While Maria Gilberta Reyna may have received her COVID-19 vaccine information, for many individuals in the Brown and Black communities, this is not an easy feat. Others, like Maria Sousa, are pressed about their address to confirm their legal status, even though proof of legal residency is not necessary. The risks and fear of deportation or racial profiling have perpetuated the already large quantities of vaccine hesitancy and inequities. 

In 2019, a new supervillain arrived in the world names Sars-Cov-2. Having claimed more than six-million people, the virus, which causes COVID-19, takes refuge within our bodies, and continues to wreak havoc using its shape-shifting abilities, finding novel ways to grow its reach. However, awaiting the challenge, were multiple scientists who provided the world with COVID vaccines that were dubbed to be one of the top 100 inventions of the year 2021. These miracle workers gave the world bottled hope. 

But, has everyone received a drop? 

Despite calls for action by organizations, such as the Centers for Disease Control, World Health Organization, and the UN Development Programme, vaccine equity remains an immediate issue, not only amongst lower-income countries, but also amongst the marginalized here in the United States. As of May 2021, counties in the United States with a large population of Blacks were less likely to serve as COVID-19 vaccine facilitation centers compared to counties whose Black population was lower than the national average, even though Black and Latinx individuals have a higher likelihood of being infected, becoming severely ill, and dying from COVID-19. Globally, only 9.9% of individuals in low-income countries finished the initial COVID-19 vaccination protocol, which is a stark contrast to the 73.7% of individuals in high-income countries. This disproportionate access to vaccines is adding enormous strain to already fragile economic and health infrastructures in low-income countries. 

The burden of the Sars-CoV-2 virus on the marginalized is a theme in the HIV/AIDS epidemic as well. In 2018, 5,000 HIV infections emerged each day, and 61% of them were from sub-Saharan Africa. Moreover, there are significant inequities with HIV/AIDS antiretroviral treatment with countries outside of western and central Europe having less treatment. When considering countries like those in sub-Saharan Africa that are compounded with both COVID-19 and HIV/AIDS, vaccine equity becomes an even more pertinent topic.

How do we fix these health disparities to achieve vaccine and treatment equity?

Sandy Thurman spoke about community engagement, and how local leaders and spokespeople were utilized to power efforts. She discussed bringing people with power to the sites most affected. Thus, there needs to be an emphasis on investing in marginalized areas, organizations, and networks, leading to a greater emphasis on decreasing health barriers. Disregarded communities, and lower-income countries should have a spot at the decision-making table because only they truly understand what policies will be effective in their communities. Likewise, resources for treatment, knowledge to build strong health infrastructures, and research centers should be localized in affected areas. In this manner, there is less influence from organizations swayed by the agenda of higher-income countries.

Furthermore, health must be treated as a right. Yes, in our society, economics does play a role. However, when higher-income countries centralize the wealth, health no longer remains for everyone, rather it becomes a commodified good only available to the rich. 

-Sriya Karra, 9/20/22 1:01AM

This week, Sandy Thurman visited our class to discuss the government’s response to pandemics. Throughout her presentation, she highlighted communication and community-building as essential tools for progress.

Sandy Thurman centered her presentation around answering some major questions. First, who are we using to communicate the message? For the HIV/AIDS epidemic, Thurman let us know of world leaders and celebrities such as Desmond Tutu, Nelson Mandela, and Elton John. But similarly, we were given the example of Ryan White, a small-town boy with hemophilia who shared his story with the world and captured the public’s attention.

Similar to HIV/AIDS, when COVID first started, it was Tom Hanks sharing his positive COVID status that shook many Americans into realizing the immediacy and seriousness of the situation.

I found that President Biden attempted to use similar tactics with a campaign that enlisted celebrities to come to the White House, such as Olivia Rodrigo for vaccines and BTS in order to talk about anti-Asian hate crimes. At the time, they trended on Twitter for their appearances, but I wonder if their appearances truly changed people’s minds, or if it only energized the same group of people who already had been vaccinated. However, at the same time, I don’t know if someone who has a following with the vaccine-hesitancy or anti-vaccine crowd would be willing to come and speak out because it could lead to a lot of negative reactions from their fans. And in this polarizing climate, it could lead to violent threats against them. However, if they were trusted sources, it could have at least started the conversation to getting vaccinated. But this comes back to Thurman’s question—how do we get to the last people? Especially when high-profile influencers, politicians, and groups like QAnon have made it their mission to sow distrust in the vaccine?

On a personal level, you can say that some people can’t be saved and let it go. But if you’re in public health, if they are the last ones left, do you still try? If so, what are some strategies that can be used? How do you gain trust in people who have learned to distrust you?

