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• HIV & COVID-19: Comparing Public Health Crises

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  Kevin Karami: Welcome toPolicy Chats, the official podcast of the School of Public Policy at the University of California, Riverside. I'm your host, Kevin Karami. Join me and my classmates as we learn about potential policy solutions for today's biggest societal challenges. Joining us today is Greg Rodriguez, the Government Relations and Public Policy Advisor for the fourth district in the County of Riverside. We chatted about the comparisons between HIV and COVID-19. Greg Rodriguez serves as a Government Relations and Public Policy Advisor for Manuel Perez, the fourth district supervisor for the county of Riverside. He has years of government experience in a multitude of departments and policy areas, including health. Mr. Rodriguez, it is an honor to have you here with me today. 

   

  Greg Rodriguez: Thank you for having me, Kevin, appreciate the invite. 

   

  Kevin Karami: Awesome. So I think this is such an interesting topic that I've heard rumblings about, but I haven't really ever had a full fledged discussion with an expert. But before we get into comparing COVID-19 and HIV epidemics and pandemics and how they correlate, or maybe how they don't correlate. I think it's important that we first establish a foundation for context. Can you describe how the HIV epidemic began and what were the impacts at the time and how they affect us today? 

   

  Greg Rodriguez: Yeah. And I could probably take two hours just on this alone with them. I personally have been HIV positive noe for 35 years. So I was alive in and around when the height of this started to happen. Obviously, it began outside of our country. The 80s it was noticing, especially amongst gay men in San Francisco, New York, a high prevalence of pneumonia like symptoms disease. And so that's when basically HIV was discovered. You know, what we saw as many people dying, there were no, obviously no therapeutics. Testing was very difficult in the early days. Nobody knows how it was transmitted. It was a different health climate than most people didn't have insurance that were at least low-income or at high risk populations. You had a very unresponsive government. In fact, the government at that time in the United States that denied that it even existed or that it was simply a plague on a population they didn't approve of. Because of that, a lot of discrimination, a lot of isolation and not just isolation from government and public entities to individuals, but self isolation, self humiliation. Those even that didn't necessarily die from the disease but had it and we're committing levels of suicide that had not been seen. So really just a different, different era. Again, just a lot of ostracization and discrimination. Those were the early days. 

   

  Kevin Karami: Definitely, and something you said that was super interesting. And it kind of got the gears moving in my head was how there were some people who just outright denied it. And there was a lot of even though there was evidence and people could clearly tell that there was something going on. There was that denial. Even in government, it wasn't just the population. And so something that I thought of and I think you know where I'm going with this, is the way people were denied COVID-19 since it started in 2020. In that specific context, in the context of that with similarities and differences. Did you notice with COVID and HIV where there are some areas where you're like it's the same phenomena or maybe it was a totally different kind of denial.

   

