HIV experts provide lessons for mitigating COVID

HIV experts provide lessons for mitigating¹ COVID

Transcript²

Federal officials have a favorite refrain about COVID-19: "We have the tools." There's just one problem: As those who have worked to end HIV for decades know, just having the tools is not enough.

LEILA FADEL, HOST:

For COVID-19, federal officials seem to have adopted a refrain.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED PERSON #1: We have the tools.

UNIDENTIFIED PERSON #2: We have the tools and protocols³...

UNIDENTIFIED PERSON #3: Do we have the tools we need...

UNIDENTIFIED PERSON #4: We have the tools.

FADEL: Three years ago, before COVID-19 even began, officials in the Trump⁴ administration said the same thing about the HIV epidemic⁵.

(SOUNDBITE OF ARCHIVED RECORDING)

ALEX AZAR: We have the tools. This is an historic opportunity.

FADEL: That is the former health and human services secretary Alex Azar speaking with NPR in 2019. But those who've worked on HIV for decades say to stop a pandemic, it's not enough to have the tools. NPR's Selena Simmons-Duffin reports.

SELENA SIMMONS-DUFFIN, BYLINE⁶: Stephanie Brooks-Wiggins is 76 years old. She lives in Baltimore. She was diagnosed with HIV in 1986. Back then, there were no tools to help her.

STEPHANIE BROOKS-WIGGINS: There was no treatment. There were no drugs. You would go to the clinic, and the psychiatrist⁷ would talk to you to keep you from going off the deep end.

SIMMONS-DUFFIN: Over the decades, scientists developed many HIV treatments. And they got better and easier to take, she says. But HIV has not ended in the U.S. as these tools became available. A stubbornly high number, more than 30,000 people, are diagnosed with HIV every year. Only 25% of people who might be eligible⁸ actually take a preventive pill called PrEP. And even with accurate and at-home options for testing, over 150,000 people in the U.S. are HIV positive but don't know it.

ADAORA ADIMORA: Scientific discoveries are a necessary but not sufficient factor to completely eradicate⁹ disease.

SIMMONS-DUFFIN: That's Dr. Adaora Adimora, a physician and professor at the University of North Carolina at Chapel¹⁰ Hill. She first started treating people with HIV in the 1980s. She says the tools to combat HIV have come a long way. There are now topical gels and easy-to-take pills and even injections.

ADIMORA: I don't know that I ever greeted any of these new advances saying, this is the thing that's going to end HIV.

SIMMONS-DUFFIN: That's because she's seen the barriers to access and implementation¹¹, she says, barriers like the high cost of prescription¹² drugs and the maddening patchwork¹³ health care system. The barriers to COVID's tools, like tests and vaccines¹⁵ and therapeutics, have been different.

But A. Toni Young says there are parallels and common mistakes. She lives in West Virginia and runs the Community Education Group, which does public health outreach.

A TONI YOUNG: We keep doing the same thing over and over and over again, saying, it's over there, why don't you go get it?

SIMMONS-DUFFIN: That attitude hasn't worked to fight HIV or COVID, Young says. It doesn't work for people who don't have access to health care, who don't trust the medical system or who don't think they're at risk. As she sees it, when it comes to the COVID-19 pandemic, the country has missed out on the chance to make the most of the vaccine¹⁴ by failing to understand and work with people in all their complexity¹⁶.

YOUNG: It was an all-or-nothing approach. You're either with me on this vaccine, or you're not. You're either on my side, or you're my enemy when it comes to the vaccine. You're either a vaccine denier, or you're a vaccine getter. And there is a whole lot of room between those two.

SIMMONS-DUFFIN: The frame of us versus¹⁷ them is implicit¹⁸ in a lot of the rhetoric¹⁹ these days about getting back to normal. It's in terms like pandemic of the unvaccinated and telling people they've done the right thing by getting vaccinated²¹ and should therefore have special privileges, like not being punished with things like indoor masking and testing requirements.

