Carolina Journal; Aids Update

A production of the South Carolina Educational Television Network. The epidemic could affect all of us. It's spreading so fast that some scientists say it is the most serious threat to man's survival since the bubonic plague. Tonight on Carolina Journal a look at some of the ethical and public policy ramifications of AIDS when reading your prospectus always determine if your investment is a registered offering or an interesting offering. Contributing Editor Steve Judas has more to say about limited partnerships as investment opportunities and you'll find out about lasers and their applications in the workplace particularly in heavy industry. All tonight on Carolina Journal. Good evening I'm Mike Collins. AIDS acquired immune deficiency syndrome is spreading at an alarming rate. It is almost impossible to pick up a newspaper or a magazine or watch a TV show of this type and not read or hear something about

AIDS. Still there is a great deal of misinformation about the disease and AIDS has begun to raise some serious social and public policy questions questions that desperately need answers. Tonight in segment one of Carolina Journal we welcome the commissioner of the south part of the problem of Health and Environmental Control Dr. Robert Jackson welcome. Don't waste too much time with preliminaries we get right into this there are twenty eight known cases of AIDS in South Carolina four in a can Cal you see when Anderson wanted to Buford went to Berkeley six in Charleston three in Cherokee one in Florence two in Greenville. Seven in Richland County one in Sumter County. And I would think that for a state with a fairly small homosexual community these are fairly alarming statistics are they are or are they not. I think they're about par for the course in terms of what we would expect based on national statistics if you know the disease is now primarily a problem in large urban centers like New York and San Francisco where there's a large gay population has the AIDS

issue because of the fact that it is increasing geometrically and it's such a seemingly rapid rate as the AIDS issue seems to be a homosexual issue exclusively. Absolutely it is. It is really not been that although the the overwhelming majority of the cases that we're now identifying are in fact in gays but the the 17 percent. I've been from other causes. The primary one the one that has been of particular public interest has been from blood products in other words a blood transfusion or a product made from blood that was contaminated. We have talked about this issue a number of times on this program and we will get to talk about how it is contracted in all those nuts and bolts questions but there are some other serious things have cropped up in in the meantime now that the country's becoming more aware of all this which I like to cover first. The Center for Disease Control in Atlanta says that 4000 people died in this country in April due to AIDS in July that figure rose from 4000 people to eleven thousand people. In your experience in the public health

sector how does that stack up against other serious contagious diseases in terms of the rapid increase of affected people. And can we continue to expect that kind of a geometric pattern. Well I think it's easy to look at numbers like that and get it a little bit out of perspective. The fact of the matter is it is a very infectious disease. It is a disease that takes a certain number of conditions to exist before. It can be spread and it is not like the common cold or any of a number of relatively well understood things easily spread among people it's very difficult to spread but when those conditions are there it will pass the other thing is that the incubation period for the illness is so long anywhere from two to five years in many people that from the time of exposure to the time you actually develop symptoms the because of that long period of time our counting process makes it appear that there are a lot more cases suddenly growing and rapidly increasing.

Is that a reason even more of a reason to be alarmed and to be afraid. Because the incubation period is what two to three years. That we really don't know what's here now or what's worse what's ahead of us down the road. We can do some pretty meaningful extrapolations of the data that we have and draw curves and show what we project and so far those projections have been pretty accurate so we've we've been able to pretty well target the expansion of the disease and we know pretty well what's going on from an epidemiological point of view. I don't think that it is that it is doing anything that is really unexpected given the information that we have but it is still alarming and it's still very serious and we are not yet at the point where we're talking about solutions to the problem in any way. OK some nuts and bolts. How do you get it. OK. AIDS is spread through the transmission of some kind of body fluid from one person to another. That includes a life not as far as we know although the virus has been cultured from saliva. OK. The two ways in

