“When people think of plagues, they think of me,” jokes David France. Since the COVID-19 pandemic started, the director of 2012’s Oscar-nominated documentary How To Survive A Plague has seen an uptick in media requests, the title of his most known work all but an engraved invitation. The film chronicles the life-or-death fight for effective AIDS treatments waged by Act-Up, the era-defining AIDS activist group that demanded to be heard by the government, Big Pharma and the country at large.
What can his film, or more broadly the AIDS Plague Years of the 1980s and early ’90s prior to the arrival of life-saving drug cocktails in 1996, teach us about living with a pandemic today? What does that moment in history have to say about our own, about our government and healthcare system, about ourselves?
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France, a former print journalist (Newsweek, New York magazine, The New Yorker, among others), followed Plague with 2017’s critically lauded The Death and Life of Marsha P. Johnson, which chronicled the journey – and possible murder – of the transgender activist. His Welcome to Chechnya, focusing on that country’s anti-gay purges of the 2010s, debuted at this year’s Sundance Film Festival and will premiere on HBO in June.
But it’s Plague that has the most obvious, uncanny relevance to life as we’re living it this very minute. Deadline spoke to France about his film, the similarities and differences between 2020 and the 1980s, the public re-emergence of NIAID director Dr. Anthony Fauci, and the critical moment when fear turns to anger.
The following interview has been edited and condensed.
DEADLINE: I watched How To Survive A Plague against last night. What do you think it can teach us about this current plague, or is plague even a word you would use for the coronavirus?
DAVID FRANCE: Yes. A plague is by definition a disease for which there is no cure or treatment. AIDS was a plague for 15 years, the Plague Years, up until 1996. So we’re in the same place right now, where if you get this thing, you’re on your own. That’s what makes it a plague. And that’s what makes it terrifying, like all plagues.
DEADLINE: There’s a lot of fear right now. Myself included.
FRANCE: There is reason to be afraid. Being afraid is absolutely the appropriate feeling. The reason that fear works is because it keeps you from doing things that would put you at risk, right? So back then it was the very first tool for prevention. It created this notion that everybody’s probably sick, that you could either be sick and exposing yourself to others, or they could be sick and exposing themselves to you. There were no tests, just like there are no tests now, no real access to tests anyway. So you had to convince yourself that, for ethical reasons, you had to consider yourself both healthy and infected simultaneously. And that drove your behavior accordingly.
So that’s what we’re seeing now – that’s why people are wearing masks, that’s why people are avoiding going inside stores, and that’s why people are sanitizing before and after putting gasoline in their cars and that kind of stuff. That sense of fear is what led to a clever series of innovations in public health. The first was safe sex, which told us that you could be afraid but you could also start going back to your regular life in ways that would still be protective.
We’re trying to find a way to do that now, with these sero surveys that are being conducted to find out how many people have been exposed already, research to determine whether or not having been exposed to or having survived COVID-19 confers immunity. And if we have conferred immunity, can we start putting those people on the front lines and putting more vulnerable people in the back lines? All these things that are born out of fear are gonna help us find a way through this. If you look at that 15 years of AIDS – and this won’t be as long but it will certainly be incredibly devastating – the fear led to innovation, which led to good advice, neither of which got us out of the plague and so that led to anger, and anger led to activism and activism led to the kind of political pressure and economic pressure and cultural pressure that saw our way out of the Plague Years.
DEADLINE: This plague feels very compacted, in a way, like those 15 years crammed into a matter of months. If we’re in the fear stage now, when do we hit the anger stage?
FRANCE: If I were to predict, I would say next fall. If we’re lucky and we get a few weeks or months of reprieve this summer, then when this thing roars back in the fall we are going to have had a moment of time to measure what terrible political and moral errors were made in the first round of this pandemic, and see how little has been laid for protecting us into the second round. I don’t think we’re going to get out of the fear state until we get a vaccine, and I think when we realize that we’re going into another year of COVID deaths that’s when people are going to become really furious.
DEADLINE: What will that look like? I can’t imagine it will look like the activism of Act-Up, with people gathering together in the streets and demonstrating. So what will anger look like now?
FRANCE: Certainly that anger will be expressed at the ballot box one way or another, and that’s an appropriate place to put it, because this is really a political disaster that we’re in.