  Greg Rodriguez: Yes, So there's both similarities and differences and I'm gonna start with the similarities because they're very few. Differences are many, but the similarities is that it was, it was a public health crisis. Both of them were, now, of course, in the eighties it wasn't recognized to the level that COVID was. Because again, it was relatively isolated in certain pockets of the world. Where COVID was an overnight public health emergency worldwide as we saw. And I use overnight loosely, but you know what I mean? Really within a month's time, the entire world was affected by it. The other similarity which you just referenced was the political polarization of a public health crisis. We had a president in the 80s that wouldn't even mention the word. And was a denier and many below him on both sides of the aisle. It didn't really matter whether you're Republican or Democrat. Then as we saw and as you mentioned, especially in the United States, it became a political weapon. Not just the masks and the vaccine, but from the very beginning, the denial of it that, oh, this is just the common flu and it's not going to affect anybody. Nobody's gonna die. Even when we're reaching three hundred thousand, four hundred thousand, eight hundred thousand deaths, that political polarization was still there. So those are real similarities. I see. The other similarity though that I see is. A single gentleman, Dr. Anthony Fauci, realized in both cases, this was a public health crisis and that's something needed to be done. You add at least public health officials both at the CDC NIH, in both cases that recognized it. But in both cases we had governmental bodies and political players that didn't want to listen to the reasoning in public health. That being said, though, I'll go to the differences and spring off my last comment and that there really was more of a public health response to COVID than there was HIV and aids. We really didn't see a robust response on HIV and aids outside of those that were really embedded in the research. Until the nineties, where we did see public health officials and not just in Washington DC. But I say this from one who worked very closely with our Public Health Department as the lead COVID person out of our office. Take this seriously from day one. Many people may remember that it was actually Riverside County on January 29th where the plane from Wuhan, China landed. So we really were the first county to be exposed to this. But our county health department took that very seriously and started preparing, working with our emergency management department and other departments across the gamut. But you also saw that in other county public health agencies as well, at least people did get, and again, I think this gets back to one of the differences that this was happening worldwide, unlike HIV. So I think that was the reaction. Also, just as I said, the healthcare landscape has changed. We look at public health more in a role than we did in the early eighties. When we talk about social determinants of health, public, public health plays a huge role in that. I think one of the benefits to out of this is that a lot more people know about the importance of public health now than they did before two years ago as well. Some of the differences to government response, even though I talk about politicization, you know, and I will give the Trump administration some credit about the response. I think it took a lot of urging from other people within political circles. But you did see the development of testing relatively quickly. You know, you did see at least work for vaccines. Now that's not totally attributable to Donald Trump as there had been decades of research, especially after Ebola breakout about the mRNA vaccine types and that fundamental type of research. The differences too is just the speed of treatment. I mean, we saw received more prophylactic treatments now, but the speed of the vaccine and the rollout of that and the way the FDA ruled that timeline versus HIV blown out of the water because it took years and years for anything like that. So that's kind of some of the major similarities and differences. 

   

  Kevin Karami: I think it's really interesting in a lot of ways for those of us who weren't around during the HIV epidemic, that there have been some positive changes. For example, even though there is still politicization and there's still those in government who deny it. It's not the way it was back then where it seemed like it was almost like a majority of people just outright denied it and those in power. Whereas now that there's at least more, when you mentioned that even though the Trump administration, there were obviously some problems with that, at least there was some response and we did get testing out relatively quickly. That being said, though, I think something interesting about both of them. And then really this might even apply to other crises as well that are health-related is the idea that social and cultural perceptions have an impact on whether or not governments will enact policy or will go after, will actually be active in trying to solve these issues. And I think I'd like to hear your thoughts on the idea that the idea that because HIV targeted some specific populations, because that was an era where LGBT rights was in a totally different place than it is now. And even though there's still a lot of work to do now, it's 40 years or so that has passed. There's been a lot of work done. What are your thoughts on those kinds of phenomena interacting with one another when social perceptions and stigma and stereotypes, we might not think of those as factors in health. But when you are a minority, when you identify as something that isn't considered ‘the normal’, that can have an impact on if you know your peers and people like you end up getting treatment or end up getting the attention they deserve. So can you maybe speak and kind of expand on that idea when these things intersect? Because I feel like a lot of people don't realize that they intersect.

   