That way of talking about public health, says Steven Thrasher, creates the conditions for pandemics to last longer. Thrasher is a professor of journalism²² at Northwestern and author of the forthcoming book "The Viral Underclass." With HIV in the mid-1990s, when treatments became much more effective...

STEVEN THRASHER: People who got access to the drugs began to pull away and take their political capital and go home because they didn't need to be in the fight anymore. And the virus continued to pool in what I call a viral underclass in the United States.

SIMMONS-DUFFIN: This was a sad and lethal²³ mistake in the fight against HIV, he says. And now it's happening again. The lack of political will in Congress to pass more COVID-19 funding is a perfect example, he says. And those still at particular risk are those who are warehoused away, out of sight.

THRASHER: People who are in nursing homes as elderly people or who are in convalescent centers as disabled people, and, of course, people who are incarcerated²⁴ - they're already out of public view, and people are not listening to them.

SIMMONS-DUFFIN: Those settings can act as epidemic engines, he explains. People visit their loved ones in these places. Staff come and go back into the community. And so the pandemic drags on, and lives are needlessly lost. He is disappointed that policymakers seem to be centering the people who have the most access to tools to protect themselves, not the least.

THRASHER: I really hoped that that would be different this time.

SIMMONS-DUFFIN: This is not to say no one is trying to get the available tools out to people who don't have as much power and access. A. Toni Young in West Virginia has one idea for how to do it.

YOUNG: We want to hit people in the face with the COVID vaccination²⁵ because we're in the middle of the pandemic. But maybe I got to slow walk you to that COVID vaccination.

SIMMONS-DUFFIN: Here's how that might go.

YOUNG: If you got five kids and y'all are hungry, you need to figure out where you're getting your food from. You don't care about my vaccine. Let me help you. What do you need from me? If I can get you the food that you need, when we do the follow up - hey, did the food voucher²⁶ work out for you? Great. Can we talk to you now about - again - about the COVID vaccine?

SIMMONS-DUFFIN: Her organization has a $3.5 million cooperative agreement with CDC to use this approach to vaccinate²⁰ people against COVID-19 and influenza²⁷ in West Virginia. Young hopes CDC will continue funding this for three years so they can expand. She also hopes to spread one of the lessons from HIV - that people and their relationship to health is complicated, and the public health response needs to be ready to meet them where they are.

Selena Simmons-Duffin, NPR News.

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1 mitigating   

v.减轻，缓和( mitigate的现在分词 )

参考例句：

• Are there any mitigating circumstances in this case ? 本案中是否有任何情况可以减轻被告的罪行？ 来自辞典例句
• A sentencing judge is required to consider any mitigating circumstances befor imposing the death penalty. 在处死刑之前，要求量刑法官必须考虑是否有任何减轻罪行之情节。 来自口语例句

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 protocols   

n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划）

参考例句：

• There are also protocols on the testing of nuclear weapons. 也有关于核武器试验的协议。 来自辞典例句
• Hardware components and software design of network transport protocols are separately introduced. 介绍系统硬件组成及网络传输协议的软件设计。 来自互联网

4 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

5 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

6 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

7 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

8 eligible   

adj.有条件被选中的；(尤指婚姻等)合适(意)的

参考例句：

• He is an eligible young man.他是一个合格的年轻人。
• Helen married an eligible bachelor.海伦嫁给了一个中意的单身汉。

9 eradicate   

v.根除，消灭，杜绝

参考例句：

• These insects are very difficult to eradicate.这些昆虫很难根除。
• They are already battling to eradicate illnesses such as malaria and tetanus.他们已经在努力消灭疟疾、破伤风等疾病。

10 chapel   

n.小教堂，殡仪馆

参考例句：

• The nimble hero,skipped into a chapel that stood near.敏捷的英雄跳进近旁的一座小教堂里。
• She was on the peak that Sunday afternoon when she played in chapel.那个星期天的下午，她在小教堂的演出，可以说是登峰造极。

