The Coming of Aids II
Robertson, A.D.J. & Grutsch, James E. Jr.
Joe Biden. Give him credit for sup-porting the Grenada invasion when all his party's presidential candidates weren't. But that's where the credit ends. Biden presents himself as a centrist. He gives...
...The second is political—when does the government's duty to protect its citizens become overriding...
...But don't worry...
...James Curran, the leader of the AIDS task force at the CDC, bravely apologized for earlier underestimating the disease...
...opinion, is not a disability that can be discriminated against...
...in no cohort has the rate of progression through the stages decreased, though of course it will once most members of a cohort are dead...
...The rate is increasing steadily, as it is in the other infected groups...
...Screening the blood supply has thus reduced the rate of contamination, but it cannot eliminate it...
...At what rate were recipients of transfusions being infected before screening began...
...If one in a thousand samples is found to be positive, some-where between five and thirty in a hundred thousand will have been missed...
...Another fallacy, thoroughly laid to rest by the Paris meeting, is the comforting belief that only those whose immune systems are impaired by taking drugs, of apparently any kind by any route, will succumb to AIDS...
...For example, the journal Science quoted Dr...
...As the number infected has roughly doubled since screening started, the current range of possible false negative results is more like 10 to 60 percent of the true positive rate found a year ago...
...Finally, both observations on people and experiments with chimpanzees show that the chance of being infected if given infected blood by transfusion is over 90 percent, not 30 to 50 percent as Johanna Pindyck of the New York Blood Center said in a press conference on July 15 when discussing the look-back program to identify recipients of contaminated blood...
...Thus there were about four years of contamination of the supply before screening started...
...therefore between 12,000 (400x30) and 40,000 (400x100) were in-fected...
...This arises frequently because, inevitably, there is a delay in reporting cases to the CDC...
...Our calculations suggest that when all sources of testing error are combined, the range of false negative results is between 5 and 30 percent of the true positives...
...In the final plenary session of the meeting Dr...
...The first is one of fact ArmYourself'WI Be Latest Facts, Harvard University Press has joined with the Institute of Medicine/National Academy of Sciences to publish an unprecedented study of all that is now known about AIDS...
...Even among the purely heterosexual the death rate will be noticeable in three to five years...
...What makes this sobering is that almost all transfusion-caused AIDS cases are still due to infection incurred long before testing started...
...This leads to a gross underestimate of the heterosexual spread of the Aids virus...
...Groopman said, is rather like choosing a meal in a Chinese restaurant: "Tivo from each column...
...Finally, the Public Health Service has issued estimates of about 300,000 new cases by the end of 1991...
...ARC is diagnosed if a patient has any two of both the signs and symptoms of AIDS, which, as Dr...
...Estimates from small numbers are notoriously unreliable for a process like the spread of the Aids virus...
...This gives a true picture of the rate of increase of the disease...
...It is even worse for everyone else...
...Jackson hasn't dropped his radical Third World ideology in which dictators like Hafez Assad and Fidel Castro rank so high...
...The opinion issued on June 20 by the Justice Department is unusually clear and soundly-based scientifically...
...A pretty good speech, in fact...
...This kills before true AIDS symptoms develop and has been wrongly diagnosed as Alzheimer's disease...
...Curran said: "The only co-factor appears to be time...
...There has also been some additional information regarding transmission of the Aids virus...
...many children born infected with the virus do not develop properly and in particular their brains grow too slowly...
...On the other hand, we know that a lot is missed: in California a report to the governor shows that there is serious under-reporting of AIDS...
...The book will serve as a major resource for educators and policymakers...
...This opinion is reinforced by the most recent data from Uganda, where, as in other Central African countries, high prevalences of infection have been measured, though the death rate is not yet known except from horrifying anecdotal accounts...
...For example, in January 1985 there were 3,864 cases reported as diagnosed in 1984, but by December 1985 this number had grown to 5,341 and now it is 6,751...
...Lots of Jackson-bashing is needed...
...There is an unknown, and unintended, under-reporting of deaths caused by the virus...
...we don't know how many units of blood are falsely negative...
...Against this defeatist background, the number of AIDS cases caused by heterosexual transmission, particularly from women to men, is rising more rapidly than the number in any other of the CDC's risk groups...
...A Red Cross spokesman in Georgia recently comforted potentialrecipients of infected blood by telling them that most of the infected blood was only weakly positive...
...this is about as reassuring as telling a virgin that she is only a little bit pregnant...
...The apparent differences in risk now can be ac-counted for by the shorter period in which the infection has been spread by transfusion than, say, by needle sharing...
...Somehow, though, he never got around to mentioning Jackson by name...
...James F. Grutsch, Jr...
...Michael Gottleib, M.D., Co-Chair, Board of Directors, American Foundation for AIDS ResearchObjective "An excellent summary of the full range of issues associated with AIDS...
