Because of the coronavirus, the 7 million people who live in the San Francisco Bay Area have been one step shy of a full lockdown since Tuesday. Amid all the canceled plans, cratering small businesses and disruptions to everyday life, another poignant postponement stands out: The Names Project Aids Memorial Quilt’s return to Golden Gate park has been delayed. A viral pandemic, one whose scale we haven’t fully grasped, has interacted with another.

She's a legend in the fight against HIV. Now Dr Deborah Birx is taking on Covid-19 Read more

Many Americans have drawn parallels between HIV and Covid-19, noting the inept government response, the stigmatization of certain groups and the heroism of frontline health workers. Like a ghoulish reboot of a television show, some of the same people have returned. Deborah Birx, a longtime HIV doctor in the US military who later became the United States Global Aids coordinator, now serves as the response coordinator for the White House Coronavirus task force. Anthony Fauci, an immunologist, has been the director of the National Institute of Allergy and Infectious Diseases since 1984.

“We had another silent epidemic: HIV,” Birx said at a White House press conference on Monday. “And I just want to recognize the HIV epidemic was solved by the community: the HIV advocates, and activists who stood up when no one was listening and got everyone’s attention.”

Her words are unmistakably direct, but for many, the comparison is a cautionary one. HIV has killed nearly 40 million people worldwide since the early 1980s, roughly 700,000 of the victims were Americans – almost 20,000 of them in San Francisco. The coronavirus has not proven nearly as lethal. Contracting it is certainly not the death sentence that HIV was for so many years, and some advocates are reluctant to push the analogy.

Facebook Twitter Pinterest HIV has killed nearly 40 million people worldwide since the early 1980s, almost 20,000 of them in San Francisco. Photograph: Brendan Read/Fairfax Media via Getty Images

“They’re both viruses, obviously, and there are some overlapping parts of this that obviously can be compared,” says John Cunningham, the executive director of the National Aids Memorial in San Francisco, which had been set to debut the quilt in early April, for Golden Gate park’s 150th anniversary. “But in totality, I would never want to draw that direct comparison. That being said, the National Aids Memorial and the Aids Quilt take very seriously our responsibility to share the stories of the epidemic and the stories of a tragic virus that befell a community.”

That the Bay Area is a focal point in both epidemics is not lost on longtime Aids activist Cleve Jones. When the city of San Francisco got involved in the fight against HIV, it was spending more than the federal government was, he says.

“The most glaringly obvious similarity is that both pandemics began with Republican administrations and a Republican president who did not acknowledge the gravity of the situation,” Jones says. “And the failure of a strong early response led to tragic consequences.”

The similarities extend to nomenclature. In the early days, before the term “acquired immunodeficiency disease”, Aids was known as Grid, for “gay-related immune deficiency” – when it wasn’t simply called the “gay cancer” or the “gay plague”, that is. When Donald Trump insists on tweeting about the “Chinese virus”, he claims to be playing tit-for-tat with Communist party propaganda that the virus is of US origin. But it ignores the dangers of scapegoating in a time of panic.

Racist tropes, like homophobic stigma 35 years ago, can also inspire false confidence in groups who presume they won’t be affected.

“In the early days of the Aids epidemic we were told it only affected gay people,” Jones says, “the result of which was the death of tens of millions of heterosexual men, women and their children”.

But before the millions of residents in the six-county Bay Area were told to shelter in place, a meme had spread far and wide among LGBTQ+ Americans. It has two panels, upper and lower. The upper one reads, “Straights: I can’t believe the government would just ignore an epidemic that threatens thousands of lives.” The lower panel reads, “Gays: You don’t say...” superimposed over a picture of the Aids Memorial Quilt spread out over the National Mall in Washington DC.

It’s a bit harsh and oversimplified, maybe. But the question it presupposes is a valid one in a region on near-lockdown – because for some people, HIV and coronavirus aren’t separate at all. The fear among long-term survivors of HIV/Aids is potent, according to Dr Lary Abramson, a retired San Francisco physician who treated patients during that epidemic’s early phases.

“I can tell you that the people I know who are currently on meds for HIV, who have survived our plague, are taking extreme precautions,” he says. “They don’t want to get anywhere near this coronavirus and are doing all they can to follow the guidelines the NIH is promulgating.”