  Greg Rodriguez: Yeah, absolutely they intersect. The HIV era is a perfect example, as to your point, is that nobody god forbid, even talked about marriage Back then, let alone employment rights and leasing and housing rights and all that you'd be left with, lived in the closet outside of your main metropolitan areas, that was it. The only time you ever saw other gay people was when you were in a bar, if you knew them from the bar where he worked with them and that was it. But to that point is because of that stigmatization. And again, because HIV targeted primarily a specific population, obviously some individuals outside with blood transfusions and pregnancy and stuff like that. It played a huge role in policy response, in government response in even the healthcare industry. I mean, you had you had facilities that would not treat HIV and aids patients, primarily aids patients at the end of life. How do you get over and shine a light on that stigmatism and a lot of criticism in the beginning of act up. But I tell you what they were the ones that may policy started to happen because they were vocal and they were telling people We may be a marginalized and forgotten community and discriminated. But we're still your sons and daughters were still your friends and coworkers and we're dying. And you have to realize that. And then I think that's where you really started to see the shift is when activists really made this not only a public health crisis, but to your point, to a social crisis and discriminatory type of practice that we got some. I would even stay out of COVID though to Kevin is that we saw this targeted at minority communities. At first it was Asians, then there was dialoguing. And because we know predominantly African-Americans that experienced diabetes at higher rates were being blamed because of what they ate and how they took care of their bodies. And that's still happened within COVID. One good thing about social media is that a lot of that can be debunked. The other bad thing about social media is that it perpetuates those lines. But again, I think what you had to I don't think I know what you had at this point was public health and a far more larger presence on mainstream media than you had in during the HIV crisis that was able to actually debunk some of those discriminatory statements and false claims upon people of color, people of different regions. And so hopefully we learned through this how to develop policy to prevent that from going forward. We always already have antidiscrimination ordinances on the books and all that. But What's the public health lens to your point? How do we do those social contract in relation to the public health and physical health concept of that as well. 

   

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  Kevin Karami: That's really, it's so interesting and I really like how you brought up the point about how it didn't, that kind of stigmatization didn't just disappear. That happened during COVID and how Asian-Americans became targeted. I remember it was, it wasn't even a week before or after the pandemic had started and quarantine started that you would see these sound like subways in public where they would get harassed and attacked? I do think that there is this is really more of a broader question and it really maybe it goes at the core of this. Obviously, The world has changed a lot since then, but there's still a lot of discrimination. Even though we have like you mentioned, there's policy, There's anti discrimination policy, but it still happens. It didn't just disappear with COVID as the example because that's what we're discussing that do you think that there do you think that that was a rational, do you think that these people were using logic and rationality in those responses? Or was it more so? That's a natural human response to automatically blame what you think is the problem. Even though logically we're talking here at, Hey, you know, that isn't gonna do with it. You know, your skin color doesn't have anything to do with it. There are other factors here. African Americans aren't biologically more likely to get diabetes. There are factors that affect them, they live in. Is it, is it just a human response that we automatically have to blame another group that were not a part of for our problems? Or do you think that there are other factors at play? I think it's a really vague and broad question, but I think it really maybe tackles the core of what, why these kinds of things happen in the first place. 

   

  Greg Rodriguez: I think it's a combination of both. It's a fantastic question, Kevin, I think I think it is human nature that when we're faced with fear or crisis, we're looking to figure out where it came from, who caused it. There is that fear. However, while I do believe there's a sense of human nature I think was escalated in the COVID case. I think what you saw is three years prior and you could even argue just the fracturing in the just the ideological divide that's been developed in unfortunately federal politics over the last 20 years, to be honest with you. But what we saw three years prior to COVID was that on steroids, the xenophobia, the racism. When you have a presidential candidate announcing a campaign calling. People of color from our next door neighbor, rapist and killers. And it just created this environment. The development of groups like Q Anon. The far right groups that, that's what they live on, is racism and fear and blame. And so when you have a community where it started of Asian descent, or you have people of color, both black and Brown who experienced at much higher rates, primarily health issues in the African-American community. But then you've got living situations within the Latino community where you have multiple families in a very small set quarters. So the spread is much more likely. Obviously, both communities are high in the service industry, so on the frontlines of essential workers. But I really do believe that while we always want to react as an individual on why is this happening to me? Who's to blame? And you hate to get into blame game. But I just think it was just so much more escalated. And then I'll get back to Kevin is just social media has played a huge role in that. You've got even mainstream media companies that feed into that. And when it's spread over and over and over and over again, it becomes part of peoples just regular dialogue. And unfortunately, it's mostly those that are uneducated that don't believe in science, whether it's around COVID or climate change and try not to get too political here, but I'm just trying to set the reality of working in a political environment that trying to set the reality of what kind of foundations were set for those type of happenings. 

