In The Viral Underclass, Steven Thrasher, Ph.D., examines why certain populations are more at risk from viruses, such as HIV and COVID-19. Celadon Books sat down with the author to understand this societal problem and how he thinks we can eradicate it.
What is “the viral underclass”?
The viral underclass is a way to think about the kinds of populations repeatedly put in danger by viruses, and to think about why and how they are put in danger. If you look closely, you can see a viral underclass made at every juncture: at moments of “zoonotic jump” (when viruses transmit from nonhuman animals to humans), while transmitting between humans, during treatment, and in facing death. Regardless of the particular virus, Black and Latinx people, people without homes, migrants, LGBTQ folks, shift workers, and people living in the Global South are hurt the most. This is because of “the isms”: ableism, racism, sexism, capitalism. So, a theory of the viral underclass doesn’t just let us see who is affected by literal viruses; it’s also a prism for seeing what’s plaguing society beyond viruses. And if we centered the viral underclass and addressed what is really harming them, it would make life healthier for almost everyone.
For years you’ve studied viruses — primarily HIV and hepatitis B — and how they impact marginalized communities, politics, and law. What similarities did you see in how COVID-19 has affected those same communities? What differences?
When people started dying of COVID in the U.S., I looked at maps in New York and in St. Louis — two cities where I have studied HIV — and I saw people were dying of COVID in the same neighborhoods as they’d died of AIDS. In one way, it didn’t make sense. HIV and SARS-CoV-2 are very different viruses, with different modes of transmission and different qualities. Everything with COVID happens so fast compared to HIV! It can take seven, 10, 15 years from the moment of an HIV transmission in a community until an AIDS death, while a COVID transmission can kill many people in mere weeks.
And yet when I started looking at maps of COVID and AIDS deaths, despite all the differences of the viruses that cause them, they were happening to the same kinds of people, in the same places. Increased mortality isn’t driven by the viral outbreaks alone, but by 12 major social vectors I outline in the book.
Recently you've written poignantly about George Floyd's posthumous COVID-19 diagnosis. How does this diagnosis help you understand the idea of the viral underclass?
Yes, an autopsy revealed George Floyd had, in fact, been infected with the novel coronavirus prior to his death. And at Officer Derrick Chauvin’s trial, Mr. Floyd’s girlfriend revealed that she and he both struggled with opioid addiction.
If he had lived longer, might Mr. Floyd have died of COVID-19? Or from addiction?
We will never know, because Chauvin murdered him, by kneeling on him for eight minutes and 46 seconds. Minneapolis spends more than a third of its budget on police. Perhaps if it spent more on public health, Mr. Floyd might not have gotten the virus and never had a fatal encounter with Officer Chauvin.
Also, the presence of the virus in Mr. Floyd showed me that it’s the same kind of people who are harmed by police violence, and by addiction, and by health disparities. If we want a fairer world free from systemic racism, we can’t just deal with any one symptom, even though that symptom might be lethal. If we don’t deal with the root causes plaguing our society — racism, ableism, transphobia, capitalism — the people in the viral underclass might still be killed by means other than viruses.
In your book, you explore the stories of people from this viral underclass. Whose story has stayed with you most?
Except for the politicians and business tycoons, I love pretty much everyone in this book. Everyone who shared their story with me personally, or who revealed themselves to me from beyond the grave, occupies a place in my heart. But if I had to pick just one story which has stayed with me the most, I’d say it was the story of Lorena Borjas. As a transgender immigrant, she transgressed borders of gender and nation. She lived with HIV for many years and survived human trafficking. She dedicated herself to helping others for decades, passing out food, condoms, and sterile needles on the street. She created bail support networks to get poor people out of jail quickly, long before community bail funds were a thing. She’d show up for other transgender women at court arraignments, even if she didn’t know them personally, just so the judge might see someone cared about them. And after surviving all of that, she was the first person in my extended social circle to get COVID. Her loss to her familia was immeasurable.
Looking forward, what are the first steps toward creating a world where the viral underclass does not exist?
An important step was taken by the United States as I finished edits on this book, when the Biden administration supported suspending patents on COVID vaccines at the World Trade Organization. That was a first step: to prioritize human life over intellectual property. Another is letting viruses teach us, because they can lead us toward a new politics of care. If we let them, viruses will teach us that we must take care of one another before, during, and after moments of transmission. Finally, a step to take right now is to learn from what has worked in the COVID pandemic. In the U.S., if people needed a test, treatment, or vaccine for the novel coronavirus, they could show up and get them. Free. It was paid for by the bounty of our society. Now that we know we can do it and people have gotten used to it, we need to take a step toward universal health care. That would not only mitigate or prevent the next viral pandemic, it would free the viral underclass (and the middle class) from medical debt, eviction, and homelessness — from the things truly plaguing our world.