POLITICS OCTOBER 5, 1987
The people of Arcadia, Florida, want you to know that they are not ignorant. The reverend at the local Methodist church complains that "the media seem to want to paint us as illiterate and belligerent rednecks." True, they ostracized the Ray family because their three hemophiliac boys carry the AIDS virus. True, they tried to keep the boys out of school, until forced to relent by a court order, at which point the Ray house was destroyed in a suspicious fire and the Rays decided to leave town. But, explains Sue Ellen Smith, wife of the mayor, who took her child out of public school when he was assigned to a class with one of the Ray boys, "If you are intelligent and listen and read about [AIDS], you get scared."
You certainly do. It is not ignorance that ran the Rays out of Arcadia. Quite the contrary. The people there have been told a thousand times who gets AIDS and how they get it. They may even know that there is not one recorded case of a child contracting AIDS from a classmate. In fact, there is not one documented case of a child contracting AIDS from a sibling, and brothers and sisters are in far more intimate contact than schoolmates.
To which the parents reply that no one can guarantee that such a thing could never happen. True, but no one can guarantee that an earthquake will riot swallow up the school tomorrow or that Mrs. Smith's boy will not get killed in a car accident on the way to his new private school--and neither possibility induces Mrs. Smith to keep her boy home. The Smith boy is as likely to die by earthquake as he is by sitting in homeroom with young Ray, and far more likely to die in an auto accident. But AIDS is on his mama's mind. Her selective irrationality in the face of improbability is not the product of ignorance, but of a media-fed national panic. AIDS is one case where the truth is not making people free. It is so packaged in hype and hysteria that it is simply making people afraid.
Doom sells. In a comfortable culture, the notion of apocalypse--any apocalypse will do--fascinates and enthralls. Kids go to horror movies to find this kind of thing. Adults go to newspapers. At the beginning of the decade there was nuclear apocalypse. Doctors' groups called it "the last epidemic." They were premature. When arms control talks resumed and the freeze movement went bust, the last epidemic was succeeded by two more. First, the drug epidemic, which enjoyed a certain vogue last year. (One newsmagazine compared it to "the plagues of medieval times.") Drugs have been consigned for now to the memory hole. They have been overtaken by today's terror, AIDS.
AIDS is a serious problem. But the hyperbole surrounding it is embarrassing and, as the Rays of Arcadia have learned, dangerous. And though the hype is amplified by the media, it originates with political leaders who ought to know better. The secretary of Health and Human Services, for example, says that AIDS can make the Black Death "look very pale in comparison." And the chairman of the House Subcommittee on Health and the Environment, Representative Henry Waxman, calls AIDS the "most serious epidemic we've ever faced."
Nonsense. In three years the Black Death killed one out of every three Europeans. The flu epidemic of 1918-20 killed 22 million people, more than died on all sides in World War I, civilians included. In America alone, a half million died of the flu, 20 times more than have died of AIDS in this decade.
It is not just the numbers that are incomparable, but the state of scientific knowledge. No one knew what the Black Death was and no one knew how to treat the flu. In contrast, less than four years after the first reported case of AIDS, we knew the cause. We have identified and isolated the offending organism, one of the fastest such discoveries in history. "We now know more about this virus than perhaps any other," says Dr, Samuel Broder of the National Cancer Institute. It is six years after the discovery of the AIDS syndrome and human testing has begun on the first vaccine.
Most important, however, is that compared with most other infectious diseases, AIDS is very hard to spread. It is transmittable, but it is not contagious. You can get tuberculosis if the wrong person coughs on you. During the TB outbreaks of the last century, every time you rode the trolley or sat in a cafe you exposed yourself to danger. This is simply not true of AIDS. TO contract AIDS you must undertake a complicated behavior (intravenous drug use, sexual activity) that requires conscious intent and your full cooperation. The number of exceptions to this rule is exceedingly small: babies born to mothers with AIDS, medical workers infected by the blood of AIDS patients (12 recorded U.S, cases), and medical patients infected by blood transfusions or blood products (an almost negligible source of new cases, now that the blood supply has been cleaned up).
Stephen Jay Gould warns that AIDS is "potentially, the greatest natural tragedy in human history." It "may run through the entire population, and may carry off a quarter or more of us." Gould is a respected paleontologist and media figure, but Harold Jaffe is chief AIDS epidemiologist at the Centers for Disease Control in Atlanta. And Jaffe, who studies the figures every day, concludes that "we really have not seen much evidence for the spread of the virus into people who are not in risk groups." (Drug addicts and gay men continue to account for 90 percent of AIDS cases.) "For most people, the risk of AIDS is essentially zero." Just how hard it is to get AIDS is confirmed by a Berkeley study that looked at heterosexual transmission. It found that of women who had sex more than 100 times with an AIDS-infected man, only three in ten became infected. The director of the study concludes: "This is a hard disease to transmit."
You wouldn't guess it from the hype, which justifies itself with the claim that only information can prevent AIDS. Sure, but how much? For AIDS, the problem is not so much ignorance as it is will. How many gays are there who don't know about how AIDS is transmitted? How many addicts are there who don't know that they shouldn't use contaminated needles? In this respect, AIDS more resembles lung cancer than older epidemics such as tuberculosis or polio. We know exactly how to get AIDS and exactly how to prevent it. With the rarest exceptions, those who acquire the infection today (as opposed to those who contracted AIDS before the cause was known) are those who decide to take a risk, thinking that the roulette wheel won't stop at them.
Americans tend to believe that information is the key to social progress. Educate people about democracy or hygiene or better wheat-growing techniques and things will get better. For AIDS, however, the information flood is precisely the wrong remedy. Obsessive coverage does not create cures. It creates panic. Sue Ellen Smith is quite right. If you are intelligent and listen and read about AIDS, you get scared.
It is not more AIDS information that drug abusers need, but treatment for their addiction. It is not more condom ads scientists need, but money to pursue their studies. And it is not more stories about the terrors of AIDS--roll calls of the dead, first-person accounts of the agony of dying--that the public needs, but fewer. What harm can come from overreaction to a disease that kills 24,000 people? Ask the Rays, late of Arcadia, Florida.
Charles Krauthammer is a former writer and editor at The New Republic.
By Charles Krauthammer