Attempts to minimize the pandemic began almost at the beginning. In March 2020, Chris Cuomo—then the anchor of a CNN news program—put a challenge to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Cuomo proposed that some people could not tolerate two weeks at home to stop the spread of the virus and wanted to open up, accepting that “whatever happens, happens.” He contrasted this attitude with the warnings of his brother Andrew, then governor of the state of New York, that Covid was still intensifying. “How do you deal with those opposite interests?” Cuomo asked. “We’ve done it long enough, we’re frustrated, we want to get over this, and, what you’ve told us to do so far, it’s still accelerating?”
At the time, New York state’s lockdown, closing nonessential workplaces and barring nonessential gatherings, was five days old. The chyron noted that by that night, 921 people had died of Covid in the whole United States. The push to abandon mitigation measures nearly immediately had little to do with the lethal facts of Covid and more to do with broader feelings of discomfort. “You’ve got to be realistic,” Fauci responded. “You don’t make the timeline. The virus makes the timeline.” In another two weeks, in New York City alone, 816 people would die in a single day.
Less than a week after his Fauci interview, Chris Cuomo announced that he had tested positive for the virus. Working from a home studio, he could continue to trade “brotherly barbs” with the governor, as CNN’s Brian Stelter put it. Of his brother’s infection and quarantine, the governor said at his daily press conference, “This virus is the great equalizer.” He went on to win a special Emmy for these briefings.
“Like all pathogens,” writes journalist Steven W. Thrasher in his first book, The Viral Underclass: The Human Toll When Inequality and Disease Collide, “the novel coronavirus was not a ‘great equalizer,’ as some initially called it, but a magnifier of the divisions already present in our world.” While much journalism on Covid-19 continues to tell the story of the pandemic the way Chris Cuomo did at the outset—as a struggle between safety and personal liberty—Thrasher offers a different approach. Instead of focusing on individual choices, Thrasher investigates the social factors that “enable the relationship between viruses and marginalization.” What if, instead of focusing on the behaviors of “vulnerable people,” he proposes, we tried to understand how we make people vulnerable to viruses?
Thrasher draws the title of his book from Sean Strub, the longtime AIDS activist and executive director of the Sero Project. Strub used the phrase “viral underclass” in 2011 to describe how governments sanction stigma against people with viruses by enshrining discrimination in the law, producing “a viral underclass of persons with rights inferior to others.” It’s a way of explaining why, despite scientific gains in managing and preventing HIV infection, the HIV pandemic has never ended. The benefits of medical advances accrued to those who already had access to health care and other life-sustaining resources. Those who lacked these resources were effectively abandoned again, reinforcing their status as outside the realm of protection.
The first time Thrasher sees “the manifestation of the viral underclass” is several years before the Covid-19 pandemic. He goes to St. Louis in 2014, where a man named Michael Johnson is on trial, facing a possible life sentence in prison, for the charge of “recklessly” transmitting HIV. Johnson was 23 years old, and nationally recognized as a junior college wrestler, when he was arrested in a classroom at Lindenwood University. He was among the few Black students enrolled at the school in one of the city’s “white flight” suburbs, Thrasher writes. Johnson was accused of having sex with six men, some of them fellow students, without disclosing his positive HIV status. When he was diagnosed in 2013, he signed a form acknowledging his test result would be reported to the state of Missouri. His mother tells Thrasher her son didn’t understand that signing this form could lead to his incarceration—that anytime he had sex afterward, and didn’t share his status, he would be committing a felony. Laws like the one Johnson was charged under may have aimed to prevent virus transmission, but in truth, as Thrasher writes, when they are used in a high-profile case, as Johnson’s became, such laws incentivize people not to learn their status—so as not to be prosecuted.
Thrasher notes in much media coverage of Johnson the familiar trope of “the irresponsible Black body as a vector of disease.” Johnson’s story was being told as if HIV followed Blackness, followed by criminality. A white student who had sex with Johnson but tested negative and did not press charges likened Johnson’s action to “a form of murder.” Racist commenters online called Johnson an “HIV Positive Buck” and the “Worst type of homosexual: a strong one with HIV.” Before his arrest, Johnson was valued as a promising athlete. His body only became “dangerous” once one of his white sex partners pressed charges. In jail, Johnson was held in solitary, and in court, jurors would be shown images of his penis. On the stand, Johnson testified that he told each of the six men in question his status. He was found guilty. Thrasher writes that he sensed “the macabre but festive sensation of a lynching” in the courtroom at the sentencing.
There was a relationship between race, the law, and the virus here, Thrasher argues, but it was one produced in significant part by the criminal legal system. “Because Black people were far more likely to be living with HIV,” Thrasher observes, “the kinds of laws being used to prosecute people were a manifestation of an American tendency once again to criminalize Black sexuality in general and interracial sex in particular.” In many ways, Johnson’s case presents the clearest and most stark example of Thrasher’s definition of the viral underclass, perhaps owing to the term’s origins in Strub’s work around HIV criminalization and the law.