   

  Kevin Karami: I think that's a fantastic way of putting in the point on how it was escalated and that there is, these routes existed even before COVID. Really in a way they've always existed. Even though there has been worked done. yeah, policy has been passed. But it goes beyond that. I do want to kind of pivot a little bit and I want to talk about social media specifically because it seems like every time we have a discussion is had about policy, about something going on in the world. Social media always has to come up because it had such an impact on how we interact with each other. What impact? This is again, another really broad one. I'm so sorry, but what impacts do you think social media had on not just COVID-19, but social media as these platforms. As a way for people to communicate. You mentioned the advantages and disadvantages of it. How has that played a role with COVID-19? How did the lack of that, that technology back then, how did that affect things when it didn't exist? So I guess what I'm asking you is, I was social media changed the way these kinds of crises, these are how we respond to them. 

   

  Greg Rodriguez: Another really good question. So let me do the history one first and we were still at pay phones and there wasn't even smartphones at that time, the big ones. So what you had more personal interaction, specifically on HIV and aids, you had many support groups that develop not only for those affected by the disease but for families. And so there was a lot more personal interaction. special books written and documentaries and stuff that you just are old traditional stuff that people used to do. When we only have three or four channels on TV and on 180 or something, social media has completely changed the game. And I will hearken back both positively and negatively. I'll hit the negative first because I like to end on a positive note. But obviously most of the negative has been the conspiracy theories, the racism, the dissemination of false health information. That was the biggest hurdle to get over. Especially when one working for an elected official that has a big role in communicating what was happening with COVID within our county. Having to combat the false disease, flat out lies about public health. With that being said, is a lot of positive though, the ability to communicate the spread was happening fast in 42 characters in under five seconds to get it online. Really the great effect to was an outside of what we consider traditional social media, I'm lumping websites as well with that and online platforms because we can start tracking where the prevalence of outbreaks, where we can get real-time data. We could get linkages to articles and public health and all that. As we moved into the testing social media was a huge tool for us because we can advertise where testing sites were. What are the parameters of testing? How often you should be testing? A lot of great memes and partner organizations. So it really got that word. Same thing was true with vaccines as well. Really to be able to connect the community to sources of vaccination. This is especially true in the young community. But more so too is like in our farm worker communities who a lot of them don't have cable TV or watch TV. Most of them were using WhatsApp or Twitter or Facebook. And so really, it really helped to do that again to is it helps too. Tamp down some of the negative and disinformation that always work, no, but it was a really good benefit, I think in the long run. 

   

  Kevin Karami: Yeah, it's, it's, it's such an interesting, It's so fascinating comparing how things are with social media in the last ten years or so and how it was before. And you mentioned the first thing you mentioned was personal interaction. And it's just so fascinating to talk about because it intersects in everything. That's why I feel like it comes up in every conversation. We always talk about a policy or maybe it's just a general policy area and it comes up, how does social media change things? How did it change the game? I didn't want to shift gears a little bit. Kind of going back to the main topic about the HIV, COVID-19 and these kinds of crises. And in general, do you think that these instances we'll see with COVID-19 because it's still happening. But do you think these instances prompt governments and societies? Governments and societies, and maybe even just people to be better prepared in the future. The reason I asked this is because I remember a TED Talk, I believe it was given by, by Bill Gates, maybe 6-7 years ago, roughly about a pandemic that with a virus and a lot of people after COVID happened, we're pointing at the ideas that he was talking about when we're saying, Hey, he literally said everything was gonna all of these things are gonna happen if you don't prepare. And then a few years later it happened. So do you think we're going to learn from COVID? Have we learned from these things from the past? 

