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Melissa Harris-Perry: You're listening to The Takeaway. Thanks for joining us today. I'm Melissa Harris-Perry.

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Melissa Harris-Perry: In late July, the World Health Organization declared monkeypox a global health emergency. According to the latest numbers from the CDC, there are now more than 5,000 confirmed cases in the US. Much of the reporting on monkeypox, which some researchers are now calling MPXV, has focused on high transmission rates among men who have sex with other men.

Despite all of the lessons we might have hoped officials had learned in earlier parts of the COVID-19 pandemic, the rollout of MPXV testing vaccinations has been haphazard and uneven. At the same time, more than 430 people per day are still dying of COVID-19 here in the US with Black, Hispanic, and Native American people still being about twice as likely to die from the virus. See, the viruses are more than pathogens. Surviving them depends on more than physical health.

Steven Thrasher: My name is Steven Thrasher. I'm the author of The Viral Underclass and a professor at Northwestern University.

Melissa Harris-Perry: In The Viral Underclass, Thrasher upturns simple biological notions of vulnerability pointing to the social determinants of health. Who is the viral underclass?

Steven Thrasher: The viral underclass is composed of people who are affected by different kinds of viruses sometimes with extremely different characteristics, but it keeps affecting the same kinds of communities. We've seen in the last three epidemics that are most of my mind, HIV/AIDS, coronavirus, and monkeypox. For instance, we're seeing a very disparate impact on the LGBTQ community, particularly on gay men, men who have sex with men.

HIV behaves very differently from COVID. Even COVID, which is a respiratory illness, had a disparate impact on LGBTQ people because of the ways that transphobia and homophobia make LGBTQ people marginalized in society, were poor, more likely to be unemployed, more likely to be homeless, less likely to have health insurance. Whenever any kind of pathogen in the world is moving, it's more likely to hit us even in ways that might be a little counterintuitive.

In the book, I'm trying to work through how their dynamics to a viral underclass in many countries around the world, but there's a particular way in the United States where viruses themselves make people economically downward-mobile. It makes people more likely to be poor and that's not true in every country in the world. I was just reading an account of a person who got infected by monkeypox and broke down crying because their doctor told them they would have to quarantine for a month unpaid.

In the United States, we let infection happen to somebody and then cast them into the economic pit and say, "You're on your own to get help. Even if you're forced not to work, we're not going to help you out economically," and so viruses themselves become a way that people fall down the economic ladder in the United States.

Melissa Harris-Perry: I want to go back for a second because I want to be certain that we're clear about this question of the likelihood of being affected by an infectious disease. The claim that you're making here is about the social determinants of health rather than a claim about biological vulnerability.

Steven Thrasher: Correct. We often focus on the moment of transmission because that's sometimes the most visible and it's a time where sometimes we can put a physical barrier. For instance, a condom or a mask of something of that kind can stop transmission right there. That's only one step in a chain of events that happened before and after. I'm really interested in these social determinants, the ways that racism, ableism, homophobia make people vulnerable, make their bodies more likely to be in the pathways of viruses, but also to become infected when they encounter them.

For instance, one thing I'm thinking about in the book is the ways that we barely give children sexual health education in this country. Many states only give them an abstinence-only sexual education, but we generally don't give children an LGBTQ sexual education. When young people are becoming sexually active and then coming into their adulthood, they don't know what to do.

Because we haven't given them the information they need, we are putting their bodies in the pathway of viruses in the ways that they're more likely going to enter their bodies. I think that's a real failure of the state and society and making particular populations vulnerable, and then getting angry at them and economically punishing them and stigmatizing them after that happens when they've been failed by the society even before the moment of infection.

Melissa Harris-Perry: Much of your previous research has been around HIV. You write in the book about the maps of New York City and your realization about the COVID maps and the HIV maps. Can you say more?

Steven Thrasher: When I first was seeing deaths happen from COVID and I was here in New York when things locked down and the deaths started to be reported, the first person in my outer social circle was an activist named Lorena Borjas, who died of COVID-19. She was a trans, Latinx, immigrant-rights activist. I started looking at the maps of where she died and where the hospitals that we're in in Queens and Jackson Heights and some of the places in the city where the deaths were rolling in.

They were very similar maps to the maps I'd seen with HIV and AIDS. In one sense, this was counterintuitive. These viruses behaved very differently and the transmission is different. What they share in common is that there are dense concentrations of poor people, people of color, trans people, people who have been marginalized by the society. When you look at the places in the city where transmission and deaths are happening across a variety of viruses, they're kind of similar.

A lot of that has to do with the social determinants of health. If you're the kind of person who sees a doctor regularly or who, in the case of COVID particularly, can afford to work from home, you're going to be less affected by the virus. One of the things I'm trying to drill down into this is I think many Americans have a misperception about gay people. They might think of LGBTQ people as being rich, but queer people and trans people are overall poor than others. In New York City, for instance, a huge percent of LGBTQ people work in retail.

