In South Africa, we are just beginning what will most likely be a stay-at-home that will last longer than the current projection of three weeks. Today, Monday 30 March, we stand at 1,280 total Covid-19 infections. Two people have died, a man and a woman. What does it mean that the first person to die is a woman? And when will our numbers come back down to Sunday’s 255 new infections and one death?

Today we look at these numbers with dread. Weeks and maybe months from now, we will look at a return to these same daily numbers with relief. We don’t yet know. None of us know what we will endure in the months to come. Italy reported 5,909 new cases on Sunday and suffered 919 new deaths. Spain on Sunday reported 6,529 new cases and 832 new deaths. Their return to South Africa’s numbers of today will be a victory. At some unknown point in the future, our numbers of Sunday, 255 new infections and one death, could signify our own victory.

A decade ago, South Africans were beginning to emerge from the Aids pandemic that has killed 2,943,500 people from the country to date. Thirty-two million people in the world have died of Aids. At its peak in 2005 and 2006, 210,000 people in South Africa died of Aids. By 2009, that number had dropped to 160,000, a sign of victory. In 2010, 140,000. Another victory. Today, 240,000 South Africans are still becoming infected with HIV every year, 660 per day. And 71,000 are dying, 194 per day. Some victories remain incomplete.

HIV left a wide swath of trauma and pain in our country, grief still carried by parents, brothers, sisters, children and friends of those who died. We remember the fear and stigma that lasted longer than it should have; family members pushed from their own homes because people were afraid; hospital wards that for over a decade did not have the necessary medications to save lives; a government unwilling to provide medications that had been saving lives in the North and the West since 1996; infants and children who died not knowing life; the pain on the faces of doctors and nurses when they told us our relatives or friends had died, their own tears mixed with frustration, powerlessness and anger at the unnecessary deaths they saw every day.

We remember what our graveyards looked like on Saturdays, rows and rows of mourners with ministers and lay clergy conducting funeral after funeral after funeral. We remember the many tents in our townships and communities where families gathered before and after, symbols of death and collective grief.

We remember the shame and embarrassment we felt when a family member died of Aids, making and receiving phone calls before funerals to make sure no one spoke the four letters we all feared. Shame complicated our grief, complicated our healing, undermined what should have only been love. We regret now the code of fear-driven silence we kept about HIV, forcing those who had it to hide and those who thought they might have it to be too afraid to get tested.

We try not to remember that 22 years ago, we killed Gugu Dlamini because the 36-year-old woman dared speak openly about her own HIV infection as she tried to help others. But we must. We must remember the Aids pandemic so that we do better now, better with this Covid-19 pandemic that will condense the 30-year timeline we experienced with the Aids into just a few months.      

Aids gave us time to support those we love who are ill and prepare for their deaths. Covid-19 gives us no such time. No time for those who are ill to come to peace with their pending deaths. No time to put things in order. No time for final conversations or good-byes. Covid-19 will not allow us to gather at the bedsides of those we love, singing, chanting, praying and telling stories, accompanying them in their final graves. It will not allow us to wash the bodies of our mothers, fathers, sisters, brothers and children when they die. Until it is over, Covid-19 will not allow us to gather together to mourn, to weep or to bury our dead. Our grief will get complicated and our hearts will grow sore.

Aids taught us about complicated grief. The world knew little about it until then. Complicated grief is when you lose someone you love and, while travelling the path of healing from that loss, someone else you love dies. And just when you pick yourself up again and rejoin that path of grief and healing, someone else you love dies. And then another and another and another. We remember the years between 1999 and 2015. We remember that the most common thing we felt was nothing. Numbness. This was our companion. It looks to join us again.  

Aids also taught us about historical trauma. The trauma experienced by Aids triggered South Africans’ unhealed trauma from apartheid. The trauma of apartheid triggered the unhealed trauma of colonialism. In this way, for South Africans and many Africans as a whole, the trauma that will be experienced because of Covid-19 will tap into deep intergenerational and ancestral roots of still unhealed pain.

Aids taught us that we will need the support of others to get through this Covid-19 pandemic. We will need to listen to each other. Check in with each other. Keep asking the question, “How are you?” and really listen for the answer. We will need to tune in to each other’s feelings and emotional states, for when our friends and family members go numb and disappear inside themselves. This will all be much harder while we are stuck at home, unable to take our friends’ hands, look in their eyes or share the hugs that they and we will need.

Covid-19 is real, just as HIV was and remains real. But we should not be foolish, thinking it cannot touch us like we thought HIV could not touch us. HIV did. Covid-19 will. In ways we have yet to imagine. Aids taught us about fear, to overcome it while not being foolish. We need to use our fear to protect ourselves and others from Covid-19, not to stigmatise and alienate others, not as fuel for our gossip. We need to be afraid of Covid-19, but not of each other. Aids taught us that gossip, shame, blame and stigma are all symptoms of fear. We let that fear divide us from each other. It made us reduce people with HIV to the virus inside them. It made us kill Gugu Dlamini. None of these things has a place with Covid-19. Our fear should guide us to be safe with our own lives while protecting others. But we must not let fear divide us or lead us to kill Gugu Dlamini again.