   

  Greg Rodriguez: Let me, let me address HIV first. And I think especially as acceptance of LGBTQ Americans has come leaps and bounds. One hundred, three hundred sixty degrees. Still work to ago. But I think we realize to recognize a public health crisis, it's like this much quicker. I think we know there has to be a scientific lens on it. Additionally, even with HIV and aids, there was a real push for treatment. A perfect example is when the last few years with the whole PrEP and PEP and the ability to utilize medicines and treatments to prevent people from getting it. So if you're on PrEP negative with somebody who's positive but no viral load and on medications, their inability to transmit. There's been some good lessons learned out of that. Let me throw in Ebola in the middle of that. And I referenced this earlier. A lot of the research that was done for HIV and aids vaccines, which of course we still don't have yet, was utilized in the Ebola studies and work that was done after those outbreaks, which of course attributed to the speedup of the vaccination. For COVID. I do see some real lessons out of COVID in a couple of different areas. I'll start with the healthcare side of it first is that I know our public health department and I know many across not only the state but the country, are setting up infrastructure systems right now. Millions and millions of dollars and an allocated to these departments so that they can step up not only their testing abilities, but their internal processing abilities of test results, of documenting data better of utilizing dashboards, better dissemination of information, better response time, coordinating, and we did an incredible job in Riverside County or this could coordinating not only your inner county departments, but also working with your non-profits and your community-based organizations and other healthcare industry outside of the regular structure of the County Public Health Department. We've learned some great lessons and our public health right now is already building that type of infrastructure. Again, working in conjunction with other partners, community-based and for-profit within within the county. As far as on a federal level or research level with the healthcare lens is the development of a vaccine for HIV. There's a lot of talk now about if we were able to do this for COVID, why don't we renew our focus on communicable diseases such like HIV because I believe it's doable. But I think it took COVID-19,  to put that sense of urgency back in people more. On the economic side, because I think we can learn some lessons to HIV is perfect example as well. The hardships that people faced, and primarily again, because of the denial of that, again, because it really hit more vulnerable populations, lower-income gay men, primarily. African Americans, gay man of African American and even bi men and straight men. People of color too. But especially in COVID-19, I think I give our government a lot of credit through the CARES Act, the ARRP dollars, the amount of money that I went to public health, indirect allocations from the state or from the federal government to the states and down to the county. The need to Protect what was foreseen as the huge economic disaster because of the shut down, which was not the case with HIV and aids. That we responded very quickly with dollars rental assistance, dollar business improve, business retention dollars, employee retention dollars. But not just to react to it as we looked at, especially through the use of acronyms, I  apologize. The ARRP dollars, the American rescue and recovery plan. Look at how we're utilizing some one-time moneys to build up infrastructure and I'll use it physical infrastructure, housing, non-profit assistance. That we're creating. Infrastructure not only in that physical infrastructure, but also human capital, as well as public health infrastructure so that we are prepared if something like this, god forbid happens, again. I believe that if any crisis, there's always something that can come good out of it. This was a horrible two years, but I'll tell you just one instances in our homeless population here in Riverside County where we started what was called Project room key. Even before the state started it, we took money out of the cares Act dollars because of the fear of it's spreading so fast in our congregate homeless settings, especially those on the street, it rented hotel rooms and gotten individuals their own hotel rooms. But what we did is we didn't just put them in that room and leave them alone. We actually actively case manage them, actually set up housing exit plans. Through that, our success rate and permanent housing for those individuals was 65%, which is unheard of in a shelter type setting or housing first model. And so really, really highly effective. And so how do we learn lessons like that going forward now, of course, we're running out of the money for that. But my point there is how do we look at new policy decisions and new allocations where we learned something that worked really well and do that on an ongoing basis as well. 

   

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  Kevin Karami: I think that's so, so great to hear that. Some things you said that stood up so much was we didn't just put them in hotel rooms and said, alright, good luck. There's follow-through. And I think that is the crux of it. That's the, that's the point that sometimes gets lost. It's not just taking an action, it's following through and actually making sure that it works the way it was intended to work. And another thing that you talked about throughout that answer was also, there's this interdisciplinary nature when it comes to solving these kinds of problems. It's not just, it's not just a health crisis. There's a social aspect, there's a housing one that you just mentioned. Um, and I think again a lot and I mentioned this earlier. A lot of people don't realize that all of these things intersect. And it's important that we address if you just have only an answer for one of the issues, we aren't really solving the problem. Economics and it's not, you know, there was a lot of talk about that. Earlier on. Smaller businesses were being shut down and talk about as a public health crisis, but also what about small businesses, these family-owned businesses? How do we, how do they keep going? When there's so much to handle when you have to juggle all of these different factors. And sometimes you might, because of funding, you might not have the ability to address everything. How do you this is part of the work you do like you mentioned, how do you manage that? I mean, when you look at this and you see housing economics, health, social problems, how do you even go about managing all that? 