which most cases have been found to have been caused have been either through the transmission of blood products from one individual to another or in most cases semen from a from a male either to another male or to a female sex partner. There's a much lower rate of transmission from females to males because little fluid transfers. In that in that heterosexual process from from the female to male. But on the other hand from male to female it does. Those are the two main ways that the spread has been confirmed. Now there are a lot of other possibilities of course a lot of research is going on. AIDS virus has been identified in tiers it's been identified in virtually every body fluid that has been tested. But there's a different it's a different question of whether it can be spread that way. We don't know of any cases that have been stret spread through other than either sexual or intravenous blood type of transfer so if you

take a bite out of somebody's sandwich if you take a drink out of their glass if you shake their hand if you use the same toilet if you chew on a pencil that somebody with AIDS has chewed on what are your chances. None. No chance. So in the school environment the normal school environment in the normal working environment working with a person who has AIDS is not a threat to your health. That's correct. Now this is a very critical problem because as the public gets more and more knowledge about this illness and gets more and more alarmed about it at the point before they have complete information they may be put in the position of needing to make some decisions and they're scared and this is a scary disease. I think the case in Kokomo is a good example that a child 13 year old who has hemophilia who has AIDS because he got a transfusion of contaminated blood was prevented from going to school this year. And there's absolutely no evidence that that child has the ability to transmit the onus to the other

members of his class because that letter when a core but what if he falls down on the playground and scrapes his knee and begins to bleed that blood which has the AIDS virus in it. It's not a threat. No it's not a threat because it would would be almost impossible to conceive of a way that that could get into another human being's bloodstream. OK I said at the beginning that some scientists believe that this disease is as serious as the vomit plague was in the Middle Ages in Europe perhaps as serious as the polio outbreak of the 30s 40s and 50s in this country would you agree with that. I would agree with that and I think the potential for it to get far worse than it is now is very real if you look at the attack rate of the illness in the population that's at risk. It is it is very high and it's getting higher. And in communities like San Francisco where the gay population represents 25 to 30 percent of the males over the age of 15 are gay that's a substantial portion of that of that community. And so in populations at high risk like that one certainly the devastation has the potential to be is as frightening as it did you know the the other thing that

characterizes those things that you mentioned plague was that you had a set up in a very poor crowded time in our in the history of the world when the disease came along and ravaged the population in the population was vulnerable to some extent we had that same kind of set up today we have sexual practices going on in certain communities very promiscuous lifestyle among gay populations which makes it spread very rapidly from person to person and to be very difficult to control. How serious. This was are probably taking this very seriously now but initially were they slow to react. Are accusations from the gay community about the government and researchers not taking this seriously enough. Are they found that in fact. Well I think you know you can hear arguments from both sides that there are many people that feel that the Reagan administration because of its very high association with very fundamentalist religious principles and its conservatism for a long time wanted to ignore the fact that that AIDS was out there and that there were a number of people who are

supportive of that administration who felt perhaps the way many fundamentalists do that that that aids may in fact be ravage that is caused by immoral behavior and what have you. I think that we have gone past that now and I think the administration particularly the official public health service component of that administration is taking this disease very seriously and has now asked for almost 100 million dollars in funding to support AIDS Control Program Development to support the states in continuing alternative testing sites for blood and other things so I think that I think that that is turning around and certainly Congress in the form particularly of Congressman Waxman from California have been pushing very hard to get the attention of the administration on that. I believe that one member of the religious community has called for at least the questioning of whether or not we should have some sort of public policy or legislation. With regard to people who have AIDS and their sexual practices are we heading for a time when a person who has AIDS knowingly

has AIDS who will then go out and have sexual activity with someone I would look at I would look moving toward the day when that person will charge me with some kind of a crime to get murder or some kind of a felony. A bill was submitted into the New Jersey legislature which would have done precisely that and it treated knowing transmission of AIDS from someone who knew they had it to a non infected individual as if it were a homicide and murder. And that legislation did not pass but I think clearly the the there will be additional bills that will put equally controversial positions before legislative bodies and who knows what what they may do with it as time goes on. There have also been allegations by members of the gay community that. Doctors feel a need in fact in this day. They are required if I want I'm not mistaken to report a diagnosis of AIDS in a patient.

