The response to COVID-19 in the United States was disastrous, in my view. Like the AIDS epidemic that preceded it, COVID-19 has not been handled well. Efforts to control COVID-19 have been hampered by our increasing polarization, along with the willingness of politicians and commentators to weaponize public health issues.

It is frustrating to witness.

I have resigned myself to what I did not want to face for years: ignorance, paranoia, and anti-intellectualism are ascendant in my country. The fissures that could lead to the disintegration of the American Experiment are in place, deepening at a rapid rate. It may be too late to turn the situation around. Despite my pessimism, I find a glimmer of hope in looking back at the AIDS epidemic and one of its key figures: C. Everett Koop.

Charles Everett Koop, the 13^th Surgeon General of the United States, is the only surgeon general I immediately recognize. His heavily bearded face, beset with glasses, and the immaculate gold trim set against his onyx uniform was a familiar sight in the 1980s. While Surgeon General Koop soberly informed Americans of the dangers of smoking, I remember his work to slow the march of AIDS the most.

 

As a child, I only knew Koop was the surgeon general and seemed to be genuinely concerned about the health of Americans. Later, I discovered the steep opposition he faced for positions he refused to take at the behest of the Reagan Administration and scientific information he provided to Americans.

 

Everett Koop was appointed by President Ronald Reagan as Surgeon General in 1981. It was widely assumed that Koop would bow to whatever demands Reagan and the growing Religious Right he sought to appease made of him. After all, Koop was a Republican and a Christian with pro-life views. But during his time in office, Koop would prove his detractors wrong. Reagan pressured the Surgeon General to issue a statement declaring abortion fundamentally unsafe for women on multiple occasions. A report from the Surgeon General condemning abortion as a threat to women’s health would make the Religious Right swoon. It could lend further weight to overturning Roe v Wade, a primary goal of Reagan’s base. However, as surgeon general, Koop refused to issue the statement. Koop’s refusal was based on one simple fact: there was no medical evidence to support it. Reagan fumed at what he viewed as a betrayal, but Koop remained firm.

 

Everett Koop becoming surgeon general was not the only significant event of 1981. In Los Angeles, New York City, and San Francisco, strapping young queer men were coming down with a host of strange ailments. Over the next few years, they started dying in alarming numbers. The cause was unknown, but similar patterns were emerging among IV drug users and Sub-Saharan Africa. The medical field hadn’t seen anything like this before. The patients’ immune systems disintegrated completely, leaving them vulnerable to infections that a healthy person could fight off with ease. Existing treatments had no impact, and the infected wasted away before experiencing a lonely and excruciating death.

 

SOMETHING WAS TERRIBLY WRONG. From California to the Congo, doctors and public health officials sounded a desperate alarm. We needed to figure out what it was. This new plague could be stopped if we mobilized, cooperated, and devoted enough resources before the carnage worsened…

That is not what happened, though.

By the time AIDS was taken seriously and the virus which causes it isolated, it was racing across the globe. AIDS wreaked havoc on communities, leaving death and devastation in its wake. In the early days of the epidemic, President Ronald Reagan-leader of the free world and the most powerful and influential nation on the planet-refused to address it.

But Reagan wasn’t satisfied with his own silence. He demanded the Surgeon General’s silence as well. A physician above all, Koop saw the emerging threat posed by this new disease. Casting aside the political concerns of Reagan, Koop wrote and published his report on the AIDS epidemic in 1986. But he did not stop there. In 1988 he went even further, mailing information brochures on AIDS prevention to every American household.

 

Now, from our perspective, in 2021, that may not seem like a big deal. But in the 1980s, it was hugely controversial. Discussing AIDS prevention meant discussing sexual orientation, drug use, bodily fluids, and condoms-topics a vocal segment of Americans did not want to address. In this brochure, Koop acknowledged that abstinence and monogamy are not the only ways to prevent AIDS. He also refrained from morally condemning homosexual men and heterosexuals who had sex outside of the strict confines of his personal religious views.

 

As with his refusal to parrot what Reagan dictated about abortion, Koop stayed the course. His leadership as Surgeon General had a significant impact on the AIDS epidemic. Koop’s actions and advocacy stripped some of the stigmas from the disease. When he left office, he continued his HIV/AIDS advocacy and pushed for people living with AIDS to be treated with compassion. These two actions earned the Surgeon General additional ire from conservatives, who were on his own side.

There are not many heroes of the AIDS epidemic. However, C. Everett Koop, in my opinion, is one of them.

He promoted the distribution of the information my generation needed to keep ourselves safe from a new epidemic.

Koop did not use an epidemic to stoke fears and resentment.

Koop did not encourage Americans to dehumanize one another.

And Koop did not play political games while Americans died. So, when I am nearly overwhelmed with sadness and disgust with the numerous bad actors endangering public health, I remind myself of the 13^th Surgeon General.

Footnotes

 

https://www.nytimes.com/2013/02/26/us/c-everett-koop-forceful-surgeon-general-dies-at-96.html?auth=login-google1tap&login=google1tap

https://profiles.nlm.nih.gov/spotlight/qq/feature/aids

https://www.theatlantic.com/health/archive/2013/03/doctor-not-chaplain-how-a-deeply-religious-surgeon-general-taught-a-nation-about-hiv/273665/