Monthly Archives: May 2006

HIV/AIDS and the Avian Flu

In a previous post I linked to a short note about the early days of the AIDS epidemic.

It’s well-written, but I’d like to address a side issue that rubs me the wrong way. The author touches on it in her opening sentence:

At a time when the mere threat of avian flu or SARS can set off a coast-to-coast panic—and prompt the federal government to draw up contingency plans and stockpile medicines—it’s hard to imagine that the national response to the emergence of AIDS ranged from indifference to hostility.

This is an echo of a certain resentful tone that I’ve noticed before when people affected by AIDS discuss the public health response to other diseases. One of the commenters makes it a little clearer:

So interesting that you point that out, everyone so worried about chickens. No one cared when so many of my friends were dying each in there own individual horrible way.

Obviously, I’m not condoning indifference and outright hostility against AIDS victims. The public health system responded poorly to the early days of the AIDS epidemic. One of the things that struck me while reading Randy Shilts’s riveting And the Band Played On is the way public health officials uttered a depressing progression of statements about the emerging crisis:

  • It’s not a priority because only 5 people have died.
  • It’s not a priority because only 20 people have died.
  • It’s not a priority because only 100 people have died.
  • It’s not a priority because only 1000 people have died.

Of course, the best time to try to stop an infectious disease is before it infects a whole lot of people. It’s as if these policy makers didn’t understand the implications of the word contagious.

Actually, I think there’s a grain of truth to that. I’m pretty sure that much of the foot-dragging in the early years was due to routine bureaucratic inertia. The kinds of people that climb to the tops of government agencies by winning budget battles and currying favor with political power brokers are not necessarily the kinds of people you want in charge when something terrible happens. We had another reminder of this when hurricane Katrina struck New Orleans.

Still, I have to believe that a big part of the problem responding to AIDS was due to dislike for the types of people the disease was infecting. When people affected by AIDS get angry about that, I can’t begrudge them their feelings. The have every right to be angry and to act on that anger.

What does bother me, however, is the attitude of resentment towards the response to bird flu. The injustice here is the weak response to AIDS, not the strong response to bird flu.

[Clarification: I’m pretty sure the author of the original article doesn’t really want bird flu to receive an ineffective response. I didn’t mean to imply otherwise.]

I’ll start with the hyperbole in the comment and just point out that the big panic today is not about the birds, of course, but about the people that will get sick and die if the disease spreads to humans.

The flu we hear about every year hits most people as sniffles, coughing, fever, and soreness. But for a portion of the population—newborn babies and the elderly—influenza is a deadly disease that kills about 35,000 Americans every year. Worldwide, the annual death toll is around a quarter million. It’s the equivalent of the Indian Ocean tsunami of 2004 happening every year.

There are several active flu strains evolving from year to year, so every year we get hit by something a little different. In some years, the death toll rises to half a million. In a few years, it rises much higher.

If you asked any influenza epidemiologist about his worst-case scenario, he’d probably say it’s a repeat of the Spanish Flu pandemic of 1918. Nobody is sure how many people died, but the lowest number I’ve found is 25 million, and nobody would be surprised if it really killed twice that many.

This brings us to the reason everyone is so upset about bird flu. It’s genetically very similar to the Spanish flu. And based on the 100 or so human cases so far, the resemblance doesn’t end with DNA. Bird flu has killed 40% of the people who’ve caught it.

[Update: According to Bird Flu Breaking News there have been 229 cases of bird flu in humans, 130 of them fatal. That’s a 57% mortality rate.]

In a typical flu season, about 10% of the people in the United States come down with the flu. If the bird flu spreads to humans and follows the same infection pattern, it could kill 12 million people in this country alone.

Of course, that figure is a statistical fiction. Bird flu in humans is a rarity, so we are unlikely to have much natural immunity. The infection rate could be much higher than 10%. Then again, bird flu is presumably rare in humans due to some biological barriers. If those barriers hold, the infection rate in humans could remain tiny until the disease burns out in the avian population. Nobody knows how these factors will balance out.

Even if bird flu hits us hard, we really can’t extrapolate what will happen based on our annual experiences with flu because we can do things to fight bird flu that we would never do to fight seasonal flu. We can cancel sporting events and musical performances and movies. We can close the schools for a few months. We can shut down non-essential businesses and restrict travel. We’ve seen influenza before, and we have some pretty good ideas what to do about it.

