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The Agency of the Irresponsible

Like many faculty at state universities, the beginning of this school year brings me more terror than excitement. Colorado Mesa University (CMU), the institution at which I have taught since 1999, will require neither masks nor vaccines for students, and faculty cannot enforce mask mandates in the classrooms. This flies in the face of best practices for public health. When I asked the reason for this policy, I was told that there were strong feelings on both sides.

“Strong feelings” is clearly code for the fact that CMU is in a politically conservative region where there is strong resistance to both vaccination and masks. These words remind us that public health measures have always been politicized. Because I teach about HIV and AIDS and because I was a young adult in the 1980s, it is that pandemic that is foremost in my mind as I try to negotiate my own and my students’ safety.

As a young adult in the 1980s and 1990s witnessing the beginning of the HIV/AIDS epidemic, I saw dangerous disregard for common-sense public health measures every day. Even after we learned that condom use was largely effective in stopping the spread of HIV, hatred and politics kept information about condom use out of the American public health response.

When Surgeon General C. Everett Koop took office in 1981, he called for explicit instructions in public schools on condom use. He was prevented from addressing the epidemic from the time he took office in 1981 through 1985, years that could have been used to slow the spread of a deadly virus. In March 2011, he wrote, “[For] reasons of intra-department politics that I can still not understand fully, I was cut off from AIDS discussions and statements for the next five years.” He continued, “My exclusion from AIDS was just another facet of Washington politics, especially the disturbing interplay between politics and health, which – no surprise – still goes on today.” While Koop died well before the COVID-19 pandemic, that disturbing interplay has shaped recent public health responses on local, regional, national, and international levels.

In the 1980s, those who resisted educating Americans about condoms usually couched their arguments in terms of morality. In 1983, Patrick Buchanan, then a news commentator and a former advisor to President Richard Nixon, ended an opinion piece for the New York Post with: “The poor homosexuals; they have declared war upon nature, and now nature is exacting an awful retribution.” By 1987, President Ronald Reagan began calling AIDS “public health enemy #1” but urged abstinence education rather than condom use. “After all,” he asked, “when it comes to preventing AIDS, don’t medicine and morality teach the same lessons?” The tragedy of the 1980s remains that political vitriol stood in the way of good public health measures. The HIV/AIDS epidemic could have followed a very different path.

Currently, opponents frame their resistance to an equally effective prophylactic measure, mask use, less in terms of morality and more in terms of freedom. Western Colorado’s US Congresswoman Lauren Boebert has derided masks as “totalitarian.” In June, a group of Mesa County residents testified at a county commissioners’ meeting that masking violated their civil liberties. They asked the commissioners to declare Mesa County “to be free of state and federal laws.” More recently, residents disrupted a school board meeting, “shouting anti-vaccination and anti-mask messages.”

In this atmosphere, the CMU administrators have bowed to local pressure, adopting a policy they call “mindful masking.” Dr. Amy Bronson, a member of our COVID-response team, described the policy in The Daily Sentinel in this way: “If you’re in a crowded indoor space, it’s probably best to mask up in that scenario. If you’re out in the grass eating lunch with friends, you probably don’t need to.”

Read entire article at Nursing Clio