept thinking about while reading was: how much has this book, in particular, affected how the world (over)reacted to Covid?
Let us go through some of the things Shilts talks about:
The one thing this book is probably the most famous for is its attacks on Reagan administration’s unwillingness to answer the pandemic right from the start, only belatedly getting into the game during the later phases when Surgeon General C. Everett Koop decided to take initiative on his own to send information on the pandemic to all Americans, recommend the use of condoms etc.
This was probably mostly due to Reagan’s general small government agenda and unwillingness to use federal funds for new efforts. Or maybe due to it being the 1980s in general, as Shilts basically portrays almost every public instance, not only the federal government but also states and cities, particularly New York, as slow to respond and uneager to spend money. On the other hand, during the Covid era, almost every government suddenly decided that money's no thing when it comes to saving lives, with many governments going quite deep in debt at least for a while.
The book is probably the second most famous for Shilts's anger against the 1980s gay community, particularly its unwillingness to admit that having a new, mysterious but fatal STD going on might meant limits on culture that encourages guys to have (unsafe) sex with huge amounts of other guys. A memorable topic is the battle by Shilts, some public health officials and a part of the gay movement to close the bathhouses in San Francisco and other cities.
Anyway, even though Covid and STDs are two very different things, much of debates about lockdowns did revolve around places like bars and other places where a lot of people (gay and straight) mingle. This seemed to include a moral aspect - sheer anger that people would be so selfish as to spread a disease just to have fun. Of course the devil-may-care, who-knows-if-it's-even-real, I'll-get-it-anyway attitudes like the ones expressed by number of subjects of ATBPO, like that of Gäetan Dugas, one of Shilts's villains, were denigrated as "plague carriers" and the like.
One now-forgotten public health narrative of the Covid era was that the monkeypox outbreak of 2022 might become an AIDS-like epidemic, but control was obtained reasonably quickly. Of course, the infrastructure and culture for keeping STD-like diseases has improved considerably post-AIDS, and so have the various cultural practices that might help provide soft landing on sudden STD-like epidemics.
Alongside the bathhouse narrative, Shilts concentrated on the blood banks, which become aware at a fairly early point that their blood is contaminated and poses a considerable risk to hemophiliacs and many others needing blood transfusions. Shilts blames the profit-seeking motive, which is also mentioned when talking about the bathhouses (whose owners often made stack and were moves and shakers in the local gay communities), and there's many cases where the blood bankers and bathhouse barons are shown willing to refer to high-minded ideals about privacy and freedom when they really just cared about not losing the revenue streams. Of course with Covid, states were quite willing to run over businesses, even letting some go under.
Shilts also shows the scientific community being unable to decide on a narrative early on, almost seemingly demanding that the scientists to have immediately converge on the correct narrative from the beginning, whether this was actually possible or not), and much energy being spent on, for instance, turf wars between European and American scientists on who actually found HIV and what to even call it.
With Covid, the scientific community often seemed conspicuously willing to go in lockstep and offer recommendations even with paltry knowledge on what happens, like with the "Covid-is-not-airborne/no-actually-it-is" twists and turns, or the early decision that lab leak is not possible and all suggestions on it would be conspiracy theory, something that might actually have been mostly just European and American scientists being unwilling to do anything that would prevent cooperation with Chinese scientists on this issue.
One specific figure fingered as a source for must misery in ATBPO is none other than Antonio Fauci, who made an early statement that AIDS might spread by touch in some situations, leading to massive panic and increasing considerably people's unwillingness to be in any contact or touch with AIDS sufferers.
Whatever Fauci's role with Covid was, it's pretty remarkable that after this AIDS debacle he still was the one who implicitly became the American pandemic czar, and I think one reason why he was so willing to take this role was the feeling that after his reputation being blackened by actions during one pandemic he now had the chance to repair it by tackling another one.
Where I felt Shilts was being the most unfair was the parts where he accused the authorities of just doing something wrong but then had multiple conflicting views of what they were doing wrong. Shilts blames the media for not reporting on HIV earlier and more aggressively, but many of the cases where media reported on it they seem to just have spread wrong views or caused panic; wouldn't earlier and heavier reporting just have led to more of that?
Again, COVID pandemic and its reprecussions are surely a topic that has enough material for whole libraries of analysis. Certainly it can't be just be explained by reference to AIDS history. If there’s some further reading on this, I’m always open for recommendations.
Image: https://commons.wikimedia.org/wiki/Category:AIDS_Memorial_Quilt#/media/File:AIDS_Quilt_at_the_National_Building_Museum_14081_(7617456936).jpg