And that’s the biggest reason you can’t compare bird flu to AIDS: We know all about bird flu, but AIDS was something new and mysterious.

We didn’t know what virus caused it, or even if it was a virus. It wasn’t even clear that it was an infectious agent. Some doctors thought it might be a side effect of some new kind of club drug. That sounds strange now, knowing what we know, but at the time everyone knew of drugs that could compromise the immune system, but no one had ever heard of a virus with that ability.

And the kind of virus it was, a retrovirus, had only been identified as a class a few years earlier. The first AIDS cases presented with mysterious diseases. It took a while to figure out that these were opportunistic diseases, and that the main problem was with the patients’ immune systems. Equipment for doing T-cell counts had only just started to become available.

It’s been 25 years since AIDS was discovered. Descriptions of influenza have been found that date back 2500 years. It’s an old enemy that we have learned how to fight.

I imagine that someday, eventually, AIDS will be an old enemy too. There will be ever-improving treatments for those infected, and a vaccine to protect those who aren’t. AIDS will become just another once-deadly disease being held in check by medical science.

And maybe someday epidemiologists in Africa will spot a dangerous new strain of HIV emerging among the simian population and crossing over to humans. And maybe this strain will be just different enough from the known strains that our vaccines and treatments might not work as well as we’re used to. That’s pretty much what’s going on with bird flu right now. Let’s hope that any such new strain of HIV is handled like bird flu and not like AIDS was handled the first time it emerged.

Gods, Powers, and Saints of Small Things

Yesterday we went to see the new X-Men movie. The movie was pretty good, but the really amazing part was that we got the closest possible parking space to the theater. The only closer space was handicapped parking.

After the movie we went to dinner and this time we got the parking space right in front of the restaurant door.

Normally when I get good parking, I quip that the parking space gods have smiled on me. Hey if the Romans had a god of boundaries and border markers—Terminus—why can’t there be a god of parking?

But then it hit me: Maybe finding good parking spaces is my mutant power! Now all I need is a mutant name. Parking Man is too campy, it sounds like a DC character, not Marvel. How about Spaceman? Still campy, but with a touch of irony.

Later, on the way home, I wondered if Roman Catholics have a saint for finding good parking spaces. They seem to have one for everything else. There must be a saint for migrants, looking for a place to settle. How hard would it be to adapt him or her for finding parking spaces?

Update: I looked it up. Of course there’s a saint for finding good parking places. That would be Mother Cabrini, also the patron saint for immigrants.

25 Years of HIV

Alexandra Billings has a moving account of the early days of the AIDS pandemic here in America:

At a time when the mere threat of avian flu or SARS can set off a coast-to-coast panic–and prompt the federal government to draw up contingency plans and stockpile medicines–it’s hard to imagine that the national response to the emergence of AIDS ranged from indifference to hostility. … People with the disease were routinely evicted from their homes, fired from jobs and denied health insurance. Gays were demonized by the extreme right wing: Reagan adviser Pat Buchanan editorialized in 1983, “The poor homosexuals–they have declared war against nature, and now nature is exacting an awful retribution.” In much of the rest of the culture, AIDS was simply treated as the punch line to a tasteless joke: “I just heard the Statue of Liberty has AIDS,” Bob Hope quipped during the rededication ceremony of the statue in 1986. “Nobody knows if she got it from the mouth of the Hudson or the Staten Island Fairy.” Across the river in Manhattan, a generation of young adults was attending more funerals than weddings.

I almost died. I was in the hospital and my doctor told me to call my parents and arrange the funeral. Chrisanne did just that. We were arranging my funeral as I lay in my hospital bed with my blue checkered gown wetting myself and sweating so bad they were changing my beddings three times a night. I was 35 years old. I had already been infected since the late eighties. The tip of the disease. I lived long enough, stayed away from the hospital just long enough to watch every single one of my friends waste away to ash. I had seen more death before I was 40 than anyone in my family.

Read the whole thing.

Am I What They Warned You About?

In my continuing attempts to reach out to our nation’s youth (’cause, you know, they’re the future) I’ve decided to sign up for AOL Instant Messenger, or just AIM as it’s called these days.

