Viruses do not discriminate. As Covid-19 has made abundantly clear, no one is safe from infection, not even Queen Elizabeth II or Kim Kardashian. But as journalist Steven Thrasher discusses in his new book, The Viral Underclass: The Human Toll When Inequality and Disease Collide, the universal properties of viruses do not mean that all humans will contract them at the same rate or experience their infections equally. Rather, viruses collide with entrenched power structures and result in disproportionate rates of exposure, transmission, serious illness, disability, and death for historically marginalized groups of people. Viruses can also deepen unequal power relations and worsen state violence by creating new forms of stigmatization for already criminalized individuals.
The state’s production of a viral underclass threatens everyone. Keeping in place racist, sexist, ableist, and capitalist systems and pushing neoliberal public health policies that frame health as a wholly individual pursuit hastens viral replication, worsens transmission, and encourages the proliferation of even deadlier viruses to come. I spoke with Thrasher about who makes up the viral underclass, how pandemics magnify inequality, the lessons learned from the HIV/AIDs crisis, and what we should do to confront the ongoing Covid-19 pandemic. This interview has been edited for length and clarity.
—Charlotte Rosen
Charlotte Rosen: What is the viral underclass?
Steven Thrasher: The term “viral underclass” helps explain why marginalized groups of people are disproportionately infected with and harmed by viruses. Being in poverty and/or a member of a stigmatized or criminalized social class makes someone more likely to become infected with viruses, because they are more likely to be living under conditions that hasten viral transmission and to lack the resources to care for themselves should they become infected.
The “viral underclass” also refers to how viruses deepen marginalization and create a distinctly disadvantaged group of people. Becoming infected with a virus makes people more susceptible to fall into poverty, experience deprivation, and face state violence.
The term itself was coined by a man named Sean Strub, and he originally used it to describe the criminalization of HIV. He wrote about how, when people became HIV-positive, they suddenly took on this second-class status under the law. Today, most laws don’t outright say that a biological reality puts you in a second-class status, but HIV laws do. Once somebody is HIV-positive, they are under this other set of laws, including infants born with HIV, who carry this status with them their entire lives.
When the coronavirus broke out, I realized that the viral underclass was an analytic I could use to explain how viruses exposed and reproduced inequality throughout society—certainly along racial lines, but also in ways outside of the traditional and US-centric Black/white binary, such as along the lines of citizenship, sexuality, and class.
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CR: What insights does the history of HIV/AIDS offer for understanding the viral underclass under Covid-19? And what lessons does this history hold for how to fight back?
ST: There are some resonances between HIV and Covid that are obvious—they are both viruses, and they affect marginalized populations. HIV mostly affected gay men and people injecting intravenous drugs, while Covid initially harmed elderly people. But very quickly I saw that despite the fact that the viruses have very different properties and are transmitted very differently, the same groups of people were predominantly affected by both viruses; the geographic maps recording rates of viral transmission among particular communities looked almost identical.
The history of how gay people were considered disposable during the height of the HIV/AIDs crisis is helpful for understanding when and why there’s been action around Covid and when and why there hasn’t. Initially, when HIV was only thought to affect gay men and people who injected intravenous drugs, there wasn’t much wide-scale societal outrage or pressure to develop mitigation measures or a cure. When Covid was initially dubbed the “great equalizer,” however, we saw an unprecedented, massive coordination on a medical issue, because in theory it could infect anyone. And that’s true: the vice president of the United States, the queen of England—they all got Covid. When a virus affects a population deemed disposable, there are different levels of care in response.
Even under Covid, however, we see disparities that are reminiscent of the HIV/AIDs crisis. There’s actually not much care provided for elderly people who are at high risk of dying from Covid, in the same way that gay men who were getting AIDs and dying in the 1980s and ’90s did not receive care. They are both considered disposable populations—there’s no capital to be extracted from elderly people; they are outside of the workforce, and so the market and politicians crudely see them as nonproductive. There’s almost a collective shrug or some satisfaction in knowing that these people who are considered to be a net drain on resources are not going to be on the balance sheet.
Another similarity between the two viruses is that Covid is now being pooled to circulate most among people who are the most likely to be harmed and lack access to life-saving care, which also happened with HIV/AIDs. Despite some initial bursts of state mobilization in response to Covid, we’re now seeing the dismantling of any social safety net enacted during the pandemic. There’s no longer funding for people to get tested or treated who are uninsured, even though there’s clear evidence that people without insurance are the most likely to transmit Covid, get sick from it, and die. But the uninsured and poor are considered disposable, and so we’re seeing less and less money spent on protecting them.
CR: Your book suggests that viruses are some of the “greatest teachers”—how so?
ST: Viruses help us see who is being neglected by society and show us how, if we were to actually dismantle the structural forces that make particular groups disposable during pandemics, we would have a host of positive economic and social benefits for working people more broadly.
There are countries in the world, like Cuba, that have done pretty well with this pandemic—they have very low death rates, they vaccinated almost everybody over 2, and they did this all while being crushed by the US empire, in Cuba’s case, because they put a lot of money into public health. The idea that people need to work together—work collectively to protect the public health—is in and of itself something that viruses make clear and force people to deal with.