   

  Greg Rodriguez: You use the perfect word? It's an interdisciplinary approach. I talked about our reaction immediately after that plane landed is we basically built up a war room for lack of a better word, that was within a one to two week period and within that was Emergency Management, Public Health, Department of Publicand  Social Services or housing and Workforce Solutions Department. I can go on and on on the number of agencies that were involved, obviously our executive office board representatives. But what there was basically stations set up. It's like what is something somebody's having an issue with public health but having access to resources. And then as the closer started to happen, the county formed in economic recovery task force on that. We're not only business representatives, public health representatives, social service representatives. It really was the ability to communicate across sectors. As we move further into it, we realized we couldn't do this on our own as a government. That's as I said, that's when we brought in our Community-based organizations. This is like the desert healthcare district, United Way lifted to rise TO deck. Numerous organizations not only help us to get the word out, but also the feedback, what they were seeing within the consumers that they serve. And what were the economic needs? What were the social needs? What were the public health needs? Our county was the first county to launch an outreach campaign on vaccinations and testing to the farm worker community. They couldn't leave the fields to go get tested or get vaccinated. So what did we do? We took the testing and vaccination out to them, worked closely with the growers. And central in California, took the model and ran with it as well. So the word you use is perfect. It's interdisciplinary reaction to it. Another thing that's come out of this highly related as the county right now is embarking on what we call an integrated service delivery model. It's not just specific to COVID, It's county wide is how do we look at how are we delivering our constituents data-driven solutions but across sectors. Just give a really brief example is that say you have a family, either the mother or father gets incarcerated. The punishment they get put in jail. But we don't a look at what's happened with the family units. So part of this whole model is, let's reach out to either the wife or the husband because obviously some source of income is probably been loss. There's probably some emotional trauma on not only the spouse, but the children. What does that do to their school settings? So how do we involve the school district into that? Is there any behavioral health needs, is there any workforce development needs for the remaining spouse and addressing those concerns then? And that's across very many departments. But more importantly to it's not just leaving the incarcerated individual just to serve their time, but how are we working with them so that then they exit the system back to that family. If they need any substance use treatment that they're getting it. If you need any behavioral health treatment that they're getting it, do they need counseling, integration back into the family setting? And so that's one example of something that's a huge, huge systems change. But a lot of that came out of COVID. And to your point about the interdisciplinary approach that we had to take to address that crisis. 

   

  Kevin Karami: That's so great to hear these past two years. You've heard a lot of rhetoric and a lot of talk about, about how it's going to take all of us to solve the issues in a way you just described. You just described that. You describe all of these organizations, government agencies, non-profits, for-profits, all these people coming together to address these different problems because it really can't be done by one personal or by one group or by one government agency or whatever, because it's too big for one. But if everyone works together and I think that's such a, such a great note to talk about that if people do come together, there are actually ways to solve these problems. And yeah, it's difficult and it's gonna take funding, but there are avenues to actually get there. One thing in this kind of goes off in about one thing I do want to ask before we end is policy. After the HIV epidemic started going downhill? Was there any policy? Was there something maybe it happened decades after. And also in this probably this is more of a hypothetical, but what kind of policy changes at a federal, federal level, state level do you think might happen or maybe even should happen as a response to the COVID-19 pandemic?