~ Emie Ung

NPR has a fascinating article titled, “40 Years Later: The Denialism That Shaped The AIDS Epidemic.” It describes how fear funneled misinterpreted theories in a time of panic and confusion, and how this was ultimately exacerbated by politicians’ dismissal of the issue. Reagan’s refusal to say the word “AIDS” until 4 years into the epidemic, Senator Helms trying to block education that would encourage or condone homosexuality: these are just a few examples of how the silence of powerful political actors can cost thousands of lives. It is chilling the way history repeats itself, as 40 years later we find ourselves in similar waters.

Denialism is two-fold in it’s impact; misinformation or misinterpretation stokes the fire of disbelieving scientists altogether and it makes blatantly clear which communities we as a society have left behind. When Reagan won’t say the word AIDS or Trump blocks scientists and officials from the CDC from speaking to the media about COVID-19, misinformation spreads like wildfire. Not only does a lack of accurate information lead to distrust, but it encourages many to mirror the rhetoric of their elected leaders and, ultimately, undercut the true impact of the disease. Injustice in health has been present in both pandemics, as both of these diseases have been the most rampant and fatal in marginalized communities. In the 1980’s and 90’s, black men who had sex with men saw some of the highest rates of infection and fatality. Today, indigenous people, Latinx people, and African Americans are two times more likely to die from COVID than white Americans, people with disabilities have a 3 times higher risk for death from COVID, and people living in extreme poverty grew by 115 million in 2021 due to the effects of COVID-19.

Government response has played a key role in both the AIDS and COVID-19 pandemics; their silence was loud, catastrophic, and fatal. I was especially inspired by Sandra Thurman’s concept that attaching stories to our data can make all the difference. Discussions surrounding COVID so often deal in percentages – like fatality or hospitalization rates – and I think such a clinical approach has made many feel detached from the humanity and gravity of COVID’s destruction. One million people have died in the United States. One million. Six million people have died globally. Disproportionately, these deaths have been people from marginalized, impoverished, or under-resourced communities. We have looked back on the AIDS crisis in shock of how much loss could have been prevented had political actors advocated for science and destigmatization, and I believe we will find ourselves in a similar position in 40 years, reflecting on COVID. As stated by Noel King in the NPR article, “Expertise tells us a virus doesn’t care who you have sex with or how, what drugs you use or whether you think it’s real. A virus doesn’t want you to get a vaccine or wear a mask. It wants to live. To live, it needs to spread. And with every denial, we send it on out into the world to live.”

During the 15th century, the Western world saw a widespread outbreak of syphilis. The Germans called it the “French disease,” the French called it the “Italian disease,” Italians called it the “Russian disease,” Russians called it the “Polish disease,” and the Polish called it the “German disease.” Though syphilis has no way of knowing someone’s nationality, it seems that, on the societal level, we have a tendency to alienate the sick and to deem infected individuals as “other.”

Though we have certainly changed our response to public health crises since the 15th century, our instinct to “otherize” diseases has remained. This instinct extends to some of our highest societal systems, including our governing bodies. As such, we see that disease is a social justice issue just as much as it is a health one.

Similarities with government response to HIV/AIDS and COVID-19

In both the HIV/AIDS and COVID-19 pandemic, government leaders tried to convince the nation that the disease was not an “us” problem, but a “them problem.” During her lecture, Sandra Thurman described government officials like Jesse Helms who, due to “religious” beliefs, refused to even mention homosexuality to the public. This posed a dangerous issue in which gay/bisexual men who were at the greatest risk for being exposed to HIV at the time did not obtain health knowledge on the disease. This stigma around sexuality and HIV/AIDS showed that homophobia and bias affected how our government responded to the virus.

Bias infected our response to COVID-19 as well. Frequently, former President Trump would refer to COVID-19 as a “Chinese virus” in the attempts to distance the disease from Americans. Through this racist rhetoric, he shifted the blame onto China. However, blaming another nation for a particular disease does not prevent United States citizens from dying from it.

The biased rhetoric of our government leaders in both the HIV/AIDS and COVID-19 pandemic slowed the spread of much-needed surveillance, prevention, treatment, and information to the nation while the spread of diseases accelerated. The sick– not the sickness– became the enemy.

Differences with government response to HIV/AIDS and COVID-19

While bias in the rhetoric of government officials were present in both pandemics, the timeline of response differs. Former President Reagan did not even reference HIV/AIDS in a speech until 4 years into the crisis. On the other hand, government officials and organizations like the CDC referred to COVID-19 as early as 2019. This is partly due to advents in communication. For example, platforms like Twitter made it easier for government officials to address their constituents. The response to the COVID-19 pandemic occurred closer to recognition of the disease than the response to HIV/AIDS pandemic.

Looking forward to reading everyone’s blogs and comments. Please let me know if you have any questions.