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The Making of Our “Viral Underclass”

The Viral Underclass digs into capitalism, Big Pharma, “Gay-Inc.” and other factors surrounding Covid-19 and HIV that force a greater toll on the already marginalized.

The Viral Underclass: The Human Toll When Inequality and Disease Collide
Steven W. Thrasher
August 2022

Two global pandemics, HIV and Covid-19, have exposed deep social divides. How people experience these two viruses depends on class, race, gender, sexuality, and other social categories and the interactions among them. The prominent AIDS activist, Sean Strub, coined the term “viral underclass” to describe how stigma and government policy combine to produce discrimination against people with HIV. In his new book, The Viral Underclass, Steven W. Thrasher builds on Strub’s concept to develop a theory of “how and why marginalized populations are subjected to increased harms of viral transmission, exposure, replication and death.” Just as marginalized people are made vulnerable to viruses, viruses are used to justify the marginalization of people who have contracted or transmitted them.

Thrasher writes that the viral underclass is produced by social “vectors” that “enable the relationship between viruses and marginalization”; they lead to the conditions for unequal viral transmission or compound the harms of viruses through discrimination or poverty. The interaction of these vectors determines how some not only survive pandemics but profit from them (billionaires’ wealth surged during the Covid pandemic) and why others not only get sick and die but also experience stigma, shame, and economic precarity. (150 million people fell into extreme poverty by 2021 because of the pandemic.)

Thrasher is a journalist turned academic, and his book combines in-depth reporting, social theory, and personal reflection. He writes in an engaging, accessible style, and his voice is thoughtful, indignant, and passionate. As a gay Black man who has faced personal and professional challenges, he hasn’t produced a distanced, “objective” account. The issues explored in The Viral Underclass are structural, embedded in government, institutions, and organizations, but for Thrasher, also deeply personal. He tells the stories of people in the viral underclass across the world, focusing on how they encounter and cope with various pathogens, but mainly HIV and SARS-CoV-2, the novel coronavirus. Thrasher focuses on them because although effective treatments for the former and vaccines for the latter now exist, the two viruses “still power two of the world’s most dangerous ongoing pandemics” and are unlikely to be eradicated anytime soon.

The Viral Underclass shows how the various social vectors operate through the stories of several people, most notably Michael Johnson, a Black gay high school athlete who served six years in prison, including solitary confinement, for transmitting HIV to sex partners; Olivier Le Borgne, a gay, HIV-positive French actor who committed suicide; Zak Kostopolous, a Greek gay and AIDS activist and drag performer murdered in Athens by right-wing thugs, with the collusion of police; Lorena Borjas, a Mexican transgender woman and former sex worker in New York City who, until her death from Covid-19, was beloved among her peers for her efforts to protect them from HIV; Bob Rasky, a white, gay AIDS activist who confronted Bill Clinton; and Ward Harkavy, Thrasher’s editor at the Village Voice and friend who died from the coronavirus.

Their stories, poignant and moving (and sometimes infuriating), illustrate what it means and feels like to be pushed into a viral underclass.

The title of Thrasher’s book is a good one, punchy and memorable, but also problematic. In the 1960s, the Swedish-born sociologist Gunnar Myrdal used the term “underclass” to describe people in the lowest economic stratum of US society, the long-term poor who experience little or no advancement despite general prosperity and ameliorative government policies. However, the term has become more associated with conservatism as a behavioral category. Sociologist Charles Murray, for example, proposed that in the United States, there is a “hardcore” of poor families and individuals who are welfare-dependent and commit a disproportionate amount of crime. Because this underclass is supposedly intergenerational (either by heredity or socialization), he argues, social welfare programs to improve their lot are futile and a waste of money.

Thrasher avoids (mostly) the potential pitfalls of “underclass” by conceptualizing it as a socioeconomic category and analytic tool in a left-wing critique. He does this most effectively in the section titled “Parasite: Capitalism”. He cleverly uses Bong Joon-ho‘s 2019 film Parasite (which won the Best Picture Academy Award in 2020) to illustrate his argument about capitalism as a global system that is the “main vector” for the creation of a viral underclass “whose life value is depleted and sucked upward … toward the ruling class.”  

