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The last pandemic with a death toll anything like (actually much worse than) COVID-19 is the still-ongoing HIV pandemic. It's entering its 40th year.

Trasmatta 6y ago
It's crazy to think about how HIV has killed some ~32 million people, and yet we rarely hear about it anymore. COVID probably won't even hit 4 million deaths (barring some much deadlier variant that we can't easily produce a new vaccine for).
- monoideism 6y ago
  Yeah, but that's > 3 million over 12 months vs 32 million over 40 years, the majority before 2010. AIDS was a huge deal back when there was no treatment for it.
  - Trasmatta 6y ago
    Right, I don't mean to downplay the severity of COVID at all. It's just interesting that we generally don't hear a lot about HIV/AIDS anymore, even though there were still 690,000 deaths associated with it in 2019. I also realize that probably depends largely on where you live.
    - retsibsi 6y ago
      > I also realize that probably depends largely on where you live. Yeah, I think this can largely be explained by the usual tendency to focus on our own backyards. Google says 'nearly 13,000 people with AIDS in the United States die each year', and I assume the rate is similar in other wealthy countries. Even if we assume the full total is causally attributable to AIDS, that's significantly less than the usual toll from flu, which we also tend to treat rather casually (which isn't to say that we should).
    - jfengel 6y ago
      The treatments for HIV are incredibly effective, if you can afford them. It can even reduce your viral load to undetectable. There is a campaign that Undetectable=Untransmittable, to reduce the stigma associated with it. I have to admit I don't know if I'm comfortable with having unprotected sex with someone who had the virus, but the data says it's safe. There is also pre exposure prophylaxis, which isn't a vaccine but does dramatically reduce the risk. Between the two, the disease just isn't the problem it used to be -- assuming you can afford it. In poor counties it's still a problem.
    - XorNot 6y ago
      HIV is not a proximity transmissible disease so the reality is it's well controlled anywhere you've managed to get the use of barrier contraception methods into widespread adoption. And at the end of the day if it can't spread through casual contact then it's impact on wider society will be limited once it's understood.
    - astura 6y ago
      HIV is only transmitted during the exchange of bodily fluids. Beyond that, we learned to treat it extremely effectively, today if someone who is HIV-positive adheres to their antiretroviral therapy they have a normal life expectancy.
- HPsquared 6y ago
  We heard about it a lot when it was new and unknown. Now it's better understood, not so much.
- gher-shyu3i 6y ago
  Because any attempt to address the underlying cause of spread of HIV will be deemed as homophobic or backward in today's culture.
  - blueline 6y ago
    You’re right, that worked super well when Reagan gave it a go
- Izkata 6y ago
  Also tuberculosis, which kills 1-2 million people per year.
mensetmanusman 6y ago
1 million per year... endemic versus epidemic
mhh__ 6y ago
The response to Covid has also been night-and-day compared to AIDS - e.g. Trump was - I would argue - criminally negligent and disrespectful to the victims, but the Reagan admin were cracking jokes about it for example. https://www.vox.com/2015/12/1/9828348/ronald-reagan-hiv-aids https://www.vox.com/2015/12/1/9828348/ronald-reagan-hiv-aids PEPFAR is also one of the more important things the US has done, i.e. there are something like 20 million people alive today thanks to the program.
DoreenMichele 6y ago
HIV is not spread casually. You don't get it because someone with it shook your hand or coughed in your general vicinity like you can with covid. HIV gets transmitted by sex, sharing needles or similar. So, no, it's not comparable. It's vastly easier to avoid. Nonetheless, they've made a lot of progress on treatment since I first began hearing about it in high school.
akvadrako 6y ago
Considering the flu kills about 500k people every year, one year of Covid is comparable.
tinus_hn 6y ago
With PReP and PEP HIV is preventable, containable, manageable and no longer leads to AIDS and death. It’s just a chronic infection with no health effects. Is it really still considered an ongoing pandemic?
- stormbrew 6y ago
  Yes, because it continues to spread widely and access to treatment, let alone PReP, is extremely uneven across the world. Both PReP and antivirals are also not easy. You don't just get a shot and not worry about HIV for a few years, you have to take a pill every day as long as you're sexually active, and then treatment antivirals are expensive and need to be used consistently as well. One person slipping up can mean a lot of people catch it. Even assuming you know you have it to begin with, which is often not obvious until you've been a carrier for a while. Never mind religious groups going around vilifying condoms doesn't help. It's getting better, but yes it is still considered a global pandemic. I mean, it's not the same thing as COVID but like COVID it carries with it its own unique challenges and at no point has the world dumped billions of dollars into single-use vaccines for it like we've done with COVID. Its stigma has migrated (or compounded) from a "gay disease" to an "african disease". Honestly, I really hope that one silver lining out of all this is that an mRNA vaccine for HIV might get some development now. There was some work that way before everything got diverted to COVID and now that tech has proven itself so...
  - tinus_hn 6y ago
    If taking a pill to protect your own life every day is too much hard work we are doomed. But we aren’t, as PReP both protects people from infecting others as well as getting infected themselves. So no, an infection does not require one person to slip up. For an infection to occur requires both persons to slip up. Getting PReP requires regular HIV tests so it is in fact obvious that you are infected, if you get infected. Of course this indeed only solves the issue in the developed world that can pay for (and wants to use) this medication but there really is no way around that. People that don’t want or can’t pay for this medication won’t want and be able to pay for a vaccine either.

