Several decades after she first saw him on television, Torie Osborn is getting used to seeing what she calls “the familiar face” of Anthony Fauci on her screen again.
Fauci, one of the nation's leading infectious disease specialists, was at the forefront of the fight against AIDS beginning with his appointment as director of the National Institute of Allergy and Infectious Diseases in 1984. Today, in that same role, he's on the front lines of another public health crisis: the coronavirus pandemic.
For Osborn, who served as the executive director of the Los Angeles LGBT Center from 1988 to 1992, Fauci's presence is one small reminder among a broader set of parallels between the AIDS epidemic, which by its peak in 1995 had claimed more than 300,000 lives across the country, and COVID-19, which has so far caused more than 100,000 deaths in the United States alone.
"The first couple of weeks, I was notably re-traumatized,” Osborn says of the early days of sheltering in place at home. “I would have flashbacks to the height of AIDS. It was so connected in my psyche, it was an unmistakable connection.”
Osborn is not the only person to feel that way. Many AIDS activists say they see similarities between the two diseases — as well as how lessons from the past can help in the fight against the current pandemic.
The “fault lines” of disease
"I've been thinking about the parallels every day,” says Cleve Jones, who cofounded the San Francisco AIDS Foundation in 1983 and later created the AIDS Memorial Quilt.
In his memoir When We Rise, Jones recalls the devastation of AIDS on San Francisco's vibrant LGBT community — and the initial uncertainty that accompanied a disease about which little was known. “In my heart,” he writes of learning friends were becoming ill in the early 1980s, “I understood that something mysterious and dangerous and new was here."
Those adjectives could just as easily be applied to the novel coronavirus outbreak, which the World Health Organization only declared a pandemic in March. And Jones says that both diseases have manifested along what he calls society's preexisting “fault lines."
The racial and ethnic disparities in COVID-19 infection and death rates, he says, mirror the ongoing fight against AIDS in Southern states, where infection and death rates are the highest in the country and where black men and women are disproportionately affected by the disease.
Still, Jones and others note that there are some key differences between the coronavirus and HIV, the virus that leads to AIDS.
HIV spreads only through direct contact with infected bodily fluids like blood, whereas the coronavirus is thought to pass from person to person mainly through respiratory droplets, which can be spread when an infected person talks, coughs or sneezes.
As a result, the measures intended to slow the spread of COVID-19, like avoiding large gatherings and staying 6 feet apart from others in public, make the sort of community gatherings that helped sustain the LGBT community during the height of the AIDS crisis, such as bedside vigils, practically impossible.
"The LGBT community rose up first to take care of our own, but then to memorialize people,” Osborn says. “The memorial services and the funerals became organizing events. Visits to the hospital with a group of people surrounding bedsides, visiting people when they were sick or dying at home — there were always other people there."
Osborn recently attended a funeral for someone who died of COVID-19 using the video conferencing tool Zoom. “It's not the same, to not be able to gather,” she says. “Human beings need communal, real-life, real-time connections."
Looking to the future
While the science and prevention of AIDS and COVID-19 are different, Kyriell Noon, formerly the executive director of the San Francisco-based Stop AIDS Project, says that his expectations about the possibility of a vaccine or cure for COVID-19 have nonetheless been shaped by the medical community's response to AIDS.
While HIV is now treatable with antiviral drug regimens, no vaccine — a long-held hope in the fight against AIDS — yet exists, despite promising advances in recent years.
"Thirty years later, not having a vaccine or a cure [for AIDS], I have a very different time sense about [COVID-19],” he says.
But in another sense, Noon, who is now the chief impact officer at San Francisco's GLIDE Memorial Church, is hopeful. Just as the AIDS crisis generated positive change despite immense tragedy — like galvanizing a sense of unity among the broader LGBT community and advancing public health initiatives — he hopes that the coronavirus pandemic might lead to outcomes that benefit society as a whole.
Noon's current work with the homeless community in San Francisco, for example, has benefited from a city government that is now open to ideas — like allowing unhoused people to stay in vacant hotel rooms — that wouldn't have gained traction just a few months ago.
"This is an extraordinary time, and it's an extraordinary opportunity,” he says. “I don't feel like I'm the only one who feels that way. I think there are a lot of us who are thinking: Let's seize the moment and fix things that have been broken for a while."