And that breach of the Hippocratic Oath that breach of confidence might keep potential AIDS victims or people who suspect that they might be diagnosed with AIDS that might keep them away from the doctor. Well Mike let's let's let's clarify this issue because I think there is some confusion on it. There is a long list of reportable illnesses in this state and all other states some of which are also reportable nationally which for many many years the health department has been responsible for collecting information on and that reporting is a critical part of the disease control process in other words we do not have for many illnesses a medicine or a vaccine that will treat it. But we do have epidemiology we do have the ability to contact cases to identify who their contacts are and protect those people through one means or another. That is a historical fact that's been around for for many many years. The debate is not so much whether AIDS itself should be reportable which is pretty well the case all over the country and has been the case since I added

it to our reportable diseases list last year. The question is whether an individual who has had an H T O V test. And has therefore been tested and been shown to have been exposed to AIDS but not to have AIDS should be reported. And that's a critical question and that's the one that the majority of the people are concerned about because there's fear that if individuals were known to have a positive test and again not to have AIDS but to have been exposed to the virus that that might be used improperly that it might be used to deny people insurance or employment or or to somehow treat them in the same way that we are unfortunately treating some of the people with AIDS and just because of the fear and the irrational behavior that that causes and people once they get a thank you from the disease control and it was the center for disease Disease Control in Atlanta. Americans exposed to Agent April 400000 July 1 to one and a half million people in that exposure to a. Does that mean if they have that test and the test would show positive because they've been exposed. Right.

And that's all I mean let's clarify that. The test that is now available to so-called HTL v3 test has only been on the market and licensed to be used since April. That's just for five months of time. The CDC figures are based on the fact that starting in April every donated unit of blood in this country and everybody that came to an alternative testing site were tested. And so for the first time we had evidence of exposure to this virus. It absolutely does not mean that you're going to get AIDS it doesn't mean that you are sitting there at a ticking time bomb waiting for AIDS because we know with all of the diseases that some people develop immunity to illnesses and when you get exposed to a virus it doesn't necessarily mean that the virus is going to win in its battle with your body's immune system. We don't know what the precise likelihood is that an individual who is exposed to AIDS and and subsequently will develop it we don't know what the percentage is because we've only been testing for four months and we know the incubation period is for four years. So as a result we've got to wait for a couple of years anyway to ascertain

just what the percentage of those who are exposed is but the numbers that you use the four thousand and I mean 400000 are are a measure of those that we have identified through this massive testing program that's going on. Bear in mind that there are 20 million units of blood given in this country every year and used in surgery and in others and in other things. So every one of those 20 million people are being tested. And as we learned some years ago with the swine flu vaccine when you when you test or give a procedure to enough people you're going to find out a lot of things that you didn't know before you start. So you can be infected but not aspected. As far as we know OK you can be exposed but not infected and you can be infected but not after acted. And if you are infected by the virus to which you are exposed the risk is there that you may be able to transmit that to someone else. If you were exposed to blood products and are not gay and are not actively participating in any kind of sexual practice which would put you at risk you may in

fact transmit it to a completely innocent spouse or girlfriend or boyfriend or whatever. So in other words if you have been exposed but you show no signs and never develop the disease you can still be a transmitter of that disease that's correct. That's what we really try to be the case. We had a doctor on talking about venereal diseases about a year ago I think it was and he mentioned that if a woman has sex with two different men. Once a week and those men in turn have sex with two other women once a week the geometric calculation is well into the hundreds of thousands of exposures. It's great and it works the same way it works the same way with AIDS. That's why it is so important too in looking at the ways that we may be able to control this illness. For us to develop the the information flow that is the collection of data about positive exposures so that

we can begin to alert the people who are the context. You know people treat this as if it was a new threat and that somehow the risk of that confidentiality process being broken is real but health departments have for years been collecting information and keeping information confidential on syphilis and gonorrhea on other socially sensitive diseases such as that without any instances that I know of of anybody's rights having been abridged by that process. The point where we aren't at this time with AIDS is that the only control methods that we know and will be effective involves educating the individuals who are contacts of cases or contacts of exposed individuals in how to modify their sexual practices modify their behavior in such a way to minimize the risk to them as long as that's the only control method we have. We can't have an interruption of the chain of information that would keep us from being able to contact realistically what kinds of controls.