But Thrasher also broadens Strub’s term. Not long after Johnson’s trial, Thrasher returns to St. Louis to report on the aftermath of the death of Michael Brown, shot and killed by Ferguson Police Officer Darren Wilson. He talks to an HIV prevention expert, who mentions the Canfield Green Apartments, where Wilson killed Brown; the expert’s colleagues had been there while tracking new HIV transmission in the surrounding county. “Of course, the HIV folks know the area where Michael Brown was killed, I thought,” he writes. The link seems to set him on a new path, as he builds up a “guiding cartography” of “viral transmission.” Where people are living with and dying from viruses, he points out, “you’re bound to find Black people dying of police violence and poverty, too.” Here the viral underclass is shaped by another dimension of the legal system, and another layer of risk: dying of illness and dying at the hands of police.
Before the concept of the viral underclass emerged, the underclass was already thought of as a contagion, one with a distinct geography. In the 1980s and 1990s, works like Ken Auletta’s The Underclass and the writings of Charles Murray popularized the concept of an underclass of disorderly people—“criminals,” “convicts,” “addicts,” “single mothers.” As Loïc Wacquant writes in his critical history The Invention of the “Underclass,” the term has also been used to designate “not just a problem population, but also a place,” one that “threatens to contaminate the city like a virus.”
In March 2020, Jackson Heights was at the epicenter of the Covid-19 pandemic—one of three Queens neighborhoods with a positivity rate nearly twice that of the New York City average. That month, Cecilia Gentili, a health access activist, former sex worker, and author, learned that her mentor and close friend Lorena Borjas, an iconic leader in the trans Latina community in Jackson Heights, was sick. When Lorena called to say she couldn’t attend their standing Saturday night gathering, she had what Cecilia recognized as Covid symptoms, but she didn’t want to go the hospital. “I don’t know what’s going to happen there!” she told Cecilia. She was trans, and her English wasn’t strong.
Cecilia’s reservations made Thrasher think of “a less dramatic experience” he’d had at the doctor’s office himself. When he had to get a testicular sonogram at 41, referred by his university health center, the receptionist had laughed at him, saying, “You just don’t look like what I was expecting. I was expecting someone younger.” He tried to deflect, but he still felt ashamed that she thought he wasn’t young enough to be a graduate student. “At a moment of great vulnerability, I was made to feel unwelcome,” he recalls.
I remember thinking, What if a trans woman who was femme presenting and had testicles came in, vulnerable and needing help? What if the receptionist said, “You don’t look like what I was expecting”? … This is part of why lethal health disparities plague queer and trans people at such high rates, and why viruses circulate more often in our bodies.
Cecilia stepped in to help Lorena navigate her Covid care at the hospital. Elmhurst Hospital, where she was treated, was at that time the epicenter within the epicenter of the pandemic, as then-Mayor Bill de Blasio described it. Lorena’s neighbors—“day laborers, nursing home orderlies, fast-food workers, and sex workers,” some of those mythologized as “essential” workers— couldn’t work from home to protect themselves from the virus. This wasn’t just a matter of geography, then; it was a question of labor too, and Lorena, a community organizer, was among those who carried out her work in person. Now, she worked the phones from her hospital bed, bailing people out of the jail at Rikers Island, another growing Covid hot spot, “desperately trying to free people before they, too, got sick.” The virus would take Lorena’s life not long after.
Lorena was the first person I knew to die from Covid; I had interviewed her for a story for The Village Voice in 2016. “There was a sad irony at the end of her life,” Thrasher writes, that “all the thousands of people she’s given condoms and syringes and food to on Roosevelt Avenue—none of them could be with her to hold her hand in the final, transitional moments of her earthly journey.” She passed away in the early hours of March 30, 2020, one day before Chris Cuomo began broadcasting through his own viral infection from the studio in one of his homes in the Hamptons.
Cuomo’s brother’s connections meant that a doctor from the state’s lead health agency would be dispatched there for a house call to swab him for a Covid test, the samples driven to a hospital by state troopers, at a time when other New Yorkers were frantically searching for tests. By then, the governor had announced that he was drafting people caged in an upstate maximum-security prison to make hand sanitizer—a product the prisoners themselves are barred from using. 706,172 gallons of the stuff would never be distributed, abandoned on a former airport runway in pallets.
Those prison laborers, the community organizers like Lorena working to get people out of jail, the health care workers like those at Elmhurst Hospital working to keep the people of Queens alive—they carried the burden of risk, and some of them, mostly the nurses and doctors, were celebrated for it. But those other life-giving members of the viral underclass, as Thrasher has defined it, had so long been burdened with blame and stigma that the work they did so others might weather the pandemic by the beach remained mostly invisible.
Thrasher’s other major concern is with stigma: how, as viruses can harm a community’s health, the stigma surrounding them magnifies and entrenches that harm. He recalls arriving at a party held during Pride in Manhattan long before Covid, “wearing a tutu, hiking boots, and a cowboy hat” when he met a man named Olivier Le Borgne. The pair talked all afternoon and into the night as the party spilled onto the street, Thrasher relaxing into Olivier’s presence “despite how disarmed I was by his radiance.” Yet after a kiss on the Q train, Olivier ghosted him. Only after a year did Olivier connect with Thrasher on Facebook and tell him why: He was HIV-positive, and he didn’t want to be rejected, so he ran first. But he wanted to explain.