Trasmatta 6y ago

It's crazy to think about how HIV has killed some ~32 million people, and yet we rarely hear about it anymore. COVID probably won't even hit 4 million deaths (barring some much deadlier variant that we can't easily produce a new vaccine for).

monoideism 6y ago
Yeah, but that's > 3 million over 12 months vs 32 million over 40 years, the majority before 2010. AIDS was a huge deal back when there was no treatment for it.
- Trasmatta 6y ago
  Right, I don't mean to downplay the severity of COVID at all. It's just interesting that we generally don't hear a lot about HIV/AIDS anymore, even though there were still 690,000 deaths associated with it in 2019. I also realize that probably depends largely on where you live.
  - retsibsi 6y ago
    > I also realize that probably depends largely on where you live. Yeah, I think this can largely be explained by the usual tendency to focus on our own backyards. Google says 'nearly 13,000 people with AIDS in the United States die each year', and I assume the rate is similar in other wealthy countries. Even if we assume the full total is causally attributable to AIDS, that's significantly less than the usual toll from flu, which we also tend to treat rather casually (which isn't to say that we should).
  - jfengel 6y ago
    The treatments for HIV are incredibly effective, if you can afford them. It can even reduce your viral load to undetectable. There is a campaign that Undetectable=Untransmittable, to reduce the stigma associated with it. I have to admit I don't know if I'm comfortable with having unprotected sex with someone who had the virus, but the data says it's safe. There is also pre exposure prophylaxis, which isn't a vaccine but does dramatically reduce the risk. Between the two, the disease just isn't the problem it used to be -- assuming you can afford it. In poor counties it's still a problem.
  - XorNot 6y ago
    HIV is not a proximity transmissible disease so the reality is it's well controlled anywhere you've managed to get the use of barrier contraception methods into widespread adoption. And at the end of the day if it can't spread through casual contact then it's impact on wider society will be limited once it's understood.
  - astura 6y ago
    HIV is only transmitted during the exchange of bodily fluids. Beyond that, we learned to treat it extremely effectively, today if someone who is HIV-positive adheres to their antiretroviral therapy they have a normal life expectancy.
HPsquared 6y ago
We heard about it a lot when it was new and unknown. Now it's better understood, not so much.
gher-shyu3i 6y ago
Because any attempt to address the underlying cause of spread of HIV will be deemed as homophobic or backward in today's culture.
- blueline 6y ago
  You’re right, that worked super well when Reagan gave it a go
Izkata 6y ago
Also tuberculosis, which kills 1-2 million people per year.

mensetmanusman 6y ago

1 million per year... endemic versus epidemic

mhh__ 6y ago

The response to Covid has also been night-and-day compared to AIDS - e.g. Trump was - I would argue - criminally negligent and disrespectful to the victims, but the Reagan admin were cracking jokes about it for example. https://www.vox.com/2015/12/1/9828348/ronald-reagan-hiv-aids https://www.vox.com/2015/12/1/9828348/ronald-reagan-hiv-aids PEPFAR is also one of the more important things the US has done, i.e. there are something like 20 million people alive today thanks to the program.

DoreenMichele 6y ago

HIV is not spread casually. You don't get it because someone with it shook your hand or coughed in your general vicinity like you can with covid. HIV gets transmitted by sex, sharing needles or similar. So, no, it's not comparable. It's vastly easier to avoid. Nonetheless, they've made a lot of progress on treatment since I first began hearing about it in high school.

akvadrako 6y ago

Considering the flu kills about 500k people every year, one year of Covid is comparable.

tinus_hn 6y ago

With PReP and PEP HIV is preventable, containable, manageable and no longer leads to AIDS and death. It’s just a chronic infection with no health effects. Is it really still considered an ongoing pandemic?

stormbrew 6y ago
Yes, because it continues to spread widely and access to treatment, let alone PReP, is extremely uneven across the world. Both PReP and antivirals are also not easy. You don't just get a shot and not worry about HIV for a few years, you have to take a pill every day as long as you're sexually active, and then treatment antivirals are expensive and need to be used consistently as well. One person slipping up can mean a lot of people catch it. Even assuming you know you have it to begin with, which is often not obvious until you've been a carrier for a while. Never mind religious groups going around vilifying condoms doesn't help. It's getting better, but yes it is still considered a global pandemic. I mean, it's not the same thing as COVID but like COVID it carries with it its own unique challenges and at no point has the world dumped billions of dollars into single-use vaccines for it like we've done with COVID. Its stigma has migrated (or compounded) from a "gay disease" to an "african disease". Honestly, I really hope that one silver lining out of all this is that an mRNA vaccine for HIV might get some development now. There was some work that way before everything got diverted to COVID and now that tech has proven itself so...
- tinus_hn 6y ago
  If taking a pill to protect your own life every day is too much hard work we are doomed. But we aren’t, as PReP both protects people from infecting others as well as getting infected themselves. So no, an infection does not require one person to slip up. For an infection to occur requires both persons to slip up. Getting PReP requires regular HIV tests so it is in fact obvious that you are infected, if you get infected. Of course this indeed only solves the issue in the developed world that can pay for (and wants to use) this medication but there really is no way around that. People that don’t want or can’t pay for this medication won’t want and be able to pay for a vaccine either.