Thrasher follows Cedric Robinson and other theorists of racial capitalism in describing capitalism “as a system intertwined with the trade in human cargo, especially in the seventeenth and eighteenth centuries.” As capitalism came to rely on wage labor rather than enslaved workers, “it created appalling conditions in the form of dangerous factories and crowded housing, in which viruses flourished among the proletariat.” Thrasher connects capitalist dynamics to viral epidemics: state-funded research resulted in effective HIV medications in the late ’90s, but drugs were manufactured and made available for wealthy countries to protect Big Pharma profits. The outcome was that while US deaths from HIV declined, “AIDS deaths globally continued to soar for another seven years.” More people died of AIDS after the medications became available because of their cost or unavailability.

As with HIV meds, so it goes with Covid-19 vaccines; by 2021, despite the availability of several vaccines, patents weren’t shared globally to protect the “intellectual property” of their manufacturers. Once again, this occurred despite research largely being funded with public monies and government purchases guaranteed sales. Capitalism, Thrasher concludes, “exploits humans’ best abilities and their vulnerabilities alike and their relationships with others. The system does not breed wellness; it produces widespread need that can never quite be met, leading to ongoing crises that can be exploited for profit.”

The easily transmitted novel coronavirus demonstrated that in our highly connected world, even the privileged and powerful are vulnerable to it. This is why, Thrasher explains, the Covid-19 virus “has unnerved the ruling class around the world more than any other.” When it “dropped a match into decades of social kindling, those rulers became aware that the blast might even reach them.” The risks of Covid-19 “could have been shared with robust state support for protection, housing, and food security.” The “billionaire class could have shared the wealth their employees earned” (or rather, created); instead, they got richer and their workers poorer. Millions of people who lost employment during the pandemic also lost their health care, joining the ranks of millions who never had coverage at all. Because the state, “at the behest of the wealthy who control it” did not share risk, which instead was foisted on “essential workers” and others who could not self-isolate or work remotely, “the onus was put on every individual to figure out Covid-19 largely on their own.” This outcome “is not a bug of capitalism; it is one of its defining features.”

Thrasher’s radicalism extends to his critique of the Democratic Party. Liberals who believe that the Republicans are responsible for all the evil in the United States today will object, but Thrasher’s criticisms are on point. He damns the Democrats for their role in expanding “the scope of policing and the carceral state.” By this, he means not just more jails, prisons, and immigrant detention centers but “a sprawl of where these things exist and a logic of punishment that permeates increasing facets of American life.” Whereas Republicans have faced protests for their role in expanding policing and incarceration, Democratic presidents, legislators, mayors, and governors face few objections to their responsibility in “creating a police state, allowing it to grow almost unchecked.”

Bill Clinton, in particular, comes in for some fierce criticism for passing two pieces of legislation that have caused great harm: the 1994 crime bill and the 1996 welfare reform bill. Together, they “increased Black incarceration, homelessness, and precarity, which has had the alarming effect of increasing pathogenic transmission among Black people in the subsequent decades.” Most damning, Clinton’s policies “are why the rate of AIDS among Black Americans eventually became more prevalent per capita” after effective HIV medications became available than it “ever was for white America when there were no medications available at all.” 

As with HIV, “a similar kind of viral disparity happened with Covid-19.” Thrasher cites the bad decisions made by two Democratic governors during the pandemic. In August 2020, California’s Gavin Newsom refused to release people incarcerated at San Quentin State Prison despite the pleas of their families and activists; 2,500 prisoners already had tested positive for the novel coronavirus, and 25 had died.

In New York, Governor Andrew Cuomo’s frequent media appearances in the first months of the pandemic were meant to present him as the anti-Trump, a calm, reassuring, “follow-the-science” leader who exuded competence and compassion. But he sent 4,500 patients with coronavirus to nursing homes to recover. Adding insult to injury, Cuomo’s administration gave out statistics that undercounted by thousands the numbers of people who died in the state’s nursing homes because of this decision. One of those who contracted Covid-19 in a nursing home was Thrasher’s editor and friend Ward Harkavy, who died at 72 in May 2020.

