An article yesterday incorrectly reported the number of cases of Acquired Immune Deficiency Syndrome (AIDS). The number of new cases has doubled every six months, not the number of recorded cases.
Bill, 33, a victim of AIDS in New York City, called an ambulance when his fever reached 105 degrees. The drivers balked at touching him.
At Bellevue Hospital, after waiting 12 hours in a filing room, he says, he was wheeled into a service elevator by a gloved and masked attendant who shouted, "AIDS patient--keep away." When Bill vomited in his isolation room, no one would clean up after him. Later, he says, he was refused a bath.
Health officials and AIDS support groups say that Bill, who asked that his last name not be published, typifies many AIDS victims: first stricken by a deadly and incurable illness, then shunned by friends and associates who fear that they will contract it through casual exposure. Scientists say such fears are unwarranted.
No one knows exactly what causes acquired immune deficiency syndrome, which suppresses the body's ability to defend against infection, but scientists say they have reason to believe that it is not transmitted by ordinary contact.
But because AIDS is new and in some ways mysterious and because it nearly always has proved fatal within three or four years, its growth from obscure origins in 1979 to the "No. 1 priority" of the federal public health apparatus has brought outbreaks of panic. AIDS mainly strikes male homosexuals, intravenous drug users, Haitian-born residents of the United States and hemophiliacs.
Recent instances of concern involving AIDS include these:
* New York State's largest association of morticians last month declared a 60-day moratorium on embalming remains of AIDS victims. The morticians lifted the moratorium under fire June 30.
* Three nurses at California's Santa Clara Valley Medical Center "resigned rather than be terminated," a hospital official said, after refusing to treat an AIDS patient. Two ambulance drivers in New York were fired for the same reason.
* Prison guards in several states have balked at close contact with inmates suspected of having AIDS. This has led to the firing of one guard in New Jersey. In New York State, the union representing prison guards has called for strict segregation of AIDS victims in the prison population and for the wearing of protective gear while handling inmates thought to be infected.
* In San Francisco, studio technicians threatened to walk out if two AIDS victims set foot in the studios of KGO-TV. They were slated to be interviewed for a show called "Demystifying AIDS."
* On a New York cable station, similar fears led to cancellation of an interview with AIDS victims, even after Dr. Roger Enlow, a city health official, agreed to swear an affidavit affirming that there is no risk of airborne infection.
* Police and firefighters in San Francisco, paramedics in San Antonio and jail personnel in Westchester, N.Y., are wearing protective gear--including masks, gloves, and in some cases gowns and shoe covers--whenever they come in contact with suspected AIDS victims.
* Blood bank officials in Detroit, New York, Chicago and Rhode Island have reported severe drops in blood donations, which they attribute in large part to a groundless fear of contracting AIDS.
* Washington-area surgeons and hospital blood-bank directors reported last month that patients, fearing a contaminated blood supply, have postponed surgery or donated their own blood for their operations.
* AIDS hot lines in New York, Philadelphia, Atlanta, Chicago, San Francisco and Los Angeles have been flooded with calls from persons who fear that they will "catch AIDS" from elevator buttons, swimming pools, court documents, relatives of AIDS victims or food handled by homosexuals.
"I got a call," said Dr. Harold Jaffee of the federal Centers for Disease Control in Atlanta, "like, 'I'm moving into an apartment, and I know that the person who lived there was gay. Should I scrub the place down with Clorox?' "
"They hear 'mystery,' and they hear 'fatality,' " said Dr. David Rothman, director of Columbia University's Center for the Study of Society and Medicine, "and they are ready to assume a sort of black-plague quality."
Echoed by other health professionals, Rothman emphasized the need to "make discriminations around the word 'mysterious.' There is a public readiness to equate absence of definitive knowledge with no knowledge whatever. The mystery is not 100 percent."
AIDS was first diagnosed in New York in 1979, and the number of recorded cases has doubled about every six months since. There have been 1,737 confirmed cases, according to the Centers for Disease Control; 678, or 39 percent, of the victims have died. The fatality rate climbs sharply in the older cases: more than 75 percent of the victims diagnosed before 1982 and more than 85 percent of the victims diagnosed before 1981 have died. No one is known to have been cured.