That's one of the reasons why you would see a disproportionate impact with a respiratory virus that might not seem so obvious. Then when you get into viruses that involves the way that we're intimate with each other and you look at the social determinants, the lack of education, the lack of queer and trans-specific healthcare, the outright attacks on queer and trans health and well-being, it makes a lot of sense about why we see certain people in The Viral Underclass across a variety of different viruses.

Melissa Harris-Perry: Yet the book begins at a place that might seem even more surprising. What does all of this have to do with police violence? You actually begin the first chapter with the murder of George Floyd.

Steven Thrasher: A lot of people don't remember or maybe they never even knew that when George Floyd died and there was an autopsy on him, he had the coronavirus. He was living with it. I've thought about that a lot even at the time. I wonder had he survived that encounter, what if he have gotten seriously sick or died from COVID? I also look at the budget for the city of Minneapolis, which spends 35%, 36% of their money on policing.

George Floyd had recently lost his job as 40 million people lost their jobs in those months in the beginning of the pandemic. I think about, what if Minneapolis hadn't been spending so much money on policing but rather been spending money on housing and care for people like George Floyd so that they could survive the pandemic? He never may have ended up in that store and in the path of the police.

The prison abolition movement and the movement to try to defund the police, I think, has a lot of interest from a wide variety of society when they think about, "What things are we spending money on the police to do that someone else could do?" If you spend more money on public health, if you spend more money on housing and giving people what they need, particularly in economically hard times, you don't have to spend so much money on police.

The more money we spend on those, we're not spending on other things. I'm very concerned right now that the Congress under President Biden and a narrow but still a majority in both houses of Congress, they failed to pass their last $15 billion bill for COVID care. What they lost in that was funding to pay for people who don't have insurance to get testing and treatment. Research has long told us that people who don't have insurance are the most likely to get COVID, get sick from COVID, and die from COVID.

The lack of this money is basically letting people get sick and die from COVID, the people who are the most vulnerable. I think we're really failing as a society to see that you can't stop people from getting infections and diseases with a cop with a gun. That money is going somewhere else. If we spent more money on public health and well-being, we wouldn't be needing all this money for cops. The spending of money on cops create situations like the one that killed George Floyd.

Melissa Harris-Perry: Can you tease out the ways that privilege and this notion of immunity from or safety from infectious disease is connected, not only in COVID but in these previous plagues as well?

Steven Thrasher: I write about the myth of white immunity. There is a certain level of structural immunity by being born white on average that are predetermined areas of health. Many have educational and economic and wealth tools that many non-white people do not have. Like all forms of immunity, it has its limits and is not absolute. One of the ways we've seen quite poor and decreasing metrics of health in the United States is among white people.

Jonathan Metzl writes about this, who wrote the foreword in my book. He writes about this in his book, Dying of Whiteness, that you will have a lot of states, particularly in the South, that are rejecting Medicaid expansion because they say they don't need this at a time where white mortality is rising. White people are dying at younger and younger ages. I try to write about it in the book to say that there are ways that there can be cross-racial, cross-ethnic solidarities among people all around the country to try to create better health outcomes for everyone.

One of the things that's stopping white people from partaking is their belief in this white supremacist and the idea of their own immunity. This is a big part of why I think we had the birth of the anti-vax movement, which came through upper-class white people in California, believing their immunity is so superior. They don't need a vaccine because their bodies are so much better than other people. Of course, that puts their children at great risk. It puts other people at risk.

The case at the heart of this story is about a young Black man who had HIV. He's accused of transmitting it to several white men. Those white men often engaged in unprotected sex, believing somehow that they were protected when they're not. I think that's a lot of how we see people not using masks, ways that we see people not taking the things that are happening to them as seriously as they should. In my research, this is really dovetailed with looking at how HIV moves through the use of injection drugs.

Injection drug use is just one area where we see how the opioid crisis plays out, how we see how de-industrialization is having an effect on white bodies in Appalachia and states in the East and the South. If you think something's not happening to you, if you have a belief in your innate immunity, then it becomes not only difficult to help yourselves, but it precludes opportunities for solidarity with other people. Even people who think they might be immune to these things have a lot more in common with the viral underclass than they do with the ruling class that is threatening to put all of us in an underclass if we get sick with any one thing and fall off a financial cliff.

Melissa Harris-Perry: We have to take a quick break. More with Steven Thrasher just ahead on The Takeaway.

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Melissa Harris-Perry: Back with you on The Takeaway. I'm Melissa Harris-Perry still talking with Professor Steven Thrasher about his new book, The Viral Underclass.

Steven Thrasher: Most of us in the United States are socialized to think as consumers, not as citizens of a society with collective health responsibilities, I could get on planes easily and fly anywhere I could afford in the world with little thought to how that choice affected the asthmatic Black and brown children living near the airports I departed from and arrived at whose lungs inhaled exhausts from the jets faring me around, or how the carbon footprint of my travel would affect wildfires in California or Greece. Why did I need to think of their bodies when I thought about flying? I was free to do whatever I chose with my body as long as I could afford the price of the ticket.

