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The virus of inequality in ‘The Viral Underclass’

When it comes to our current pandemic, racism can kill

Illustration for review of "The Viral Underclass: The Human Toll When Inequality and Disease Collide" by Steven W. Thrasher. 0731Viral; Books; 7-31-22Rob Dobi for The Boston Globe

When George Floyd died in May 2020, the cause was murder. A white Minneapolis police officer kneeled on Floyd’s neck for nearly nine minutes while the 46-year-old Black man gasped for breath. But Floyd’s autopsy revealed that he was also infected with COVID-19, a leading cause of death in the US that summer, particularly among Black men. If police violence hadn’t killed Floyd, the virus might have — and that’s no coincidence, says journalist Steven W. Thrasher. Either way, he argues, Floyd’s life was ultimately cut short by racism.

In “The Viral Underclass,” Thrasher makes the case that racism is a social vector of virus transmission, one of numerous mechanisms that allocate an unequal share of sickness to certain demographic groups. These groups, which include people of color as well as people without homes, shift workers, migrants, the LGBTQ community, the elderly, and people with disabilities, compose what Thrasher calls an underclass that is more vulnerable both to viral infection and to its most serious consequences, such as economic ruin or premature death. Our social class, he contends, plays a much bigger role than biology or epidemiology in determining whether we get sick — and whether we recover.


Thrasher, a journalism professor at Northwestern University’s Medill School, spent a decade studying how AIDS inordinately affects Black and brown communities. As COVID tore through his Brooklyn neighborhood in the spring of 2020, he saw a familiar pattern play out. “The maps showing where people were most likely to become HIV positive (and to be harassed by police, or be killed by police, or be incarcerated, or have their HIV progress to an AIDS diagnosis, or have their AIDS diagnosis proceed to death) were maps of the same spaces where people were most likely to get the coronavirus and die of COVID-19,” he writes. “People were getting sick from this new virus because of where they lived, and they were dying disproportionately from it because of the bodies they had been living in their whole lives.”

The pandemic brought America’s health inequities into stark relief, but “The Viral Underclass” illustrates that the problem isn’t new, and that it is embedded more deeply than many of us realize. The book is organized around the different “isms” that helped create the viral underclass — including racism, ableism, and even capitalism — but its focus is on people who have suffered as a result: members of already marginalized groups who are most endangered by viruses like HIV and COVID. People of color in particular, Thrasher demonstrates, are more likely than white Americans to live in substandard housing packed with too many other people, where viruses can spread like wildfire. They are more likely to be minimum-wage service workers, who were given the glorified title of “essential” during the pandemic, but not given adequate personal protective equipment or the luxury of working from home. They are much less likely to have health insurance and much more likely to have underlying health conditions that make them susceptible to the worst effects from COVID.


Thrasher, a gay Black man, brings figures from the viral underclass to life in this engaging, enraging read. It’s no spoiler to say that most of their stories end badly; what’s infuriating is that each outcome would have been shockingly simple to prevent on its own. With access to health care, educational opportunities, a living wage, safe housing, or social support, none of these lives would have begun the downward spiral toward tragedy.


Thrasher’s narrative centers on Michael Johnson, a Black college student at a predominantly white university outside St. Louis, who in 2013 was arrested on charges of recklessly infecting a white male partner with HIV. Facing a possible life sentence for transmitting a virus that 30 million people live with, Johnson was ensnared by structural racism that not only makes Black men more likely to contract HIV — one in two gay Black men will likely be infected in their lifetime, according to CDC projections, compared to one in 11 gay white men — but also criminalizes those who do.

At Johnson’s trial, a white prosecutor urged an almost all-white jury to lock him up forever, warning that he was a danger to public health who roamed the world with a “calling card” of “HIV with a tint of gonorrhea mixed in.” It’s a disturbing, but not all that unusual, example of the scapegoating that happens whenever a virus threatens the American public. People tend to look for a “Patient Zero” — typically a member of a marginalized group — to blame for introducing the scourge and to punish for vice or “unclean” living, Thrasher says. “The United States has long viewed itself as a nation defined by its lack of pathogens and has required people to be ‘clean’ to lay claim to its lands,” he writes. That has led to attacks on perceived outsiders throughout American history — including the unfair targeting of Asian-Americans during the spread of COVID, which former President Donald Trump termed “the China virus” and “kung flu.”


Penalizing individuals for the spread of viruses that affect tens of millions of people around the globe will not make anyone safer, as Thrasher notes. But eliminating the structural inequalities that create a viral underclass will. Equipping everyone to live long and healthy lives would prevent the rampant spread of preventable illness and improve the odds for all of us. And as Thrasher illustrates, that goal requires us to prioritize equal treatment for all, rather than hoarding the resources that guarantee good outcomes for the privileged few.

THE VIRAL UNDERCLASS: The Human Toll When Inequality and Disease Collide

By Steven W. Thrasher

Celadon, 352 pages, $29.99

Jennifer Latson is a Houston-based journalist and the author of “The Boy Who Loved Too Much,” a nonfiction book about a rare genetic disorder that makes people irrepressibly friendly. Follow her on Twitter @JennieLatson.