Facebook Twitter Pinterest A lone rose sits at the World Aids Day Ceremony at the National Aids Memorial Grove in Golden Gate park on 1 December 2004. Photograph: David Paul Morris/Getty Images

For younger generations, the instinct is essentially the opposite: to come together in tough times. Even though social acceptance of LGBTQ+ people has arguably never been higher, queer people reflexively seek refuge in queer spaces. Juanita MORE!, a well-known San Francisco drag performer whose parties have raised tens of thousands of dollars for various LGBTQ+ causes, has to balance her advocacy for nightlife against a consistent message of “Stay the fuck home!”

“As a mother to so many people in San Francisco, I have noticed that a lot of people are having a hard time – and did all the way up until the quarantine was instated – staying in,” she says. “When we were in that first year of the Aids crisis, that was also hard for a lot of people, and the reason was that everyone had just come to San Francisco. They had just gotten free and come out, and were told again they couldn’t. Those comparisons, to me, are the same.”

As of Thursday, some 70 San Franciscans have tested positive for coronavirus, while approximately 15,000 are living with HIV. For Cunningham of the National Aids Memorial, the trauma lingers.

“I lived in the Castro during the darkest days of the epidemic,” Cunningham says, referring to San Francisco’s famous gay neighborhood. “And since Covid-19 came upon the scene, there has been a building wave of emotion inside of me and others. I’ve had many conversations and it’s bringing up a lot of unresolved grief and anger.”

But, he says, the noble impulse to help one another – within the strictures of a shelter-in-place order – are a welcome parallel between HIV and the coronavirus.

“What gave hope and galvanized individuals to step forward out of what was a tragedy, with the discrimination and prejudice and the lack of a response from the government, we saw some of the best in humanity. We saw neighbors helping neighbors. … Some of the best examples of what it means to be a community were born there.”

Facebook Twitter Pinterest Donald Trump speaks during a news conference with Mike Pompeo, Mike Pence, Dr Deborah Birx and Dr Anthony Fauci. Photograph: REX/Shutterstock

If people can’t feed one another, we can always check in with a phone call or by Zoom. Regarding public-health leadership under a conservative Republican presidential administration, Cunningham observes that it’s “ironic that two of our heroes, Anthony Fauci and Deborah Birx, were there in the days of the Aids crisis and are here today”.

Jones notes the surreality of their presence as well.

“One of the things that almost every longtime survivor I know has commented on is how eerie it is to see them up there smiling and nodding while this fool blathers on,” he says. “One can only imagine what is going on inside their head. I think both of them are, every day, probably laying out the degrees of harm: If they were to overly criticize Trump, they would be fired.”

Indeed, Fauci has been conspicuously effusive in his praise for the president. But for nurses at Zuckerberg San Francisco general hospital like Sasha Cuttler, the reassuring presence of capable figures at the top doesn’t necessarily translate into an adequate response on the ground. There, too, a resemblance to the Aids crisis years is unsettling.

“What strikes me is the casual disregard of the voice of nurses and others on the frontlines. That [comparison] is not off at all,” Cuttler says, adding that they’ve been removed from field nursing in retaliation for speaking with the media about a lack of urgency and coordination in testing for Covid-19.

Facebook Twitter Pinterest People march down San Francisco’s Market Street for the 10th international Aids candlelight march in 1993. Photograph: Denis Poroy/AFP via Getty Images

As it was with Aids patients during the 1980s at the hospital’s experimental and nurse-led Ward 86, the frontline caregivers are “predominantly women and queer people”, Cuttler adds. “And we’re doing it with love and caring, making it clear to the patients that we do this job because it’s our job – and we’re not afraid of them or judging them. Both epidemics are used to blame people for their own illness and doing something bad to spread it.”

In the meantime, misinformation has continued unabated, much of it from prominent voices. Displaying considerable ignorance of why residents of the Bay Area were urged to remain at home – and of how contemporary HIV medications work – the conservative commentator Mark Steyn remarked on Rush Limbaugh’s show that “It’s a big gay town, San Francisco, and they’re the ones with all the compromised immune systems from all the protease inhibitors and all the other stuff. And they don’t want all the gays dropping dead on the San Francisco mayor’s watch.”

Those words could have been uttered on Tuesday, or on any given Tuesday in 1986.