   

  Greg Rodriguez: on The HIV. Probably one of the biggest policy initiatives, policy initiatives that ever happened with the Ryan White Care Act. Because it provided substantial amount of money, mostly to our federally qualified health clinics, but to other healthcare settings to address not only the illness, but more importantly the medication prevention and hopefully development of vaccinations one day or a treatment. I would argue too that we would not have had the marriage discussion probably for another ten years if it wasn't for HIV. HIV almost forced, not almost in many cases, forced people come to, come out of the closet. I'll get back to the point to is that family members, mothers and fathers and brothers and sisters and relatives, coworkers, church, fellow church people started realizing they knew someone that was gay. It changed attitudes it changed thinking. And with that, came changes not so much at the federal level unfortunately, but at state levels of equal employment opportunities, equal housing opportunities, and then eventually marriage, adoption, adoptive father of two kids who are 25 and 26. And when we adopted them, gay men, we're not having children unless you had exited from a straight relationship. Just groundbreaking, stuff like that. Obviously, there's still work that needs to be done at the federal level. And unfortunately, what we're seeing rise up again and they're utilizing the trans community to do this. Is this hate for the LGBTQ were groomers. Now, we're getting back to that rhetoric. It's a shame so much progress was made, but until we get some federal action, again, I could go on to ours. Have we changed that? But on the COVID, it's a little early to tell. I would argue fully funding public health and the CDC, not politicizing it. That's not really a policy decision, but the funding is. I'll get back to some of the ancillary things that happen too, and that we need to find affordable housing better at the federal level. We need to fund homelessness services better. We need to fund County Behavioral Health Departments better.

   

  I can go on and on. And the President in the build back better plan. Unfortunately, that is dead now, a lot of that was in there, and a lot of that was the result of what we saw, what COVID did. I hope I'm an optimist most of the time that will piece by piece address that. But more importantly, I think where you will see hopefully policy and not per se written policy but policy within CDC and NIH and private manufacturing drug manufacturing companies is development of not only a vaccine for HIV. But also the continued research that God forbid something like this happens again. That we can respond in a quicker manner. 

   

  Kevin Karami: I think that it is really, really talk about, but I still think it's important. And one thing I did want to ask before we end is we've talked about a lot of things about the numbers of the science and the interdisciplinary nature. One thing I also think is interesting, and I've heard this talked about in other contexts is the idea that people, especially nowadays as a result of information being so quick, people tend to forget really, really quickly. Do you think that that could possibly happen? And I didn't even heard that some people say it's already begun at people who were attentive and were they weren't COVID deniers back in 2020 And maybe last year as well. But now that it's going downhill, it's not as big of a deal. Do you think people are gonna start taking it less seriously? Does that mean that that could lead to consequences down the line with COVID resurging or other problems down the line. Is that a possibility? 

   

  Greg Rodriguez: It's already happening and it's been happening for a few months down. I think that's why you saw when the Omicron 2 the first variant subset of that came out that I think that's why you saw the level of infection spikes so quickly is because by then the vast majority of people in the country outside of the areas like LA County, New York, San Francisco, Seattle that already had still in place, strict mask mandates, social distancing all that. But I believe that's for a reason. You saw a lot of the rise. I will say even though after you've been vaccinated and boosted, and for some of us we can be boosted again. Is that you just see an attitude. I live in a very high a tourist area and I'm telling you we just had two weakens of Coachella with 125 thousand people maskless and close together. I'm attending stagecoach tomorrow and you know, but your bars are Fuller. I think people are still attentive. Some, but I do believe that people feel safer and I too worry about that a little bit. To be honest with you, Kevin, I don't know how I got through 2.5 years without getting it, I really don't. I was careful, but I was also in situations where I should've got it. But I'm not one of those people. I'm still very attentive. I took a flight back to visit my father this past weekend and the woman on the plane next to me, he was in a mask and I just asked her, I said would make you feel more comfortable to wear it if I were to wear a mask and she goes, You know thats really nice of you to ask it would and so I put it on The think we need to be respectful of those that are still concerned. And I would imagine and she didn't disclose to me, but she might have had some underlying immunocompromised condition. And so I just think if we act like that, what I will say though Kevin, is that even maybe the general public maybe just settling away from it after having to deal with it for 2.5 years. Is that I know that our public health departments in our healthcare fields and all that still know that there's the possibility something like this could happen. Again, we have seen somewhat of a slight resurgence in the second variant, but from all the data I've seen and especially the data I looked at in California in Riverside County, It's not as serious as far as getting ill, especially if you've been vaccinated and boosted, we're not seeing our hospitalization rates raised. In fact, they're declining. And so I know that's a long answer question, but I do believe that unfortunately, I think it's just fatigue, Kevin too. It's just been, you know, we've got treatments now and it still can be spread. And that's important to let people know, especially if you have vulnerable people in your household. If you're older and you haven't been vaccinated or boosted, there's still deaths happening. But I think it's just we're not seeing the level that it was that fatigue is setting in. Just want some sense of normalcy again.

