Miami Herald - Thursday, November 1, 2001
Elinor J. Brecher and Stephen Smith

"I remember the hysteria," says Scott of Fort Lauderdale, newly elected president of the People With AIDS Coalition of Broward County. The Navy veteran and former television writer was diagnosed HIV-positive 13 years ago.

"I've noticed how similar the tone is. It carries with it some of the same uncertainties," though it lacks the sexual stigma.

In both emergencies, baffled public health officials issued conflicting or bare-bones information that generated more confusion than clarity.

In the 1980s, police officers started wearing rubber gloves to frisk suspects.

Today, mailroom employees don latex to handle business envelopes. Signs warn against talc usage in public restrooms. Powdered-sugar cookies are suspect, so is spilled artificial sweetener, and the residue at the bottom of a tin of Altoids.

Are spores lurking in the metal band Anthrax's CDs? Is every postal worker with the sniffles doomed? Is it al Qaeda? White supremacists? Antiabortion militants?

Just as it took years to identify HIV as the culprit in AIDS and body fluids as the vectors, at this point in the bioterrorism era, ignorance is running even with accuracy.

John Gregory Tweed, a former South Florida hospice AIDS chaplain and a retired minister, remembers when misinformation stampeded the gay community; for a time, the contagion was blamed on "poppers:" sexual stimulants popular in gay bars and bath houses.

Tweed, 61, encountered men sick with a baffling new disease long before the condition initially called GRID -- gay-related immune deficiency -- was renamed AIDS in July 1982. There were only 22 diagnosed cases when Tweed took in the first of many men suffering from an always fatal condition with unknown causes.

RESCUED A MAN

Tweed held a prestigious Dutch Reformed Church pulpit in New York City when he rescued a desperately ill man who had been living on the streets. The man had an exotic form of pneumonia.

He was Don Heche, father of actress Anne Heche, and in his mid-40s he was close to death.

"I'd go to see Don Heche in the hospital and his dinner would be sitting on the floor," Tweed remembers. "We'd have to wear gloves and masks. Patients couldn't get basic services. Landlords were kicking them out of their apartments. Families disowned their children. Lifetime companions split up over it.

"In those days, they didn't think people with AIDS should talk to each other because they'd give each other more disease. There were no volunteer services. There was no structure whatsoever."

Two decades later, AIDS support and education networks reach well beyond the gay community to the minorities and drug abusers bearing the epidemic's brunt. And AIDS no longer panics the general public, even though it's a far more widespread threat than anthrax.

"Now AIDS cases are in the general population of the hospital," Tweed notes. "We don't have AIDS hospices anymore. It's not necessary, because the hysteria is over and we're dealing with it in realistic terms. But it's still completely out of control [because] it involves caring about people who are different than ourselves."

Anthrax, on the other hand, strikes randomly, based not on intimate behavior but on logistics: As of Tuesday, it has been blamed for or suspected in three deaths.

HIV/AIDS diagnoses in the United States have reached 775,000 (42,000 in 2000), according to the Centers for Disease Control and Prevention. It's thought that 900,000 Americans live with HIV, diagnosed, and undetected.

It's "a bloodthirsty lion" in Florida, Tweed says.

The state ranks second nationally in the annual rate of AIDS cases -- 33.4 per 100,000 population -- with the third highest cumulative number of cases: 80,400.

Even as the national AIDS death rate declines, Florida's is rising: 5 percent from 1998-1999. AIDS experts blame safer-sex laxity among young gay men, and inadequate health services for at-risk groups including the poor and drug abusers.

The University of Miami's Dr. Margaret Fischl has been on the front line of AIDS research and treatment since the beginning.

KNOWLEDGE GAP

"The reason why people were so afraid -- and this was at all levels, from the medical staff down to children -- was literally not knowing, not understanding what we were up against," Fischl says.

"It was the fear of the unknown [and] how it is transmitted." As the experts learned more about the virus, they knew they had to relay information to the public in realistic yet reassuring ways.

"Education is how you deal with the fear," Fischl says.

"Recognizing how [HIV] was transmitted and how it was not transmitted. We would hammer that out with bulletins: `You don't get it from a toilet,' for instance. I think all of those were progressively important things that helped us with HIV.

"It's literally getting the word out -- and it was getting the word out at all levels, from the clergy to schools to the medical community."

Then as now, the skittish were inclined to see symptoms in every abnormality.

"One of the universal first symptoms was night sweats," says Tweed, of Wilton Manors. "They seemed to be inevitable, and everybody thought they had them. There were a lot of theories planted: that this was bioterrorism [against the gay community] sponsored by the federal government."

He thinks such mythology is predictable.

"We sort of belong to the `Hysteria of the Month Club' in the United States. There's always something," be it a genuine medical catastrophe like polio, or a paranoid overreaction, like the phantom 1976 swine flu epidemic.

Even though only one person died, then-President Ford ordered a $135 million nationwide immunization program that was blamed for numerous heart attacks.

Greg Scott, 39, finds wisdom in the motto of Act-Up!, the militant HIV activist group that has demanded greater public health resources: " `Silence equals death.' The more readily government and others who know about it share it, the less hysteria there will be."

ANOTHER WORRY

He does, however, worry that decades of political pressure on the public health system because of AIDS has left it underfunded and incapable of responding to a widespread emergency.

"Is the CDC staffed with people who remember those terrible old days?"

Tom Houston, 55, helped establish Gay Men's Health Crisis in New York at the dawn of the epidemic, then served as Broward PWA president in 1999. He recalls when "after you were diagnosed, you had a year. People had this knowledge of the trajectory of the disease: They knew the light at the end of the tunnel was a train coming, but they stayed cool and died well."

With homophobic politicians blocking research and treatment funding, the gay community turned inward.

"We held each others' hands and didn't just rely on the medical establishment," says Houston. "The specter of the disease was unknowable, so we developed this enormous system."

The lesson?

"It's very simple," says Houston: "Get informed and stay cool. Luckily, anthrax isn't contagious."

ebrecher@herald.com
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