Can we have. Well I think four or five years from now we will probably have a vaccine of some in effectiveness we can't be sure it'll be 100 percent effective but there will probably be a vaccine of some kind of Elop. There will probably be drugs that will alter the course of the illness and there may be drugs that will reduce infectivity and make it safe for a person who's been exposed to be able to carry on normally. At the moment we don't have that. So the only tools we have are the epidemiological tools that we have learned to use from other venereal diseases from sexually transmitted diseases over the centuries and from Disease Control for non-sexual diseases such as tuberculosis where the basic method of of of treatment and control is to trace contacts find individuals who may have been exposed treat them with with chemicals that help them to fight off the illness. That's the way we've we've largely succeeded in getting rid of some diseases if you look at smallpox for example which is probably the most dread and highly fatal disease with which society has dealt in the

recent 20 years. Smallpox was eradicated from the face of the earth almost 10 years ago by an effort which involved basic epidemiology techniques and a new vaccine. There was never a drug developed that was helpful with smallpox. So I think it's very hopeful that we will get a handle on this disease but many many people are going to become ill many people many people are going to die before that happens. And it's very important that individuals who think they might have been exposed or even if they just have that question be tested and and make the behavioral decisions that are appropriate given the kind of risks that they may be running with and let you sit here and you say it's very important people who think they may be exposed to be tested and yet when they are tested in the test proves positive they go down on the tracking sheet and for many that is very intent not at the present time. The only state at the moment which has a reporting requirement it was only passed on the first go round by the Board of Health of Colorado when the light within the last week. Is Colorado the

this state at this moment does not require that I am considering at the moment how we're going to do that or if we're going to do that and when. When we first started this testing program it did not seem appropriate to do it because it was very important that people be encouraged to get tested and we didn't want to discourage anyone from coming to the alternative sites and hence going to the blood bank which was which was where the other available tests were law or no law. What is the ethical responsibility of a physician who has a patient whom he diagnosed as having AIDS his Hippocratic oath said that that says that that remains between him and his patient. But what about the family what about the friends but about the lovers What about society. Well you know that is that is a classic question that government and policymakers and health professionals particularly government health professionals like myself have always had to address and that is when the individual's human rights. Become superseded by the need for the cup of the community to protect

itself from something that the individual may perhaps not intentionally but but but just expose them to through their behavior and and it's a very good there is no good answer and there's a spectrum of people from one end of the question to the other in terms of what is what's appropriate when the questions that was addressed to me on the Donahue show was. Is it possible that that we should in fact institutionalize individuals who are positive so that they can't expose other people when I said no that is not an appropriate response for us to have at the present time on the other hand if there are individuals who are knowingly carrying on the exposure of other people through sexual practices or other kinds of practices that then ought to be prohibited. And they are warned and they don't alter their behavior. There may come a time when it is very necessary for us to impose some restraints on them of one kind or another which is not at all unusual you know. We did it for leprosy we did it for syphilis we did it for many diseases historically when we were in the same position where now I am not an

advocate of doing that. And I do not believe that the time now is that this is the time to consider anything like that but in certain very selected instances where individuals are known to have infected other people and won't stop the behavior that caused that infection I don't think we're going to have any other choice. You were on the phone Donahue show and you were on with doctor from San Francisco who has treated AIDS patients and a gay couple. Who were concerned about what they perceive to be the seeming lack on the parts of many homosexuals the lack of understanding for the disease the lack of concern. They said there was a lot of lip service paid to it but not a great deal of heat in terms of the way they practiced their sexual practices. Like a lot of evidences it humiliated since that time that that wasn't. That is in fact so the Rays not facts it's not in fact so that that in fact the evidence seems to be that the gay community in particular is taking this very seriously. The rate of spread of other than arial diseases such as syphilis and gonorrhea has dropped

