AIDS touched on a really essential tension that had to do with modernity or the nature of modern life toward the last quarter of 20th century. The public health profession was feeling like contagion had been conquered, or could be. In the 1970s small pox was eradicated, polio vaccines had diminished what had been a terrible scourge among children, there was vaccination for measles. It was a hopeful moment. At the same time that there was great faith in the advances of modernity, there was a feeling that maybe bad things were going to happen (because of modernity). That’s a persistent theme in western history, that something we’re doing, something that our parents or our grandparents didn’t do having to do with piety or sex or diet, somehow means we’ll “reap the whirlwind.” Then AIDS comes, and people talk about homosexual men like they're getting their comeuppance. Jerry Falwell even used that term about gay men “reaping the whirlwind.” As if something about the sexual revolution, the post-Stonewall moment, when people were able to come out as gay, had threatened society and society was now being punished. The response to AIDS was fraught with all sorts of ideas about what society was like, and a lot of that was about sex and sexuality, but more generally it was about the sexual revolution, the idea of tolerance of homosexuality, which was still a pretty new thing in those days. And it allowed people to talk about sex.
Can the post-9/11 anthrax “epidemic” be seen as a social coping mechanism?
Living in New York in the fall of 2001, I was really struck by a contrast of (reactions). On the one hand, the World Trade Center had fallen down, 2,700 fellow New Yorkers had just died, but the mood in the city was this kind of “keep on keeping on” circumspection. A month afterward there was the postal anthrax event, and the response to that was such a dramatic contrast. There were five deaths, and that’s sad and terrible for the families of the people who died – but that’s five, not 2,700. Yet in response to anthrax, people would come up to me and say “I’m ironing my mail” or “I’m not opening my mail at all.” Buildings got evacuated whenever somebody saw some white powder. I mean, it was nutty. You would have thought there would have been a nutty response to two iconic towers getting knocked down by planes, which seemed like a science fiction scenario, a horror story scenario. And yet the craziness was in response to anthrax.
Why don’t you think we should bother planning a great deal for the next plague?
We should plan very carefully for the things we know about. For instance, it seems reasonable that if you don’t inspect food supplies for contamination, some food will be contaminated and there will be outbreaks of salmonellosis. That’s the planning I would like to see be done. What concerns me more is the kind of planning that “this might happen” and “it might lead to that” and “it might lead to a third thing” -- scenarios that seem like a stretch. It's kind of like speculation times speculation. We need more real public health planning and less “preparedness.”