If Covid-19 hits South Africa like it has hit Italy, Spain and the United States, we will need to pay extra attention to the three million people with HIV who are not yet on antiretroviral treatment. This includes 40% of children with HIV.  

Tuberculosis is a major concern in South Africa. The lung infection raises the risk for Covid-19 and complicates recovery. According to the WHO, a little over 300,000 South Africans contract TB each year. Just under 30% go without treatment. Those people are at particular risk for Covid-19. These people will need our extra special attention and care.

Aids taught us the terrible lesson of poverty, that those who are victims of inequality get sick sooner and die sooner. Like HIV, Covid-19 could hit South Africa’s under-resourced communities hard where families already struggle to eat. It can bring an impossible challenge to an already overburdened system of local clinics and hospitals. It has the potential to break families and leave behind a new generation of orphans and lasting grief.  

Aids taught us another important lesson, to not put someone in their grave before it is their time. Speculating if and when someone you care about who is ill will die does not help that person. Or you. In the time before ARV medications, many of us fell into that trap, worried that some had only days or weeks to live. Those we worried most about often kept on living. Those we did not worry about sometimes caught us off guard and died quickly. If, and when, someone you care about becomes ill, keep thoughts of recovery strong in your mind and heart. It will not help them – or you – to think about, or talk about, their possible death.

Like Aids, Covid-19 fills us with uncertainty. Covid-19 is taking the world on another journey into the unknown, this time much faster than our journey with Aids. The task of taking care of those we love who are ill is filled with hope, fear, hurt, anger and despair. It is exhausting. Our hearts will feel like washcloths rung dry each day, not a single drop of water left. Days and nights of caring for those we love become unrecognisable from each other. This time, some of us who care for those we love will also become ill. Some will die. But this is what we do as human beings. We care for each other. Even if it means we die.  

We learned long ago that Aids is about people, not the numbers reported to us week after week. Each number we read not about Covid-19, a new infection, a death, represents a person. A person with hopes, dreams, successes, failures, joy, fear, love and despair, just like us.   

Aids hurt. Covid-19 will hurt. Many of us on the front line of the Aids epidemic understood early on that Aids was telling us something about the quality of our love and demanding more from us. Demanding us to be better in our love, to be better in who we are, to be better in our humanness. What could we say about the quality of our love if we were willing to risk someone’s life – or our own? Aids was a hard mirror to look into, and when we did, we saw that healing was not just about those who were sick. It was about all of us.

For years, we thought Aids was about death. Until we realised it is about life. Our lives. Our lives together. And now Death has returned, this time riding the back of a coronavirus. But this time, our social media posts, WhatsApp messages, blogs and newspaper editorials around the world are fearlessly looking into the mirror, writing honestly about what they see. A species that is willing to kill its very host, planet earth, in the very way that HIV and Covid-19 kill the human bodies that host them. A species that allows some to starve while others feast off their suffering. A species that long ago signed on to the emotional, physical and sexual abuse of women and children. A species busy building higher and higher walls, not longer and wider bridges.

We fought HIV. We have already geared up for an epic battle against Covid-19. Medical and political leaders are declaring war. Perhaps this time, we will act differently than we did with Aids. Perhaps this time we will look into the mirror, be honest and take what we see seriously. Aids was a war fought by soldiers who “conquered” the enemy with tablets that demand little or no reflection on how we live our lives together. Will we repeat that same battle plan with Covid-19, fighting as soldiers, blasting, bombing and shooting our way forward so that we can remain in the same place? Or will we be warriors who are not afraid to learn from their enemy, who act with their hearts, who know when it is time to embrace change and not fight against it?

Death is here again. But Covid-19, like Aids, is not about death. It is about the future and about life. It is about the possibility and our lives together. It is about our capacity to care. To love. To live with compassion, empathy, humility and humanity. It is our chance to live with renewed kindness and truth. Aids asked us to think about these things. To become better versions of ourselves. Maybe this time, with Covid-19, we will get it right. DM

Dr James Lees, Senior Lecturer at the HIV & Aids Programme, University of the Western Cape, has been on the frontline of the Aids pandemic since it first emerged in the early 1980s. After working on HIV treatment and prevention among street children in San Francisco and India, he joined UWC’s effort to counter the growing Aids pandemic in South Africa in 2002.

Joachim Jacobs is Director of the HIV and Aids Unit at UWC. The work of the University’s HIV & Aids Programme includes training university students, teachers and communities to addresses the difficult matters of sexual violence, inequalities and vulnerabilities that are highlighted by the Aids pandemic and exacerbated by it.