If I’m signed into AIM right now, and I’m not away from my PC, you should see a message near the top of the right-hand column that looks something like this:

AIM id Windypundit is now online

I set that up a few days ago, but no one has contacted me…until last night. I was getting ready to run an errand, so I clicked on the AIM bar and set my status to away. When I glanced at the Windows task bar, however, I noticed that there were task buttons for two AIM windows. I clicked on the other one, and sure enough, even though I had heard nothing, there was a message for me:

SomethingSheepLove: yo

The fateful moment had come. My first out-of-the-blue instant message ever. (I’ve disguised the AIM screen name, but the real one did say something about sheep and love.) I closed the window without saving the message, so I’m reconstructing it from memory, but it went a bit like this:

SomethingSheepLove: yo
Windypundit: hi
SomethingSheepLove: I like your photos
Windypundit: Thanks
SomethingSheepLove: Do you sell them?
Windypundit: No I’m an amateur
SomethingSheepLove: Cool
Windypundit: What brings you to my page?
SomethingSheepLove: Photography
Windypundit: I gotta go
SomethingSheepLove: Bye
Windypundit: Bye

That wasn’t so bad. I had expected something more like this:

CoolYoungPerson: yo
Windypundit: hi
CoolYoungPerson: CZ4 XQ R84Z?
Windypundit: I don’t understand
CoolYoungPerson: LUSR

It’s a little weird being contacted by someone I don’t know and don’t expect. I wanted to see if I could find out more about this person. I don’t know anything about AIM, but there’s got to be some kind of user profile page, right? So I double-click on their screen name, and it shows up in a little search box at the bottom of the chat window. So I clicked the “Go” button to see if that would show me a profile.

No such luck. It turns out this is just a Google web search. But it does find the MySpace page where my mysterious chat buddy mentions their AIM screen name. I click on the search result to visit the page.

It’s a 17-year old girl.

MySpace is full of people looking for a hook-up, so this makes me feel just a little bit creepy somehow… On the other hand, (1) I’m not on MySpace for dating (as I’m sure my wife will be pleased to read), (2) she’s getting ready to go to college so it’s not like she’s a child, (3) she contacted me, and (4) she’s 800 miles away. Nothing creepy here.

Now that that was settled, I figured that since she complimented my photography, I should send her an invitation to be one of my MySpace friends. I did so, and I got up to leave.

This time I heard the AIM chime as the chat message arrived:

SomethingSheepLove: How did you find me?
Windypundit: [I explained what I did]
SomethingSheepLove: Why would you search for me? That’s creepy.

Now I’ve gone from the cool photography guy to the creepy guy in five minutes. This blog doesn’t have much personal information about me, so I guess when she found my photos, she didn’t realize I was in my 40s. Most of her online friends are young ladies like herself, so when this middle-aged guy suddenly tracks her down and wants to be her friend…

You know, I like to think that I have a few dangerous ideas here on Windypundit, and if I can convert some of our nation’s youths to those ideas, all the better. But this was not a good start.

I apologized for creeping her out, and she said goodbye.

My Computer, My Software

Somehow, the Federal Communications Commission thinks it has the authority to tell every American what software they are or are not allowed to run on their computers.

According to the three-page document, to preserve the openness that characterizes today’s Internet, “consumers are entitled to run applications and use services of their choice, subject to the needs of law enforcement.”

The FCC didn’t offer much in the way of clarification. But the clearest reading of the pronouncement is that some unelected bureaucrats at the commission have decreeed that Americans don’t have the right to use software such as Skype or PGPfone if it doesn’t support mandatory backdoors for wiretapping.

(Hat tip: Ken Lammers)

in Legal

Why Your Taxes are Hard to Prepare

Last year, the California government had a really great idea. (No, that’s not the start of a joke.) Many California taxpayers have income only from regular employment and don’t have any unusual deductions. This means that their state income taxes can be calculated entirely from the payroll data already in the state’s tax database.

As part of a pilot program, California sent 50,000 taxpayers something called a “ReadyReturn,” which was essentially a California income tax return with all the information already filled in. All the taxpayers had to do was sign it and mail it back. So, taxpayers save time because they don’t have to fill in the form, and the state saves time because all the data on the form is already in their tax database so there’s no need to enter it again. Great idea, huh? Who could be against that?

As it turns out, lobbyists from the tax preparation industry are against that. They’ve got several members of the state legislature to oppose it.

Yes, you heard right. They’re lobbying the government to make your life more difficult so they can sell you services to make your life easier. I’ll bet this isn’t the first time, either. I’ll bet those bastards have been doing this for years. It would certainly explain a lot of things about my taxes…

Whole ugly story here.

(Hat tip: The Agitator.)