...As many as 2 percent from some cities are infected...
...The worst aspect of the AIDS problem is that the issue of rights has predominated to such an extent that it has excluded research needed to settle the first question...
...Several new observations show that we must be extremely cautious in analyzing the epidemiology of viral spread and of AIDS itself...
...The various viewpoints are objectively and fairly presented, giving readers an adequate factual basis for drawing their own conclusions" –Jeffrey Levi, Director of Governmental and Political Affairs, National Gay & Lesbian Task Force Important "Mobilizing Against AIDS is an outstanding piece of work, making a complex subject clear and understandable in a very readable form...
...A deficiency of 25 percent seriously distorts the pattern of an epidemic and has pro-found consequences for the health and insurance industries which need ac-curate actuarial data...
...However, the damage resulting from the infection is enough to cause massive loss of brain tissue, dementia, and death...
...and A.D.J...
...Another source of confusion is the classification of those infected with the virus into symptom-free carriers, those with ARC (AIDS-Related Complex), and those with AIDS...
...Jerome Groopman, a prominent clinician doing important work on the natural history and epidemiology of the virus, as saying that while he always reported a case of AIDS to the CDC he might not put the diagnosis on a death certificate since it could be hard on a family...
...Biden says that if a nominee is very conservative it means, ipso facto, that helacks judicial temperament and should not be confirmed...
...In the opinion he is at pains to distinguish infection from infectiousness...
...While 6 percent of reported AIDS cases in California involve married men, 36 percent of those in the unreported cases are married men...
...But a report of antibody production in a hemophiliac who had used only the heat-treated concentrate has just been published in Lancet (March 15, 1986), showing that we will probably have to wait until clotting factors can be mass18 THE AMERICAN SPECTATOR SEPTEMBER 1986 produced by bio-technology before we can be certain not to infect newly diagnosed hemophiliacs...
...In Cambridge, England, schools have been advised that children should not share musical instruments with mouthpieces...
...Attacking drug use gets more emphasis these days...
...Thus, even if you are lucky enough to have a disease-free identical twin, your prognosis cannot be said to be good...
...The CDC have estimated that the expression of frank AIDS occurs at a rate between one-thirtieth and one-hundredth of the cur-rent rate of infection with the virus...
...One day soon, I suspect, one of them may realize this...
...This is not true...
...About 60 percent of those diagnosed with AIDS become demented...
...He leads the charge against Reagan judicial appointees...
...The increase in the total number of AIDS cases, undoubtedly under-reported, represents a doubling in roughly eleven months and in heterosexual AIDS cases a doubling in less than seven...
...There is a widespread belief, strongly reinforced by spokesmen for the American Red Cross and hospitals and by public health officials, that the blood supply has been safe ever since screening of donated blood with the ELISA test began about a year ago...
...In Europe, schoolchildren are given ac-curate, explicit lessons about AIDS, even though they are in countries where the epidemic is three or more years behind ours...
...THE AMERICAN SPECTATOR SEPTEMBER 1986 19 from the ARC menu...
...MA 02138 ^ Institute of Medicine ^ National Academy of Sciences Mobiijzi A ainst The Unfinished Story of a Virus Fallacies must be exposed...
...He has been treating the infected members of three pairs of identical twins with chemotherapy and bone marrow trans-plants from their uninfected brothers...
...The writer, Assistant Attorney General Charles J. Cooper, separates disabilities which might arise from having AIDS itself, and cannot be discriminated against, from infection with the Aids virus, which is not a disability...
...It had been hoped that heating the concentrate used for Factor VIII preparations would kill enough viral particles to prevent new infections of hemophiliacs...
...An increasing number of people show neurological damage caused by the virus...
...Nor did Congress, as is shown by its subsequent silence on the issue, want to usurp the powers of detention andquarantine given, from the beginnings of the Union, to state and local authorities for the express purpose of preventing the spread of disease...
...Without widespread testing of the population, or a good sample of it, we can only estimate the number of people infected in this country...
...The screening tests used now exclude all but a tenth of one percent of false positive results...
...Biden got press accolades in July when he supposedly nicked Jesse Jackson in a speech to the NAACP convention...
...It's what could put a Democrat in the White House in 1989...
...He points out that, when writing the Rehabilitation Act of 1973, Congress did not in-tend to prevent an employer from exercising his own judgment about whether his workforce is put at risk by someone who is potentially contagious...
...Therefore the number of cases reported in the most recent year is always much less than it will ultimately become...
...The first case of infection from the "safe" blood supply has been reported, as have at least two from the use of "safe," heat-treated clotting factors by hemophiliacs...
...If we accept this range we can make some estimates...
...On any given issue except Grenada, he's on the other side from conservatives—contras, Star Wars, South Africa...
...It inspires us to overcome the stigmas associated with AIDS and move on to constructive solutions through scientific research and enlightened public policy decision making...
