Thread by @broadwaybabyto

HIV was a novel virus that changed people’s perception of sexual risk. Public health campaigns revolutionized the role of condoms in sexual health. Covid is ALSO a novel virus - why are there no public health campaigns helping people assess risk? A 🧵 on novel viruses & risk /1

First - I understand that people get upset with comparisons between HIV and Covid. The point of this thread is to compare public health & government responses of novel viruses as well as the role of condoms & masks. /2

Before HIV condoms were not the norm - especially within the gay community. STIs had existed for decades but were almost all treatable & non lethal so people accepted the risk and had unprotected sex. Condoms were generally only used for pregnancy prevention. /3

HIV came along and changed the game. But it didn’t happen overnight. The initial government responses to the HIV pandemic were shockingly similar to what we’ve seen with Covid. An intense “othering” of individuals that allowed majority to see themselves as “safe & unaffected”. /4

HIV was seen as a homosexual & drug user problem - and Covid is being seen as a vulnerable & elderly problem. In both cases the narrative has been that as long as you’re not a member of those marginalized groups - the virus isn’t a threat to you. /5

Governments downplayed the threat of HIV and patients had to form grassroots advocacy orgs (like ACT UP) to get access to medical care, refine definitions of the disease & educate the public on its severity. /6

The gay community also had to contend with intense discrimination and hatred from people who were afraid of HIV and didn’t understand its mode of transmission. They fought not only for medical care but to force the government & public to see them as equal & worthy of that care /7

It took years of hard work & many people don’t remember or know how many people died alone (or with only their partners) due to being refused medical care & insurance. Discrimination was rampant. /8

Advocacy orgs were essential in changing the definition from a “homosexual only” disease to one that impacted everyone. Until that change - women and heterosexuals who died of AIDS defining illnesses were excluded from the official death toll. /9

Once sexual (and blood based) transmission was confirmed AND governments finally acknowledged HIV was a threat to everyone - there was a powerful shift in messaging towards prevention. It changed from a “gay disease” to an “everyone disease” & people paid attention. /10

That shift saw a rise in sexual health education that explained the role of condoms in preventing HIV. Condoms were often freely distributed in night clubs and sexual health centres. They were normalized as the BEST way to prevent transmission. /11

By the mid to late 90s it was widely accepted that if you were having sex outside of a monogamous relationship you should 100% be using a condom. This remained true until better treatment options and prophylactic medications were developed. People adapted to the risk. /12

So what are the similarities with Covid? We have a novel virus that is once again being downplayed by governments. We are being fed a narrative that it is “only” a risk to a certain subset of people (the elderly & vulnerable). /13

We are being given incomplete information to make adequate risk assessments & we aren’t learning from the past. It’s only been 4 years. It took much longer than that for the devastating effects of HIV to be understood. We still don’t know the true long term impact of Covid /14

I’m not saying Covid is the same as HIV - but rather that we need to be humble in the face of novel viruses. We need to admit that 4 years isn’t long enough to understand what will happen to people long term. Especially given repeated infections. /15

But those of us fighting for Covid mitigations are finding it hard to get people to care - and advocacy organizations face additional barriers because boots on the ground work brings with it the risk of reinfection. /16

We are not dealing with the level of hatred and discrimination the gay community faced - but we also lack the unifying spirit they had. They worked together because they HAD to - whereas Covid advocacy is still a fractured group. /17

And what about masks? Why do I compare them to condoms when they are so different? Because I see them as a very similar TOOL. Respirators are currently our best defence against Covid. They work well when you use them properly. Condoms were the best defence against HIV. /18

People didn’t “want” to wear condoms - they did it because it made sense. It’s the same with masks. Most of us don’t “want” to wear them but recognize that until we’ve got clean air standards, a sterilizing vaccine and/or a cure for Long Covid they are our best option /19

It’s a huge behavioural shift - but so was widespread adaptation of safe sex. It IS possible. This is what makes humans unique - we have ability to adapt & survive. Do we always like it? No. Should we do it in face of a novel virus with devastating long term consequences? Yes /20

We need aggressive & accurate public health campaigns around airborne transmission and proper use of respirators. Just like the condom on a banana example from sex ed - we need to show people how to don and doff masks correctly & check for fit. /21

We need to explain to people WHY respirators work and why cloth/surgical masks don’t. And we need to make them freely available in high risk settings just like we did with condoms. /22

But in order to get people to actually WEAR them we need to help them understand the risk. We need to push back on the narrative that Covid is mild & start amplifying voices explaining it’s NOVEL with long term consequences still being studied. /23

Lastly we need to stop “othering” people. This is an airborne virus that affects everyone. It’s not only the elderly & vulnerable who are experiencing devastating Long Covid. The sooner we accept that everyone is at risk the sooner we can move the needle on prevention. /end