Fighting a Plague: Doctors' Stories of Challenge and Innovation Combatting the AIDS Epidemic in 1980s New York City.

The human immunodeficiency virus (HIV) has devastated the United States for forty years. Though there are highly effective treatments for HIV and acquired immune deficiency syndrome (AIDS) today, the early years of the HIV/AIDS epidemic in New York City (NYC) were filled with uncertainty, fear, and death-not unlike the period we are now experiencing in the COVID-19 era. Existing scholarship captures the political discourse of the HIV/AIDS era and the narratives of physicians who specialized in HIV medicine. This essay uses eight in-depth interviews of physicians of various specialties who worked in NYC to understand the uncertainties and fears in daily work during the early AIDS epidemic. Their stories provide unique perspectives into the realities of working as physicians in the epicenter of a highly politicized epidemic with limited support, information, and treatments. They illustrate that HIV/AIDS provided unique biomedical, social, and political challenges to the physicians working in NYC during the 1980s. Over the course of the decade, these physicians adapted to meet challenges using methods that have since become commonplace in their clinical practice.

How are healthcare provider systems preparing for health emergency situations?

Natural disasters, disease outbreaks, famine, and human conflict have strained communities everywhere over the course of human existence. However, modern changes in climate, human mobility, and other factors have increased the global community's vulnerability to widespread emergencies. We are in the midst of a disruptive health event, with the COVID-19 pandemic testing our health provider systems globally. This study presents a qualitative analysis of published literature, obtained systematically, to examine approaches health providers are taking to prepare for and respond to mass casualty incidents around the globe. The research reveals emerging trends in the weaknesses of systems' disaster responses while highlighting proposed solutions, so that others may better prepare for future disasters. Additionally, the research examines gaps in the literature, to foster more targeted and actionable contributions to the literature.