...Comprehensive "An interesting and well-written book...
...There was, again, no single encouraging report of a reversal, or even slowing, in this trend at the Paris conference...
...It is a thorough evaluation of where we stand now and where we might go...
...Our desire not to know the worst is justified with the reasoning that, since the disease cannot be cured and since one should advise anyone against promiscuity and drug abuse whether or not he is infected with the virus, a test can change nothing...
...The most encouraging cure was announced by Dr...
...To persuade people to be tested, however, we must first decide what to tell those who are infected...
...Bill Bradley, say...
...The highest AIDS rate, and therefore ultimate death rate, so far for those infected by the Aids virus is about 40 percent...
...It is easily the best available book that I have read on this important subject...
...This appears to mean that knowing who is infected with a lethal disease will not reduce its transmission...
...It is also important to remember that there is no evidence the risk of developing AIDS, given infection by transfusion, is lower than the risk given infection by a different route...
...Readers who could profit from it range from physicians who are not experienced with AIDS (the psychosocial aspects would be especially helpful to them) through to lawyers, social workers, politicians, and anyone interested in a broad view of the epidemic" – Donald Armstrong, M.D., Memorial SloanKettering Cancer Institute Clear "This book is a lucid review of the basics of AIDS and its implications for all Americans...
...20 THE AMERICAN SPECTATOR SEPTEMBER 1986...
...fected...
...These are high numbers and show that we cannot afford to wait much longer, since they are just what was, found in Africa three or four years ago...
...is a biophysicist working in Chicaga A.D.J...
...LaRouche has succeeded in getting onto the November ballot in California an initiative that would bar virus carriers from the food industry and schools, and would require widespread testing and quarantine...
...His emphasis haschanged a little, however...
...These doubling periods have remained constant for over two years, since the last major changes in the definition of the risk groups...
...Robertson THE COMING OF AIDS II A viral update...
...There are other systematic distortions...
...Our experience with AIDS shows that the problem of avoiding disease spread in blood is much more difficult than had been thought...
...Even infected hemophiliacs, who were almost all infected between two and four years ago, are already showing a higher AIDS rate—that is, the rate at which those infected with the Aids virus develop AIDS—than the one percent quoted by the blood banks to reassure their customers...
...Recent tests of new Army recruits show 1.7 per thousand infected, with women infected at about one-third the rate of men...
...Myron Essex of the Harvard School of Public Health, on the other hand, has suggested that the risk has been reduced by one-third to one-tenth, which is consistent with our calculations...
...The Second International Conference on AIDS, held in Paris in June, was remarkable for the complete lack of good news...
...Arguments against testing to find out who is infected are oddly similar on both sides of the Atlantic...
...Since, in the population at large, most people were infected a short time ago we will not know their ultimate fate for many years...
...This was the most encouraging development revealed in over 900 presentations...
...The true risk is very likely to be in this range...
...Perhaps he'll confront Jackson head-on, not obliquely like Biden...
...What has happened to AIDS since we wrote our first article in January ("The Coming of AIDS," TAS, March 1986...
...The number of Americans infected with the Aids virus has increased by about 40 percent and is almost certainly between two and three million, the number of AIDS cases reported to the Centers for Disease Control (CDC) has increased from 15,948 to 22,173, and the number of known deaths among these cases has risen from 8,220 to 12,186...
...Thus, once you get AIDS, there is not more than a 2 per-cent chance that you will survive five years, and there is no evidence for any factors that would improve the prognosis...
...In California it has been discovered (by matching reporting records to death certificates for secondary infections known to be part of the AIDS complex) that about 25 percent of AIDS cases fitting the CDC surveillance definition are not reported...
...each year, 120, or one in 100,000, may slip through the cur-rent screening procedure...
...There are also reasons notto classify a patient as having AIDS, since he may become uninsurable or lose his job...
...As Dr...
...Only time, and research, can tell what the real risk is...
...It is more accurate to count new cases as they come in and add them to a cumulative total...
...Public education is essential...
...The Aids virus began to enter the blood supply in force perhaps two to three years after the first infections of homosexuals and drug addicts...
...During this period there were roughly eight million transfusions in which the patient survived the accident or surgery requiring transfusion...
...These facts, which have seemed likely for a long time, were confirmed at the Paris meeting...
...Jackson is the new litmus test forDemocratic leaders...
...And my, oh my, the response from rank-and-file Democrats and conservatives, tired of the pampering Jackson gets, will be thunderous, and favorable...
...There is also deliberate under-reporting to protect patients, or their heirs, from the social and financial consequences of being known to carry the virus or of having had an AIDS victim in the family...
...While no cure or vaccine is in sight, we know much more about the natural history of the disease, because many people infected early in the epidemic have been followed in surveys for more than five years...