So will people start doing a kind of street activism? We’ve already started to see it. We’re seeing in New York nurses walking out of their hospitals and holding angry demonstrations in front of their hospitals because of the lack of personal protective equipment and the lack of any sort of administrative readiness for this. They’re protesting their hospitals and protesting the city and state governments and especially the federal government, and they’re doing it at six foot intervals.
Next week there’s going to be a a strike of nurses in New York City, and it’s going to take real dramatic and clever and angry activism to be able to break through the noise that’s being blasted out of the White House daily press gatherings.
DEADLINE: One of the things that struck me rewatching your movie was the immediate scapegoating of the victims, the anti-gay rhetoric everywhere, instantly. Aside from Trump’s “Chinese Virus” crowd, there doesn’t yet seem to be widespread victim-blaming targeting the groups that COVID is disproportionately hitting, the black and brown communities, the urban poor, the elderly. Will we see that change?
FRANCE: I don’t know if scapegoating is the right word. What we have seen, and I’m sure we will see as the year unfolds, is Red America convincing itself that this really is overhyped because it’s not in their backyard, and they’re going to see it as being a pandemic impacting Blue America, the major cities. And within those Democratic strongholds, the disease takes a much harsher course in people who have already been excluded from the American health care system, and that’s where black and brown Americans are and that’s why we’re seeing such a huge, disproportionate number of people dying in those communities. And I think their deaths are not finding sympathy in the middle of America. They can go unnoticed. I think we’re going to have a struggle to try and show that these numbers are really people, and that the identities of these people, once revealed, are going to show us how terribly unprepared the American healthcare system is for any of this. But I don’t know if we can get that message out to the Trump space.
DEADLINE: But won’t families everywhere be touched in some way? Red states have grocery stores and factories and offices, so won’t it hit home everywhere?
FRANCE: Yes, it may, but urban living and poor living are really different from the middle of America. The density of poverty in New York and Detroit and New Orleans and places like that, it’s that density that’s really driving this more than anything. We don’t know how perfectly or imperfectly the rest of the country is doing their social distancing because we seem to have no federal eyes on the ground for that, absurdly. Where is the CDC? Where are they? If they were doing that with any degree of efficiency, then it would be much easier to avoid contact with the virus there than in New York.
DEADLINE: Of course another striking thing in rewatching your film is seeing Dr. Fauci, and he seems to be saying the same thing now as he did during the AIDS crisis: Follow the scientific investigations. Except then he was trying to convince Act-Up, and now he’s trying to convince the president. Or am I misreading something?
FRANCE: What Act-Up was trying to tell Fauci was that it’s not appropriate for the federal government not to take a strong hand of leadership in the research. He was saying that government shouldn’t be the place for that initiative and leadership, that it should come out of the independent labs and academia and pharma. That’s what Act-Up was hammering him for – that he took a very passive view of intellectual rigor as it relates to scientific research. Now, he’s taking a much more active role in directing research. So that’s good to see.
But in both instances, and in every administration in between, Fauci has played the role of a politician as well as a scientist, and that’s the terrible dance that we have to watch him go through every day – speaking up in defense of science while being forced to apologize and walk back statements of fact as though he reported to Chairman Mao. Your heart breaks for him, and you’re also just enraged at him for doing that. And everybody else who does that.
DEADLINE: Everybody else, but Fauci especially. We want him to be the adult in the room, to speak truth regardless, yet we also fear that Trump will fire him.
FRANCE: Fauci really couldn’t be fired. He could be kicked out of that situation room. But only he knows what he’s accomplishing inside that situation room, and if he feels like he’s accomplishing something that no one else could accomplish if he left, then that might account for why he’s willing to swallow all grace and credibility on a daily basis.
DEADLINE: Do you know him? Are you basing that on what you know of the man?
FRANCE: I have known him for 40 years. So yes.
DEADLINE: Is there a comparison to be made of the early AIDS drug AZT and chloroquine? Someone in your documentary uses the term What the Hell Drugs, which sounds a bit like Trump’s “What have you got to lose?” Didn’t we learn what you’ve got to lose with AZT?
