Gregg Gonsalves, a Ph.D. student at the Yale School of Public Health and a veteran AIDS activist from the 1980s and 1990s, discusses what he sees as similarities in the way people and politicians responded to that epidemic and the current Ebola outbreak. Furthermore, Gonsalves has been outspoken about the use of quarantines, including here in Connecticut. His views on these issues have been published recently The New England Journal of Medicine and Foreign Policy.
You were actively involved in the response to the AIDS epidemic in the 1980s and 1990s. What was the public and political mood at the time?
GG: This was the era of Ronald Reagan, the rise of the religious Right and the definitive end of the progressive era represented by the great social reforms of the 1960s. AIDS appeared in this new conservative climate and the country alternately ignored the epidemic or lashed out at the marginalized populations it affected: gay men, drug users, and the poor.
What parallels do you see today in the same response to the few cases of Ebola that have been reported in the United States?
GG: The fear and panic that we’ve seen over the past few weeks is reminiscent of the reactions we saw to AIDS in the 1980s, with calls for quarantines, shunning of entire classes of people—gay men and drug users then, health care workers coming from fighting Ebola in West Africa now.
Is history repeating itself?
GG: Thankfully, it is not. We have no Ebola epidemic in the United States, and 30-plus years ago we had a fierce, new epidemic of HIV on the march in our country. The discrimination and stigma health care workers and others coming from West Africa are facing here will subside if the Ebola epidemic is brought under control there.
It’s been nearly 20 years since the height of the AIDS epidemic and this latest Ebola epidemic. What has changed for the better?
GG: Due to our experience with the AIDS epidemic, a coalition of public health and medical experts, as well as community activists, was ready to confront the irrational, punitive measures enacted by governors Malloy, Cuomo, Christie and other governors around the country.
What has been right about the response so far to Ebola in the United States?
GG: The United States is the single largest donor—at least in terms of pledges made—for combating the Ebola epidemic. The Centers for Disease Control and Prevention’s original guidance on isolation of those potentially exposed to Ebola was clear-headed and evidence based. Finally, many American health care workers have volunteered to go to West Africa to offer their services in the fight against the disease.
What has been particularly wrong?
GG: Some of the media and some governors have been fear-mongering for ratings and political gain, spreading misinformation among the general public about Ebola—these people are just irresponsible and reprehensible and what they’ve done should be roundly condemned.
You’ve been outspoken in the past few weeks about mandatory quarantines. What are your views on this public health measure?
GG: If someone has symptoms of Ebola virus disease, and then has documented infection, she or he needs to be quarantined and isolated. Individuals who may have had contact with patients, but don’t show symptoms of disease are not infectious and isolating them is not necessary, nor is isolating anyone for simply traveling to the region. Twenty-one-day symptom monitoring is the accepted protocol for healthcare workers and others who have had contact with Ebola patients.
Connecticut is quite a liberal state, yet it has implemented some of the more draconian measures to fight Ebola, including quarantines for people who, at least in some cases, have tested negative for the disease? What’s going on here?
GG: I really don’t know why the Governor decided to institute these overly broad measures and oppose the CDC’s guidance. However, we do know Governor Malloy was in a tight re-election battle and didn’t need criticism about handling of the Ebola epidemic from his opponent. One might say he was protecting his right-flank in this case.
Is the public right to be frightened of Ebola?
GG: Thirty-seven people in Connecticut died from influenza-related illness in 2013-2014. Thus far no one in Connecticut has contracted or died from Ebola. Ebola isn’t a threat to people in our state or our country.
What would you like to see going forth?
GG: The worst aspect of the US public’s response to Ebola has been the fact that it takes away attention from where it is needed most: on the epidemic in Liberia, Sierra Leone and Guinea. We need to all re-focus and devote our energies to beating Ebola in these three countries before the end of the year.