There is some controversy about whether AIDS is more likely caused by a single agent, as most researchers and the CDC believe, or by a "multifactorial" process--that is, repeated exposures under specific conditions.
Researchers agree, however, that AIDS is transmitted through sexual contact involving exchange of body fluids and perhaps by exposure to blood or blood products of carriers. In a few rare cases, it has spread through heterosexual contact; scientists do not know why it strikes homosexuals more often. There is no reason to believe it can be spread by casual contact or by an airborne agent.
The U.S. Public Health Service, in a fact sheet released last week, wrote:
"No cases have been found to date where AIDS has been transmitted by casual or even close daily contact with AIDS patients or persons in the high-risk groups. For instance, family members other than sex partners of AIDS victims have not developed AIDS.
"Ambulance drivers, police, and firemen who have offered emergency assistance to AIDs patients have not fallen ill. Nurses, doctors, and health care personnel have not developed AIDS from exposure to AIDS patients."
"The most powerful evidence we have," said Enlow, who runs New York City's Office of Gay and Lesbian Health Concerns, "is that the attack rate in health personnel and laboratory researchers is zero. That says something about transmittability. We know there has not been a single health or hospital worker--a group that would ordinarily be very exposed--who contracted it."
Said Jaffee: "People want somebody to say that we can guarantee you with 100 percent certainty that the disease is not spread in this or that way. We just can't do that. The public is asking for more certainty than is possible."
Jaffee said he would gladly take his children to eat a meal at the home of an AIDS victim.
"It's not spread through the air," said Dr. Dan Williams, a Manhattan internist who has treated many AIDS patients. "It's not spread through casual touching. I do it five days a week in my office. I shake their hands, feel their abdomens, listen to their hearts, look in their throats and provide a variety of normal functions without fear. You can say I'm living my convictions."
Among the general public, however, fear persists, leading, AIDS victims say, to insensitive behavior.
When an AIDS patient died three weeks ago in Queens, neighbors unsuccessfully tried to have his children removed from school as a health risk, according to city officials, who refused to identify the family. Garbage collectors refused to pick up trash from the house. Then a group of neighbors wrote to the victim's widow suggesting that she move somewhere else, the officials said.
Mike Callen, cofounder of Gay Men With AIDS, tells of a friend "who was dying and knew he was dying and during this period he heard about the 60-day moratorium by morticians. He was crying in his bed and saying, 'They're not even going to bury me.' "
Andrew Small, 30, a legal secretary in San Francisco, was called to serve on a Superior Court jury. When fellow jurors learned he had AIDS, they asked the judge to remove him. Small decided to leave without fighting.
Minor daily cruelties also cut deep, AIDS patients say.
"I was walking down the street in Manhattan," another New York victim said, "and I saw two friends I hadn't seen for a while. In a normal friendly greeting, I gave them a hug and kissed them on the cheek and shook their hands. They asked, 'How are you?' I said, 'Not too well, I have AIDS.' They got this very shocked look on their faces and literally ran away."
He said incidents like this make him feel "terrible, isolated and very angry."
"Not only are the patients made to suffer horribly, more than they would with the normal ravages of the disease," said Dr. Stuart Nichols of New York, who last year founded one of the first AIDS support groups, "but the panic wastes energy needed to solve the problem."
Bill, the victim interviewed about his experience in the hospital, said he is close to despair.
"I've had no contact with anybody on a human level for over a year," he said. "As far as any emotional support, it's nonexistent. The rejection is hard to take. I have enough problems physically, but the emotional strain is devastating."
Bellevue administrator Tony Knopp, asked to comment on Bill's description of his treatment at the hospital, said he doubted parts of the account, but added: "Anything is possible when you're dealing with 1,500 employes . . . . If in fact that did happen, we'd condemn it and not condone it."
At the close of the interview, after a long pause, Bill said: "I don't understand why you have to be two steps away from the grave before anybody will step in and do anything."