...In several states insurance companies are barred from requesting blood tests for the AIDS antibodies from applicants for life or health insurance...
...Their prognosis is extremely gloomy, how-ever, even leaving out deaths due to brain damage which may have a longer average latency than AIDS itself...
...If they can't criticize him, unequivocally and by name, then they can kiss any vision of getting conservative votes goodbye...
...Two non-sexual routes of transmission, recognized early in the epidemic, are the carriage of the virus with clotting factors used by hemophiliacs and in blood and blood products used in transfusions...
...Officials state that the risk has been reduced to one in 100,000 or less, that is, by a factor of between 5,000 and 150...
...These estimates are based on small numbers and exclude deaths from other causes, so one can only speak of broad trends...
...Robertson is a biologist interested in embryology and behavior who works at the Research, Testing, and Development Corporation of Lexington, Georgia...
...How would this go down in Cambridge, Massachusetts...
...There are some new measures and recommendations: infection with the virus is now grounds for denying a visa for entry to the United States, but, ac-cording to a recent Justice Department James F Grutsch, Jr...
...It must be remembered that all these calculations deal with rates that operated over a year ago, when the prevalence of the virus in the population was unlikely to be more than half what it is now, so whatever the risk was then it has doubled...
...The notorious Mr...
...we believe this to be a gross underestimate, though closer to the truth than the reassuring messages issued in the past...
...Martin S. Hirsch, M.D., Harvard Medical School $15.00 cloth ISBN 0-674-57760-4 $7.95 paper ISBN 0-674-57761-2 Harvard University Press Cambridge...
...There is no consensus as to whether the virus infects brain cells directly, or is only carried to the brain in infected white blood cells...
...one of these caused the first recorded infection of a transfusion recipient after screening began...
...Dividing these numbers into eight million gives risk of infection by transfusion of between one in 667 and one in 200...
...He'll be back to the Third World stuff again, finding the United States always at fault, whatever the circumstances, whatever racist demagogue that puts him in league with...
...In the oldest group, those above 29, nearly five per thousand of the recruits are infected...
...This official estimate is obviously based on the most optimistic assumptions only, since there are still unknown facts which do not allow us to estimate exactly what the rate of failure to detect infected blood will be...
...In my book that doesn't count as Jackson-bashing...
...Once AIDS has been diagnosed, the death rate in both sexes of all three racial groups counted (white, black, and Hispanic) is about the same and is remarkably similar to the overall rate of AIDS diagnosis...
...In some countries up to 30 percent of the general population in cities is now inThe number of AIDS cases caused by heterosexual transmission, particularly from women to men, is rising more rapidly than the number in any other of the CDC's risk groups...
...There must be other cases like this, just as we now know that other infectious diseases, not classified with the opportunistic infections of AIDS, are killing people infected with the Aids virus...
...The Public Health Service and the directors of blood banks assume that of the 12 million units of blood collected in the U.S...
...Anthony Fauci, who works for the National Institutes of Health in Bethesda...
...Perhaps, he said, wishful thinking rather than preventive medicine had been used for too long...
...At the Paris meeting African delegates were prompt to acknowledge infection among prostitutes, in say Zambia, with the explanation that all Zambian prostitutes come from Tanzania .. . Other studies in Denmark and the United States show clearly that at least 90 percent of those infected have some damage to their immune systems, and There are two kinds of argument at least half exhibit a serious symptom about AIDS...
...First, they are asked to exclude them-selves if they fall into a risk group—and the groups are defined more stringently than they were...
...how bad is the problem...
...He gives ILAR speeches, denouncing Ideologues of the Left and Right...
...There will be high death rates from AIDS in all segments of the sexually active population...
...When all the reports are in, the number of cases diagnosed in 1984 will probably have doubled from the number reported immediately at the end of that year...
...Roughly 400 people have transfusion-related AIDS...
...Since ARC is not reportable and widely believed to be benign, it is an attractive diagnosis...
...Overseas, foreign workers are barred from entry to Germany if they are seropositive, while in Great Britain a person who knows that he is infected may not apply for life insurance or endowment-backed mortgages...
...these include the reassuring but dangerous belief that the rate of infection is drop-ping...
...Tivo of the AIDS patients are dead, while the third has survived for ten months with some improvement in immune function...
...Nonetheless some male homosexuals still donate blood...
...Any man who has had sexual contact with another is now asked to exclude himself, whereas earlier the criterion was sexual contact with more than one other man since 1979...
...Thus Jackson showed up and gave a speech at the funeral of Len Bias, the University of Maryland basketball star who died of a cocaine overdose...
...In the small cohorts that have been studied longest, the progression from infected carrier to ARC, AIDS, and death is very steady...
...Donors are screened in two ways...
...These percentages wilt only increase, as has been the case when observation has continued long enough...
Vol. 19 • September 1986 • No. 9