off precipitously in the last few months in that population which suggests that much more care is being used for a much greater selection is being used in terms of who their sexual partners are. I think that I think the great majority of gays are in fact modifying their sexual practices and their social practices out of fear of this disease and they also said that we should not pinpoint and point the finger at gay people or Haitians or whoever else of the high risk group people that in fact heterosexuals should be just as concerned as homosexuals about contacting contracting and becoming ill for me. Well that's true I don't think just as concerned as an accurate way to put it. I think if you are a normal monogamous individual who has who has who has a. A single sexual partner and and has consistently done so that your odds of having been exposed to AIDS except through the blood route are very very low. The point they were trying to make is that we don't know what

goes on in our husbands or our wives or of the private lives of people with whom we have reasonably close relationships all the time and if they are even occasionally going to the city and having sexual relations with somebody who is at risk that that could in fact put us at risk because it does spread between heterosexuals. We have less than a minute left and I want to say that the blood supply in this country has been cleaned up or has been in the process of being cleaned up in the last year because of a test that's been applied to it and that you cannot get AIDS from giving blood only potentially from blood you receive absolutely no oath of those things are true. I have about 15 seconds that I want to ask an important question is aids out of control. I think AIDS is out of control now and we need to work very hard to get it under control I'm confident we can do that but it's going to take some time and and there will be many people who will be frightened by it. And who need to watch shows like this to learn more about it. Dr Robert Jackson the commissioner of the South going to Department of Health and Environmental Control thank you

for being here tonight. Appreciate thank you much. Well we went along of this interview on purpose tonight so we will not be hearing about lasers will carry that in a future program but we will continue now with the contributing editor Steve June as he joins us for part five of his series on limited partnerships as investment opportunities that's coming up stay with us. Centering a tax advantage investment. There are three major categories from which to choose offerings registered with the Securities and Exchange Commission. The FCC intrastate offerings which are not registered with the FCC and private placements. A tax shelter registered with the

FCC does not imply that it's approved by this agency. This is stated clearly in the prospectus. Perhaps you are wondering if an STC registration does not mean the agency is willing to approve or disapprove the offering or even attest to the accuracy of the prospectus. What good is it by applying for such a registration. The general partner is placing this investment before the scrutiny of the FCC and obtaining an FCC registration is a complicated process. Once the process is complete however a Registration allows the general partner to offer the investment in other states in addition to his or her home state. The general partner must register the investment in each state. He or she plans to offer it for sale. The process of registering the investment in states it is to be offered in is referred to as blue skying. The investment. Both the sales representative and the offering for our must be

registered in each state where the general partner plans to offer the investment. The second type of tax advantaged offering is an interest state offering as the name indicates interest state offerings are only offered in that state of the general partner and they are not required to be registered with the FCC. Also investments by the partnership are limited to that state. This could be significant if the investment possibilities within a particular state have limited appeal. An example might be an interesting real estate partnership in a state where real estate no longer offers the growth potential it once did. The lack of potential could be a result of several factors poor economic conditions overbuilding population trends or a host of other factors. But the fact that an offering isn't interested offering is not in itself a sign of a poor investment rather one that demands the buyer to make sure the

potential value of the investment is not limited. When reading your prospectus always determine if your investment is a registered offering. Warren intrastate offering. Once you have made this determination you can decide whether a registered offering or an interstate offering would best meet your investment needs. We will wrap up our discussion on limited partnerships by discussing private placements and summarizing what you should be looking at before investing in this area. This is Steve Jonas for Carolina Journal. Thank you Steve coming up tomorrow night on Carolina Journal if you're a fan of old time radio shows will let you meet one of the genres biggest fans Lou Brierly who host his own tribute to old time radio on the South Carolina Educational Radio Network. And if I can sneak it in I'll do my best to bring you that laser interview which we conducted yesterday with two gentlemen from the laser Institute of America our policies for not having time to put it on tonight we'll try tomorrow night and let you know tomorrow if not OK to make any sense. I hope so. Thank you for watching tonight.