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| https://www.jwatch.org/fw117539/2021/02/21/lancet-series-tackles-us-hiv-epidemic?query=pfwTOC&jwd=000020094311&jspc=GP
The Lancet takes aim at the US HIV burden, the highest of any of the G7 nations. In dramatic contrast to the quarantine, contact tracing, social isolation, distancing and masks demanded by Public Health for the COVID19 pandemic; HIV patients and those living an alternative lifestyle demand and receive the exact opposite. Hospitals, clinics and physicians can not test for HIV without written permission. While hospital admitting lab tests still include a routine test for Syphilis, routine testing for HIV is not included. Only a difficult strategy of universal precautions affords protection for other patients and hospital personnel. Surgical and obstetric cases must be carried out with the assumption of risk, requiring extensive shielding against the inevitable spattering of blood. The risky behavior, personal privacy and confidentiality if not silence demanded by the HIV community was political from the start. If testing, quarantine, contact tracing and isolation had been required from the first case of HIV, there would have been no epidemic in the US, or if HIV did spread by undiagnosed immigration, it would have been contained. Indeed, COVID19 would have been contained too if China had not deliberately denied its threat and encouraged its spread.
As a nation, we were more than willing to suffer quarantine and contact tracing for Syphilis, Tuberculosis, Poliomyelitis and even Mumps. The contrast between the protocols for HIV and COVID19, however, illustrate the compromise needed between Constitutional freedoms of choice and the suspension of that freedom in the face of a highly communicable and highly fatal disease. The choices needed to balance a fair compromise might better be made by medical judgements than by politicians. Even so, there will be an inevitable difference between clinical opinion and that of public health. It becomes even more problematic when public health becomes politicized or politicians intervene.