11 implementation   

n.实施，贯彻

参考例句：

• Implementation of the program is now well underway.这一项目的实施现在行情看好。

12 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

13 patchwork   

n.混杂物；拼缝物

参考例句：

• That proposal is nothing else other than a patchwork.那个建议只是一个大杂烩而已。
• She patched new cloth to the old coat,so It'seemed mere patchwork. 她把新布初到那件旧上衣上，所以那件衣服看上去就象拼凑起来的东西。

14 vaccine   

n.牛痘苗，疫苗；adj.牛痘的，疫苗的

参考例句：

• The polio vaccine has saved millions of lives.脊髓灰质炎疫苗挽救了数以百万计的生命。
• She takes a vaccine against influenza every fall.她每年秋季接种流感疫苗。

15 vaccines   

疫苗，痘苗( vaccine的名词复数 )

参考例句：

• His team are at the forefront of scientific research into vaccines. 他的小组处于疫苗科研的最前沿。
• The vaccines were kept cool in refrigerators. 疫苗放在冰箱中冷藏。

16 complexity   

n.复杂(性)，复杂的事物

参考例句：

• Only now did he understand the full complexity of the problem.直到现在他才明白这一问题的全部复杂性。
• The complexity of the road map puzzled me.错综复杂的公路图把我搞糊涂了。

17 versus   

prep.以…为对手，对；与…相比之下

参考例句：

• The big match tonight is England versus Spain.今晚的大赛是英格兰对西班牙。
• The most exciting game was Harvard versus Yale.最富紧张刺激的球赛是哈佛队对耶鲁队。

18 implicit   

a.暗示的，含蓄的，不明晰的，绝对的

参考例句：

• A soldier must give implicit obedience to his officers. 士兵必须绝对服从他的长官。
• Her silence gave implicit consent. 她的沉默表示默许。

19 rhetoric   

n.修辞学，浮夸之言语

参考例句：

• Do you know something about rhetoric?你懂点修辞学吗？
• Behind all the rhetoric,his relations with the army are dangerously poised.在冠冕堂皇的言辞背后，他和军队的关系岌岌可危。

20 vaccinate   

vt.给…接种疫苗；种牛痘

参考例句：

• Local health officials then can plan the best times to vaccinate people.这样，当地的卫生官员就可以安排最佳时间给人们接种疫苗。
• Doctors vaccinate us so that we do not catch smallpox.医生给我们打预防针使我们不会得天花。

21 vaccinated   

[医]已接种的，种痘的，接种过疫菌的

参考例句：

• I was vaccinated against tetanus. 我接种了破伤风疫苗。
• Were you vaccinated against smallpox as a child? 你小时候打过天花疫苗吗？

22 journalism   

n.新闻工作，报业

参考例句：

• He's a teacher but he does some journalism on the side.他是教师，可还兼职做一些新闻工作。
• He had an aptitude for journalism.他有从事新闻工作的才能。

23 lethal   

adj.致死的；毁灭性的

参考例句：

• A hammer can be a lethal weapon.铁锤可以是致命的武器。
• She took a lethal amount of poison and died.她服了致命剂量的毒药死了。

24 incarcerated   

钳闭的

参考例句：

• They were incarcerated for the duration of the war. 战争期间，他们被关在狱中。 来自辞典例句
• I don't want to worry them by being incarcerated. 我不想让他们知道我被拘禁的事情。 来自电影对白

25 vaccination   

n.接种疫苗，种痘

参考例句：

• Vaccination is a preventive against smallpox.种痘是预防天花的方法。
• Doctors suggest getting a tetanus vaccination every ten years.医生建议每十年注射一次破伤风疫苗。

26 voucher   

n.收据；传票；凭单，凭证

参考例句：

• The government should run a voucher system.政府应该施行凭证制度。
• Whenever cash is paid out,a voucher or receipt should be obtained.无论何时只要支付现金，就必须要有一张凭据或者收据。

27 influenza   

n.流行性感冒，流感

参考例句：

• They took steps to prevent the spread of influenza.他们采取措施
• Influenza is an infectious disease.流感是一种传染病。