So I'm going to go from feeling pride at never having covid to checking my privilege because I've never had covid.
I found this Thrasher person to be insufferable on Twitter - possibly one of the people who got a lot more so during the pandemic - and muted him. The book might be better.
It's not a coherent concept. In the most recent (omicron) wave of COVID, the group at highest risk of catching COVID were white non-disabled native-born Christian men with managerial or professional jobs, living in wealthy areas. (Completely different from the second wave!) Obviously I haven't read the link because it's paywalled.
The concept of a viral underclass simply does not survive contact with a world in which a majority of people have caught a highly transmissible viral disease. It may be useful when you're talking about HIV, but nothing is gained by putting HIV and COV-19 into the same category.
Catching, sure. Dying?
The quote says "most likely to contract". "Most likely to die" would be very different because that depends very much on when you caught it - before or after vaccination, of course, and also what treatment pathways were available and how busy the hospitals were. Asian mortality was much higher than white, but the pre-vaccination second wave in late 2020-21 - by far the most deadly - hit earliest and hardest in Asian-majority communities in places like Blackburn.
By 2022 Asian mortality's roughly the same as white.
The black mortality rates stayed high, because they had a much lower vaccination rate. The viral underclass by 2022 is largely self-recruited.
My limited experience reading books that were also excerpted in newspapers, where I read both book and excerpt, has been that the book is always better.
5: I think it works with HIV - especially now that so many MSM who have money take PREP to prevent transmission and don't wear condoms. Black and Latino men in the South are getting infected though.
It works extremely well for Covid in 2020 - who had jobs that required working outside of the house, and who didn't.
The fact that there's a bizarre self-inflicted deathwish in the Republican Party just layers on top of existing racism and classism. It doesn't invalidate it.
The black mortality rates stayed high, because they had a much lower vaccination rate.
It seems skipping a step to point to vaccination rates and say they must naturally explain the entire differential in death.
9: Also the UK and US are different.
I do think there were some black people who were afraid to get the vaccines but they are more likely to take them if they have a conversation with someone they trust.
Also, tables 5 and 6 suggest a lot of socioeconomic correlates.
From this dataset I got vaccination rates by region. As of Jan 2023, London had by far the most unvaccinated (18.5% of population, next highest North West 11.5%, lowest South East at 8.7%), presumably linked to demographics (the data shows indeed a big disparity by race) - but the third-lowest death rate of the 9 regions, 74 where the median region (Yorkshire and the the Humber) is 88.
Surprise, surprise: it's complex. (Presumably better access to health services in London is part of that, but again that can't explain everything.)
The first thing I thought of when I read this post, was the lead-crime hypothesis. Poor people, esp. poor Black people, were poisoned with pollution, and then when their children grew up physically damaged, their brains physically damaged, they were blamed for it, thrown into prison, treated as animals.
9.2: The Republican death wish is, where it kills Republicans, mostly killing poor Republicans.
I agree with 5, HIV and covid are so different that trying to treat them together is just a conceptual mess. There's similarities of course, in that everything is worse for people who are doing worse, but grouping together. HIV and covid because they're both viruses doesn't actually mean covid issues and policy have more in common with HIV than with say food deserts or transportation or opioids. Could have a book on "needle underclass" about opioids and covid.
Except that the opioid needle underclass are disadvantaged because they're far too keen on sticking needles in themselves, while the COVID needle underclass are the exact opposite...
As of Jan 2023, London had by far the most unvaccinated (18.5% of population, next highest North West 11.5%, lowest South East at 8.7%), presumably linked to demographics (the data shows indeed a big disparity by race) - but the third-lowest death rate of the 9 regions, 74 where the median region (Yorkshire and the the Humber) is 88.
This is a known issue with reported vaccination rates in London and one that I spent quite a bit of time wrestling with in 2021.
London has a much younger population, so the crude per-capita vaccination rate will be lower for that reason alone, but even once you allow for that London still seems to be undervaccinated. The reason is that London has a far bigger floating population - people who aren't long-term settled for one reason or another. It has most of our non-UK citizen population. It has a lot of students. It has a lot of people who have moved to London recently. All these people will show up in the census figures for the population of London, but won't show up in the "London residents vaccinated" figures. Students will mostly still be registered with a GP elsewhere in the country (if they're registered with one at all) so will recent arrivals from elsewhere. Non-UK citizens may have got vaccinated in their own country.
And, of course, that floating population also means that a lot of people who are registered with London GPs and who the census thinks of as Londoners don't live in London any more, so they won't turn up for a vaccination appointment in London. Whereas if the census thinks you live in, say, Worksop, you probably do, worse luck.
I have to say that I feel a deep ambivalence about treatments like this that, ISTM, do two things wrong:
A. They take analogy/metaphor and turn it into an actual organizing principle. As noted above, COVID and HIV aren't very similar in any ways except that they're viral, but so are a hundred other illnesses that wouldn't fit this framework. But even beyond that, the stretch from "this situation illuminates things about this other, more or less similar one" to "people in both these situations face the exact same problems because, and only because, of how society treats those situations" is a long one.
B. More important, it's the temptation to go from "we live in a society, so social responses to things will tend to correlate along socially significant axes" to "there's a specific social pathology to the way we respond to these situations I'm focused on" is overwhelming, since that's where books come from. But I'm not convinced it's adding value.
Take the opposite approach: I have my issues with the 1619 Project (mostly around NH-J), but its essential thesis is IMO unassailable and, more importantly, useful in thinking about social issues. Race, and specifically anti-Black racism, really are at the bottom of most American pathologies, and 1619 did a good job of teasing out the threads, even if it sometimes overreached. So if all you knew about American society is that racism distorts just about everything, from education to building codes to feminism, then you'd be decently equipped to start thinking about, if not solutions, at least responses.
By contrast, is Thrasher really enabling people to make better policy? Maybe in some very narrow ways around literal epidemic/pandemic policy, but basically not at all when it comes to, say incarceration, where HIV and COVID issues are miles apart (nobody was ever arrested for spreading COVID; COVID spread in jails has much more to do with living conditions that are downstream of systemic racism than with social conditions that are downstream of homophobia and interpersonal racism).
None of which is to say I think it's all worthless or BS. The way that victim-blaming intersects with bad public health policy is an important and I think useful insight, for instance. Like I said, ambivalence.
16.1 is what makes it such an interesting book! Why is it it that some people use needles for vaccines while others use them for opioids? Read 500 pages to find out!
It's just wild right now to read about drug shortages.
USA is always in a pickle these days.
Lots of throwing hands. 'Nobody knows why.'
FDA might be a cause. Supply chains from India and China. Drug company consolidation.
People have died. More people will get sick, some will die.
We're talking amoxicillin! Chemotherapy drugs.
If we're all at risk of feeling it, what is going to happen to the viral underclass?
I am truly scared for such people. System breaks more, fewer people care.
I was told that massive profits for big pharma are important precisely to prevent this kind of situation.
I doubt you were, because amoxiicillin is a generic drug.