FRANCE: AZT was never a What the Hell Drug. The What the Hell Drugs that she was talking about were being imported by and through a network of buyers clubs, kind of underground pharmacies for drugs that were literally proven to be harmless. Chloroquine and hydroxychloroquine are known to be harmful in multiple situations. So that’s why it’s so irresponsible to create such a a craze for those drugs without letting it be a doctor mediated discussion. And that’s what Fauci keeps saying, that this has to be selected case by case, even on a compassionate use basis.
So no, I don’t think there’s a parallel with AZT. AZT, as you know, was rushed to market without a long-term efficacy trial, without a Phase III trial, and so from 1987 to 1992 it dominated the pharmacopia for HIV and it wasn’t until 1992 that a Phase III trial was finally published and it showed that AZT didn’t extend life by even a week, and that in fact, in this large study called the Concorde Study, people on AZT, their lives were a very tiny degree shorter than people who never went on it.
Act-Up and the AIDS movement forced the FDA to start releasing drugs before the Phase III, and when they realized the mistake that they had made after the Concorde study came out, they went in the other direction. So most of the people in my film in the front line of that work, all HIV positive, said “Slow this down. We can’t afford to have unproven drugs flooding the market, creating this kind of business incentive for other pharmaceutical companies to come out with similar drugs. We need to find a drug that actually works.” And we certainly need that here, too.
DEADLINE: You’re working on a COVID documentary, correct?
FRANCE: I’m working on a COVID documentary, yes. But I’m not going to be able to tell you much about it.
DEADLINE: Is it going to be a longterm project, like How to Survive a Plague?
FRANCE: How to Survive a Plague was, like, a 20-year project if you think about it, though I only just swept up the film that other people had shot – it was an archival vérité film. I’m shooting this one, in a standard vérité documentary style.
DEADLINE: Some people might think you’d have had enough of plagues. Why this subject?
FRANCE: I was immediately taken by the fact that everybody who’s on the front line now had arrived on the front line of the early AIDS epidemic. I knew them well, I knew what lessons they had learned, I knew what mistakes they were capable of, and I wanted to go back and kind of re-challenge them and the machinery that they control for this new plague and see if they have learned from the last one.
DEADLINE: Who exactly are you re-challenging? Who was on both of those front lines?
FRANCE: Debbie Birx is an AIDS doc. Robert Redfield is from the AIDS world, and he’s now the head of the CDC who we never see. And Tony Fauci, of course, who has put himself in a position to speak for all the branches of the public health service, which I think is surprising – literally the stuff that we look to him for are messages that should be coming to us from the Centers for Disease Control and Prevention. I don’t know why they aren’t.
DEADLINE: Do you have any idea why they aren’t coming from Redfield?
FRANCE: I do, but, uh… Yeah, look, certainly the guy fucked up on testing, so I think he’s just been sidelined. I think he embarrassed people.
Like the Reagan administration, the Trump administration is intent upon starving the government of oxygen and creating the impossibility for an effective forward-leaning response to something like this. The similarities are very telling. Reagan had been defunding the FDA and the NIH just as Trump had been. Reagan wasn’t calling them Deep State employees, but it’s the Deep State employees that we need so much at a time like this. People who have the institutional understanding and experience and preparedness for attacking something like this when it comes along. So much of what’s been done to government in this administration was similarly done to government back then.
DEADLINE: Do you find that those similarities are prompting a sort of PTSD among people who were there, bringing up old thoughts and feelings?
FRANCE: I don’t frankly feel them because back then it was only the people who were being killed by AIDS that seemed to be at all concerned with it. We couldn’t look to our nightly news to find stories about it. We couldn’t look to The New York Times to cover it. We had to report it out in our own newspapers and in our own community. Now, the entire globe is involved in this so it doesn’t feel that we’ve been forsaken. I mean, we’re equally as fucked but we’re not as forsaken. Like we’re doing it all together and everybody is in the business of responding to it.
For me, this is more like 9/11, when if you lived in New York, or America and maybe even most parts of the world, you had a sense that something terrible had happened and everybody’s mind was concentrated on it. And so if I have flashbacks, it’s to that time.
DEADLINE: One last question: How do you survive a plague?
FRANCE: I don’t know. Good drugs?
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