The Grove in Golden Gate Park is maintained largely by those who remember San Francisco’s 20,000 AIDS victims.<ins> (Open Eye Pictures/New York Times)</ins>

The Grove in Golden Gate Park is maintained largely by those who remember San Francisco’s 20,000 AIDS victims. (Open Eye Pictures/New York Times)

Looking at COVID through the SF prism of AIDS

AIDS took 40 years to claim 700,000 lives. COVID surpassed that number in 21 months

By Marc Sandalow

Special to The Examiner

By the end of October, COVID-19 will have killed more Americans than AIDS. It is a grim milestone that places the nation’s suffering in a tragic perspective.

Anyone who lived in San Francisco in the 1980s or 1990s can recall AIDS’ unbearable toll. Virtually all of us lost friends and colleagues. By one estimate, more than half of The City’s gay population was infected. Gaunt, scarred and helpless young men became a defining and haunting image of the times.

San Francisco, of course, suffered a disproportionate amount of the nation’s AIDS suffering. More than 20,000 San Franciscans have died of AIDS since the first case of “gay pneumonia’’ was identified in 1981, a rate 10 times the national average.

For those who recall the empty bars, closed bathhouses and endless funerals, it is shocking to recognize that COVID-19 has claimed nearly as many lives in 21 months — roughly 700,000 — as AIDS did over 40 years.

Looking at the viruses side-by-side brings other perspectives into sharper focus.

In both instances, the refusal of American political leaders to acknowledge the obvious caused needless death. President Reagan didn’t mention AIDS publicly until 1987. President Trump insisted COVID-19 was “completely under control,’’ and that “like a miracle — it will disappear.’’

Reagan was apparently convinced that devoting resources to battle AIDS — which initially targeted gay men and IV drug users — was either a low priority or politically unattractive. Trump told journalist Bob Woodward that he downplayed the threat because he didn’t want to create a “panic,’’ though he was likely more motivated by how COVID-19 might affect his prospects for re-election.

In both cases, silence spurred ignorance, contributing to thousands of deaths. The consequences of Trump’s dishonesty continue, as millions of Americans refuse to get vaccinated, let alone wear masks. This refusal is among the reasons that the United States remains the world’s No. 1 country for COVID deaths.

There also remains with COVID-19, as was the case with AIDS, a basic misunderstanding of the nature of contagion. Many share a false confidence that someone else’s poor health is his or her problem alone, not a collective problem that requires collective action and care. When Nancy Pelosi first came to Congress in 1987, she spent hundreds of hours trying to convince colleagues that a national effort was necessary to halt a disease that remained most devastating to gay-friendly cities like San Francisco.

“It’s our problem now,’’ she told other lawmakers, as she pushed legislation directing federal resources toward research, prevention and care. “Don’t you think it’s going to be your problem? It’s a communicable disease.’’

Similarly, rural America resisted mask mandates assuming that COVID-19’s spread was limited to congested cities. Much of the nation still believes that our efforts should be confined to helping Americans, letting the rest of the world fend for itself.

President Biden has called for sending 600 million vaccine doses to other countries, which sounds ambitious until you recognize that it will require roughly 11 billion doses to achieve global vaccination. And Biden’s pledge has been criticized by some who believe that it is not the U.S.’s responsibility to inoculate the world, as if Americans can somehow isolate themselves from a raging global pandemic and the vaccine-resistant variants the virus will inevitably produce.

COVID-19 and HIV together have each killed more than one out of 500 Americans. As dreadful as that sounds, it does not compare to pandemics such as the bubonic plague, which wiped out nearly half of Europe’s population in the Middle Ages. Still, it means that if the 70,000 fans who packed the 49ers season finale in 2019 were a random cross-section of America, you could expect that 140 of them would now be dead from COVID.

Fortunately, San Franciscans have been more vigilant about masks and vaccines than those in other parts of the country, resulting in a death toll nearly two-thirds lower than the national average.

Nevertheless, we are in this together. And San Francisco, more than most places, knows what that means.

Marc Sandalow is associate director of the University of California’s Washington Program, and has written about politics from the nation’s capital since 1993.

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