Steven Thrasher: Mask Mandate Was the Last Line of Defense for ‘The Viral Underclass’

steven thrasher the viral underclass

Major transportation services dropped mask requirements last week, following a wave of similar pandemic rule reversals—from vaccination checks in restaurants to testing requirements for workers.

Within hours of a federal judge striking down the federal masking requirement, certain airlines, public transit systems, and ride-sharing companies announced that passengers could remove their masks, drawing reactions of celebration and outrage.

When transit services announce that travelers may go mask-free, the impact extends far beyond the immediate comfort of the passengers, said Steven Thrasher, PhD, an assistant professor at the Northwestern University Medill School of Journalism.

In his upcoming book, titled “The Viral Underclass: The Human Toll When Inequality and Disease Collide,” Thrasher draws on his study of the racialization and criminalization of HIV to explore the outsized effect of social inequities in the COVID-19 pandemic.

Thrasher spoke with Verywell about why masking signals a commitment to both health and empathy, and why public health should operate from the perspective of the highest risk groups in society.

This interview has been condensed for clarity.

Steven Thrasher

CS Muncy

Verywell: What do you think of the court ruling to end the federal mask mandate for transportation?

Thrasher: My reaction was extreme disappointment and anger. [The mask mandate] was one of the last remaining vestiges of the federal response to the pandemic—an incomplete one and one that didn’t work just by itself.

Seeing many of the reactions on social media that were very celebratory was disappointing. Not because it’s pleasant to wear masks—I don’t enjoy it myself, a lot of people don’t enjoy it. But seeing the glee and not thinking about who this would affect in general was really sad.

When the ruling came down, the airlines were ready to go. Within a couple of hours, all the major airlines had done away with masks. And it was disappointing that the White House, Department of Justice, and CDC were not prepared to issue an immediate appeal to a higher court and to ask them to stay until the case could be heard. They just gave up. And that could change with time, but I don’t think that they can get the genie back in the bottle after everything that’s happened.

Verywell: The name of your upcoming book is “The Viral Underclass.” Can you explain what this term means, especially in the context of COVID-19?

Thrasher: I first heard the phrase from an activist named Sean Strub, who used it to talk about how people could be prosecuted once they were HIV-positive, saying there was a group of people who had a status in their body that would always put them in a different class of the law.

When I was reporting in Ferguson in 2014 about the police killing of Michael Brown, I realized that the neighborhood I was in had a high rate of HIV and AIDS. As I did more reporting, I saw that anywhere you’d see these maps of black poverty and police killings, you’d also see a high rate of HIV.

When the COVID pandemic broke out in the beginning of 2020, the same map was emerging for COVID. I thought that was very interesting and disturbing, because these are very different viruses with different properties, but they are affecting the same kinds of people.

People who are in the viral underclass were the least likely to have the protection of working from home during the pandemic. Huge swathes of the society that were doing “essential jobs”—in fast food work, in janitorial work, in retail service jobs—did not have those protections, so they’re just being exposed to the virus a lot more. They often live in more crowded households, which means that they can’t isolate if somebody in their house is sick.

And the research has taught us quite explicitly over the past couple years that when people are uninsured, they are more likely to be exposed to COVID, to get sick from it, and to die from it… Even knowing that, the administration and Congress have let testing go out the window for COVID-19 for the uninsured.

I see the mask mandate in that context as well. This is one of the last lines of defense for people who are working face-to-face and are taking public transit. It was quite overlooked in the ruling about airlines that this affects mass transit as well. Amtrak stopped doing it. The CTA in Chicago—where I live—just got rid of it. This puts people who are in face-to-face service jobs at quite a higher level of danger.

Verywell: How should we think about masks at this stage of the pandemic?

Thrasher: Masks were never a panacea. They don’t fix everything, but they were one tool that helped. They also signified a willingness to help, which in itself is important.

COVID gave us a lot of lessons. We know that there were huge parts of our healthcare system that were not working, and that’s not a normal we should go back to. We should be saying, “Wow, how was it that we put together a health infrastructure that can deliver 4 million doses of a vaccine in a day? What better health outcomes can we get if there was access to medication on that scale, without people worrying that they’re going to be indebted? And what are the other benefits that could come from certain things, like masks?”

During the first SARS outbreak in Asian countries in 2003, people started wearing masks and continued wearing them on days with high pollution, which helps with reducing asthma attacks and other respiratory problems. They started wearing them during flu seasons. Something similar could have happened here in the United States—even without a mandate.

Verywell: What is the best way to navigate decisions around masking during this confusing time?

Thrasher: HIV triggered the use of universal precautions in terms of gloves that both protect patients and healthcare providers and the use of condoms, because you don’t always know if you have HIV or not.

I think similarly with COVID-19, people need to assume that they’re carrying it at all times. Cases are going up everywhere. Of course, if you feel sick, you should look into that and act appropriately. But even if you’re not feeling sick, you should assume that you could be carrying it right then. And anytime you’re in a public space, you should assume that there are unvaccinated and immunocompromised people around you.

If you’re having dinner with two or three other people in someone’s private home and you’ve discussed your risk comfort with each other beforehand, that’s one thing. But when you walk into a movie theater, Broadway show, a subway, onto a plane, you should assume that you could be positive and there could be people there who could be exposed and are not able to withstand it.

Verywell: What is your perspective on “returning to normal”?

Thrasher: The dominant position that I’m hearing on television and in the bulk of the op-eds in The Washington Post and other publications is to think about the reverse—what needs to happen to maintain the comfort of the upper class.

For the most part, people in the upper class are relatively well protected. If you’re vaccinated and boosted, and certainly if you’ve had a life where you’ve not been exposed to environmental racism and various forms of health inequity, your odds of [staying healthy] are pretty good. If we make the pandemic response about maintaining the comfort of the upper class, which is largely what’s happened, then we lose sight of who is going to be most affected.

People can get vaccines and antiviral medications for COVID. But if you don’t have health care, if you don’t have a stable place to live, if you don’t have money for food and rent, your odds of getting access to that medication are greatly diminished. The virus will start entering into that population moving very freely throughout it, because those people’s social networks also don’t have access to those things.

We can also construct things economically, so that if people can’t work, they’re not going to lose their homes and they’re not going to go hungry. We did it for a year and a half and it did not break the country economically. We do have the resources to do some of these things we said we couldn’t—we can get health care for a life-threatening sickness to everyone quite quickly when the resources of the society are turned towards that end.

1 Source
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  1. Centers for Disease Control and Prevention. COVID Data Tracker.

By Claire Bugos
Claire Bugos is a health and science reporter and writer and a 2020 National Association of Science Writers travel fellow.