Thrasher ties these preventable infections and deaths to Cuomo’s neoliberal policies, particularly the elimination of 20,000 hospital beds statewide. During the pandemic, Cuomo tried to cut nearly a half-billion dollars in Medicaid funds from the state budget while refusing to raise taxes on millionaires and billionaires, “something even Republican governors had done in times of past crises.” 

Cuomo was brought down by allegations of sexual misbehavior with aides and other state officials and employees. But those offenses, though deplorable, pale compared to the damage caused by his disastrous decision on Covid and nursing homes. “I often found myself wondering,” Thrasher writes, “If Andrew Cuomo hadn’t spent so many years stripping the New York hospital system to the bone, would people with COVID-19 have been sent into nursing homes to recover?”

Thrasher’s critique of Democrats also targets “Gay, Inc.”, the “operatives and organizations who benefit from their association with Democrats.” Because Democratic politicians like Newsom and Cuomo have supported marriage equality and other reforms, the members of Gay, Inc. have not held their feet to the fire on issues like mass incarceration and the party’s embrace of neoliberalism. He contrasts these figures with the activists of ACT UP, the nonpartisan grassroots group unaligned with any political party that challenged both Republicans and Democrats.

He praises several gay and AIDS activists, Bob Rafsky and the writer Vito Russo, both of whom died from AIDS, for taking on Democrats, including Bill Clinton (Rafsky), and for protesting a government and public health bureaucracy for systemic failures in responding to the AIDS epidemic (Russo). Russo famously said, “After we kick the shit out of this disease, we’re all going to be alive to kick the shit out of this system so that this never happens again.” Thrasher mourns the loss of their radicalism and wonders whether their passing contributed to a conservative turn in gay male politics that affected “Democratic carceral policies” so that “HIV, influenza, and the coronavirus” could flourish among incarcerated people.

Thrasher is correct to note that the gay movement, and in particular a class of white gay men, have become too close to the Democrats and that being joined at the hip to the party has diluted the movement’s once-oppositional stance. His critique, however, is partial and overstated. White lesbians don’t get the same critical scrutiny as their male counterparts. Perhaps this is because lesbians also confront sexism and fight for women’s issues and are less likely to be single-issue focused. Still, Thrasher’s brief against white gay men for choosing access to Democratic presidents and legislators over radicalism applies to many women, too.

Moreover, in recent years there has been a resurgence of radicalism, led by young gay male, lesbian, and transgender activists. They’re making the connections between various systemic issues—racism, anti-LGBT animus, immigration, policing and the criminal justice system, capitalist economic inequities—that recall the multifocal vision of the Gay Liberation Front and other post-Stonewall radicals. Protests against the presence of corporations and cops in Pride parades have spread across the United States, as well as alternative Pride events. Thrasher’s worthy criticisms of Gay, Inc. notwithstanding, his assessment of gay politics would have benefited from a broader perspective.

After The Viral Underclass’ rigorous critique of how state actors and institutions have helped create a viral underclass, its last chapter is disappointing. Thrasher notes that although the privileged and powerful have resources that the underclass doesn’t, they too cannot escape viral epidemics; Donald Trump, whose criminal negligence caused so much unnecessary suffering and death, contracted Covid-19 and was hospitalized. “Perhaps then,” Thrasher writes, “the most fundamental question viruses probe us to ask ourselves is: Why am I ‘me’ and you are ‘you’? If you believe that ‘you’ and ‘I’ are not separate, but that we face common challenges, then our hierarchies might melt away.”

What if, he suggests, “viruses teach us that there is no ‘me’ and no ‘you’ at all and that we all share one collective body?” If “we” were to recognize the interconnections among all of us, such evils as racism, sexism, homophobia, ableism, and “cisgender superiority” would end, along with “the hoarding of resources through capitalism”, with austerity replaced “by anarchy and abundance”. That viruses can “teach” us anything, much less be “our greatest teachers”, seems dubious. That the lessons they supposedly teach might end the various oppressions of capitalism even more so.

Thrasher’s utopian vision is appealing but has a major problem: the lack of politics. The replacement of capitalist individualism and selfishness with a “new ethic of care” cannot occur without radical political change. Unless capitalism is replaced with some form of socialism, reforms at best can only ameliorate the social, economic, and political factors that have created the viral underclass.