   

  Kevin Karami: Like I said, you mentioned it too. It's totally it's almost like it's kind of expected. People at some point will get fatigued and it happens in other areas. And then you see the same thing being reported on and being talked about. It's something that people just kind of get bored of it and want to move on. Even if it is something that is real in effecting us. There is some fatigue and like you mentioned, rates are going down. The last, the last varient, wasn't as big of a deal. It's still important and still something that we need to be thinking about it. And like you mentioned, the experts are still ready. There are still and now that we have a few years of knowledge, I think more than ever, we're more prepared than we obviously will be four. But it's just really interesting to talk about that. Human, the way our psychology works that sometimes even something super serious can just become, well, we become nonchalant. It's fine. I have the vaccine or whatever. And you mentioned, you know, Coachella had 120 thousand people maskless. So it's really interesting to talk about how our psychology and sometimes our biology can impact our decisions on these kinds of things. It's just super fascinating. 

   

  Greg Rodriguez: If I could circle back to the relationship with HIV is that as treatments became available. Was all about protected sets before. And obviously we stop blood donations from the gay populations and all that. But once treatment started coming around, the level of interest in Protected Setup dropped precipitously. So it really was the same thing. It's still the community had lived with a change in lifestyle for at that point, you know, 10-15 years. Then as you felt, not as many people are dying, as people are getting sick. It's like we can go back to some of the practices that we wanted to do. Now, keep in mind there's, some of us are still very active. That's still say there are still risks. And not necessarily HIV and aids now, but STDs and all that. And again, the healthcare industry. I just wanted to relate that back because that's how we started the conversation as the similarities and differences between COVID and HIV. And it was the same thing. 

   

  Kevin Karami: I love that you brought that up. It's just fascinating it, and the fact that it's you, you can bring that example just goes to show that we sometimes, its so interesting to study the way we react to certain things. And I guess it's almost like a risk, risk assessment type of term that has been brought up to with COVID. It just sets the risk of certain things and at some point that people, people who are healthy and don't have these other conditions might say, You know what, it's worth the risk to do whatever it is that I wanted to do. It's just really fascinating. And the fact that you brought that up just exacerbates that feeling that these things happen and people have responses and sometimes the responses aren't the most illogical orrational, but we're not always the most logical or rational creatures, right? Sometimes we just do things because we want to. That's just another factor in the mix of all the factors we talked about. That being said, Mr.Rodriguez, we're at the end of our time. Thank you so much. I learned so much about not only HIV, but also about how COVID relates, how it doesn't relate and it just so fascinating the similarities and the differences. And I found that some of the similarities are really, really fascinating. And that on a positive note that there have been changes after HIV and there has been some positive change with COVID. But on the negative side, there's also something that, you know, human nature just persists and won't let go of. But it's important to still talk about. So it was an honor to have you on here with me today. It was it was an amazing conversation.

   

  Greg Rodriguez: Thank you for the opportunity Kevin. I appreciate it, anytime. 

  
  Kevin Karami: This podcast is a production of the UC Riverside School of Public Policy. Our theme music was produced by C Codaine. I'm Kevin Karami.