Melissa Harris-Perry: Steven told me what it was like for him as a longtime researcher of the HIV epidemic to see Dr. Anthony Fauci become the face of the COVID-19 pandemic.

Steven Thrasher: Anthony Fauci has been around for a very long time that I was too young to be cognizant of him in the early years of AIDS. I certainly know him from history that he was a very central figure at the beginning of the AIDS epidemic in the United States. He's largely been beloved by liberals now, but he was really criticized and pushed by a lot of gay activists at the time to help push him to do more and to help speed up processes of things that happened and not take a "neutral observer" standpoint.

It was surprising to me just to see that one person would hang on for this long, but also it's been concerning seeing how a cult of personality around him by liberals puts too much emphasis on one person. Whether we're talking about social justice work, people leading movements, or individual medical practitioners, the things we actually need to think about enable our systems. Any one person is not going to make things better or worse by themselves.

It's been very dismaying to see that the Biden administration, having said what they said as they were running for office against Donald Trump, they have not changed a lot of the systems that perpetuate viral illness. The fact that we're still such a carceral nation that Biden wants to spend money on hiring a hundred thousand more cops that we still don't have paid sick leave, that we don't have a national healthcare system. These are the things that drive viral pandemics.

In some ways, even though Trump was an absolute cartoon of malfeasance with this pandemic, if you have a more calm, ameliorating figure like Biden in office, if you have Fauci working between administrations, it's actually less to do with any one personality than it has to do with how we're handling systems and allocating resources. In that way, it's been really disappointing. Even seeing with this new administration despite they're going quite out to get people vaccinated initially, they have not had a long-term commitment to the things that make people ill. That's one of the reasons why we still have so many thousands of COVID deaths happening every week.

Melissa Harris-Perry: I was worried about you during the early months of the pandemic, my friend. Then as I read the book, I learned that that worry was perhaps well-placed because you write about your fear of infecting others being just overwhelming. Can you tell us more?

Steven Thrasher: Yes, I remember when you reached out and I really appreciate that. It was really tough. I feel like in the pandemic, people who lived with families and had no space to be alone suffered a lot. People who lived like myself alone suffered a lot. The people I know who did the best lived with other people but in housing where everyone could get their own space when they needed it. It was extremely painful and lonely.

Being able to write about what I was going through was both helpful but also bewilderingly scary and frightening at times. I had to learn how to live without touch and live without seeing people very often. As you know, I was very afraid of making somebody else infected. I've had that fear again with monkeypox. I wrote a piece that's going to be out later in the week from The Guardian about the ways that my life as a gay man from any queer people is both about negotiating my own risk but also thinking and worrying about infecting other people with intimacy.

The realm of intimacy with COVID, of course, extended to just breath. That was an extremely difficult and painful thing to navigate. As I was writing the book, I did take a lot of solace from the people I was writing about who showed me it's not easy work to do, but it's important work to do that there are ways that we can navigate being intimate with one another, understanding this reality and that maintaining our human connection to one another despite this biological reality is extremely important.

The primary purpose of life is not just to keep the economy running. It's also to be connected to one another. Viruses have taught some of the people I write about really well how to negotiate that, but it requires admitting a level of vulnerability and a level of humility that are at odds with so much of how American life is presented. It's not easy, but it's really important work to do.

Melissa Harris-Perry: You do end on a hopeful note as you write about what we can learn, right? Viruses being teachers and writing, "Viruses have the potential to help us make a world predicated upon love and mutual respect for all living things." Are you still feeling some level of hope?

Steven Thrasher: I feel right now extremely concerned about monkeypox and sad that some of the lessons that we should have learned were not enacted. I don't think that we're done learning what we can learn from any of the viruses that we've interacted with. There's still the possibility to learn from them. I just hope that it happens and that we act on what we learned sooner rather than later before it takes more people's lives.

I really love Mariame Kaba's phrase that hope is a discipline. It's something that you work at. There are times I feel really tired. I think about some of the queer people that I know and we're tired, Melissa. [chuckles] It's hard going through this over and over again, but it has to be done. People are rising to the occasion and doing the work that they need to do, but it's really hard when you realize, "Okay, the community groups are mobilized. People are ready to get vaccinated. The federal government just doesn't have the supply."

That makes it very difficult to feel hopeful. In terms of people having learned at an individual level a lot from this pandemic and being able to draw upon the people that they loved who are affected or were lost in this pandemic, there's a lot of power that we're living at a time in human history where everyone on the planet has been negotiating the same issue sort of at the same time with the ability to communicate about that. Some good things are going to come out of that shared process.

Melissa Harris-Perry: Steven Thrasher is the author of The Viral Underclass: The Human Toll When Inequality and Disease Collide. He's a professor at Northwestern University. Steven, thank you.

Steven Thrasher: Thank you so much, my friend.

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