Viruses help us see that everything is connected. American culture and neoliberal capitalism are always trying to get us to see ourselves as the discrete heroes of our own journey, disconnected from everybody else. Whether we rise or fall is completely on us, and we shouldn’t care too much about other people, the thinking goes. On a physiological level, viruses just blow out of the water the idea that two people are distinct, when organic matter can be going between us in such a way that it helps reprogram part of our genetic code, which is what happens when someone gets infected by a virus. If we want to be safe, we have to make the air we breathe, the water we drink, safe for everyone. In that way, viruses are very helpful for helping us understand and wrestle with the fact that we are connected.
CR: I was particularly struck by your discussion of how policing, prisons, and the criminal legal system in the US and across the world creates and exacerbates harm against the viral underclass. As you write, “The carceral state is one of the most potent vectors of an underclass deemed disposable and unworthy of care or health.” Could you share a bit about this relationship between the politics of law and order and the production of the viral underclass?
ST: It’s important to recognize that being marked as a person who has been incarcerated creates disasters in life that puts someone in the viral underclass. High rates of incarceration not only help produce more pathogens, because of the unsanitary and inhumane conditions in US carceral institutions; they also exacerbate inequalities in housing, employment, and access to health care, which then heighten the risk of viral infection and death for an entire class of people. If you have been in prison or jail, it will be more difficult to get housing and to get a job, and so people are much more likely to become homeless. Prisons and jails manufacture a class of people who don’t have stable access to shelter, employment, or health care. And that is a breeding ground for the movement of viruses as well, and a critical way of thinking about the connection between viruses and the carceral state.
CR: A theme in the book is how, in many ways, both conservative and liberal elites participate in and benefit from the creation of the viral underclass. Why is demonstrating the bipartisan investment in sustaining the viral underclass—and especially the Democratic Party’s complicity in making the conditions of viral transmission worse—so important?
ST: One example that I write about in the book that clearly illustrates how the viral underclass was the product of bipartisan policy-making is the government’s treatment of Haitian immigrants. There is a long history of the US criminalizing Haitians, but in 1991, George H.W. Bush’s administration barred entry to thousands of Haitians refugees who had fled their country after their democratically elected president was ousted by a coup and instead forced them into Guantánamo. Once there, and while waiting to see if they would be granted refugee status, these Haitians were forcibly screened for HIV. Without their consent, HIV-positive Haitian women were sterilized or injected with Depo-Provera, a semi-permanent form of birth control. Fast-forward 30 years and, in 2021, President Joe Biden deported more Haitians in his first few weeks in office than the Trump administration did in a whole year. Biden used a controversial provision of the 1944 Public Health Service Act, Rule 42, that allows the federal government to speed up deportations during a pandemic as justification—the same rule that Trump’s administration used to expel migrants seeking asylum in 2020, a move that many liberals criticized at the time. Rule 42 basically argues that the government has a right to deport people because they are bringing pathogens and disease into the country—which is quite an argument to make while there are almost no restrictions inside of the country. But the point is, the production of a viral underclass is not simply a Trumpist or Republican project. Liberalism upholds these same racist and xenophobic systems, benefits from them, and refuses to challenge them.
It’s easy to be angry at Senators Joe Manchin and Kyrsten Sinema if you support the Biden agenda. But even in places where there is a supermajority of Democrats, like in California, liberals are not enacting statewide health care or creating completely free colleges so people would have more money for health care or rent, despite California having an enormous windfall in its budget right now. It wouldn’t cost that much money for the state to, say, build housing for people who don’t have houses—but it’s not doing that. This is not about personalities; this is just what the conditions in the US create, and a lot of it has to do with liberals. Liberals create the conditions where viruses happen. That’s because that’s part of how liberalism operates: It does not respond to those root causes that would meaningfully mitigate viral transmission and allow for certain conditions to disappear entirely. American liberalism depends upon systems and politics that create viral conditions: policing, prisons, neoliberal health care, fighting against Medicare for all, etc.
CR: What is your assessment of the current government response (or perhaps, more aptly, lack thereof) to the Covid-19 pandemic, and how might your book be used by social movements or policy-makers to push for different policy responses?
ST: I find the current moment completely incohesive in terms of messaging. You can’t have a public health policy that is so ad hoc—certainly not when the virus is so transmissible and affects so many different people. I think one of the biggest mistakes was leaders ignoring cues about what people would actually do during the pandemic. Last time I looked, and throughout this year, a majority of people were in favor of mask mandates; they didn’t mind them. But then you would see people like David Leonhardt [of The New York Times] and people in the White House downplaying these statistics and creating another narrative that made masking appear unnecessary or burdensome. In doing so, they drove down public opinion a bit, but there is still a slim majority in favor. So it’s not like there is just a tiny percentage of people willing to mask and take other public health measures. It’s a mistake, but a predictable one—the media and government have always catered to the comfort of the ruling class and bourgeoisie.
I think there is a mistake in not centering the viral underclass in our policy-making. If you center the comfort of the people at the top, the people on the bottom are going to suffer. If you center the people on the bottom, actually everyone would do better. What would a world look like in which a line cook doesn’t get sick and die at a higher rate than people in other jobs? Well, that would be a world where there is really good ventilation in kitchens, where people had paid sick leave, where there was an excess of labor available so that you’re not looking at one person and saying, “Can you cook 100 hamburgers in an hour?”—rather, you have two people working, with enough support so that if one person is sick, they have someone to cover for them. If we centered the people who are in the viral underclass and asked ourselves, “What would it take to get them housing, insurance, the things they need to be safe?,” that would have a net positive effect for everyone in society—well, except for the billionaires, who would have to pay more money in taxes and share their resources.