A yearslong friendship started from there. “Olivier taught me more about viruses than just about anyone I’ve ever known, except maybe Michael Johnson,” Thrasher writes. Michael Johnson taught him in a professional way, about “the manifestation of the viral underclass via racism,” but Olivier would teach him “how it manifests via individual shame.” Getting to know Olivier better from the distance Facebook affords, he writes, he realized what made having sex with Olivier impossible: “my ignorance and his trauma.” Stigma was separating them.
Stigma functions to place the responsibility and blame for the virus solely on the individual; in this way, it obscures what makes people vulnerable to a virus in the first place. Thrasher locates the manufacture of stigma in media and political messaging. One such stigmatizing narrative, he writes, is the hunt for “Patient Zero”—the individual believed to be the first to contract a virus currently seizing headlines, like HIV, or Ebola, or Covid-19, “in language that either conjures up an enemy on the battlefield … or equates a sick person with a wild animal needing to be stalked and butchered.” While the term sounds scientific, it originated with an error in the early years of HIV: Contact tracers had used the letter O to identify a patient, which was misinterpreted as a number zero. There was never a sound basis for tracing the rise of HIV to this individual. But the mythic figure of a selfish person promiscuously infecting others made for a better story than the truth.
Thrasher sees the much-hyped stories of “Covid parties” that appeared in early 2020 through this historic lens. As news outlets tracked the prevalence of Covid-19 in 2020, they also began to report that people were hosting events whose primary purpose was to spread the virus. National stories based on local stories conflated young people having parties, young people getting Covid, and young people incentivizing getting Covid with prizes—which did not happen. Such stories presented people with Covid as the villains, and not the elected officials who failed to respond to the virus, nor those already growing wealthier in the pandemic. Instead, people with viruses are represented as reckless, dangerous, and subhuman.
“Through news media,” Thrasher writes, “stigma doesn’t just make some people hyperaware that they live with a virus; it tries to trick people”—like Olivier—“into believing they themselves are viral parasites. And it tries to trick everyone (including, I am embarrassed to say, me at times) into feeling like we should be afraid of them.” Stigma serves to both dehumanize people with viruses and to deflect attention from the systems that manifest the viral underclass.
Thrasher writes of his book as a journey, an invitation to travel alongside him as he puts the focus back on the members of the viral underclass. It is also an exploration—“without romanticizing them too much,” he cautions—of what viruses have taught him about the dangers and the necessity of vulnerability, of how they have “drawn [him] around the world,” how they showed him that he “could love (and mourn) more deeply” than he “ever knew was possible.” Here is the possibility contained within the framing of the viral underclass: that viruses bind people together, even as they do not take from all of us in equal measure.
“The boundaries for who is and isn’t in” the viral underclass, Thrasher adds, are not “fixed over time.” Sean Strub, who coined the phrase viral underclass, is for instance “a well-off white man and the mayor of his town,” but also a person whose HIV-positive status “made him more susceptible to criminal prosecution.” This evocation of shifting membership could be understood as a call for solidarity with the viral underclass, as encouragement to see how you may be already part of it or could be. With this acceptance of our interconnectedness, Thrasher offers, “our hierarchies might melt away.”
I am not so certain of the power of the virus. Could viruses accomplish, or at least kick off, such a reordering? Consider again the underclass as it has long been pathologized: as hopelessly incapable of contributing or selfishly refusing to contribute to society, while also being a burden and a danger. The underclass in that sense was already viral. It was understood as a threat, transmissible across class lines.
Thrasher, for his part, narrates a life lived across whatever border divides the viral underclass from others. Yet there’s a tense parallel with those late–twentieth-century accounts of the underclass, the ones that imagined the urban landscape as another country populated with people utterly unlike its great explorers. The virus retains the power to reinforce those class boundaries, the ones across which we are not meant to have contact.
There are tensions, too, when Thrasher aims to fit stories into the “viral” framework that don’t truly belong. In a chapter on austerity, Thrasher declares that “addiction itself is viral,” which is simply untrue. It echoes—perhaps unintentionally—the notion of the underclass as a contagion. At the same time, the voices of both people who use drugs and people with substance-use disorders are absent from the chapter. This overgeneralized story, in which their experiences are collapsed into a single timeline of “legitimate” opioid use leading to “illicit” misuse and addiction, risks slipping into the kind of simplistic media tropes that Thrasher might otherwise reject.
It’s understandable to look in the virus for a crisis so widespread and persistent, requiring such a thoroughgoing response, that it would bring about a more just, more caring world. A remarkable quality of Thrasher’s book is his attentiveness to injustice on a large scale as well as in its most intimate forms. He is most persuasive when he makes the case for urgent change, envisioning a society that doesn’t force people to expose themselves to sickness in order to survive. It will take more than our shared experience of the virus to get us there.