New conservative target: Race as a factor in COVID treatment

Some conservatives are targeting policies that allow doctors to consider race as a risk factor when allocating scarce COVID-19 treatment, saying the protocols discriminate against whites.

A wave of infections and a shortage of treatments caused by omicron variants has focused attention on policy.

Medical experts say the objections are misleading. Health officials have long said there is good reason to consider race as one of many risk factors in treatment decisions. And there is no evidence that race alone determines who gets the drug.

The issue came into focus last week after Fox News host Tucker Carlson, former President Donald Trump and Republican Senator Marco Rubio joined the policies. In recent days, conservative law firms have pressured the Missouri-based health care system, Minnesota and Utah to drop their pacts and sued New York over an allocation guideline or scoring system that uses race as a risk factor.

JP Leider, a senior fellow in the Department of Health Policy and Management at the University of Minnesota who helped develop the state’s allocation criteria, noted that prioritization has been going on for some time because there aren’t enough treatments to address.

“You have to choose who comes first,” Ryder said. “The problem is that we have very solid evidence that the U.S. (minorities) have worse COVID-19 outcomes compared to whites. … Sometimes issues like race and ethnicity are taken into account when deciding when to allocate resources It’s acceptable. Societal level.”

Since the pandemic began, health care systems and states have struggled with how best to distribute treatments. The problem will only get worse as hospitals in the omicron variant fill up with COVID-19 patients.

There is overwhelming evidence that COVID-19 hits certain racial and ethnic groups harder than whites. Research shows that people of color are at higher risk for serious illness, more likely to be hospitalized, and to die from COVID-19 at a young age.

The data also showed that minorities missed out on treatment. Last week, the Centers for Disease Control and Prevention released an analysis of 41 health care systems that found that black, Asian and Hispanic patients were less likely than whites to receive outpatient antibody treatment.

Omicron has already nullified two widely available antibody treatments, leaving only one in short supply.

The U.S. Food and Drug Administration has provided guidance to healthcare providers on when treatment with sotrovimab should be used, including a list of medical conditions that put patients at high risk for severe outcomes from COVID-19. Other factors, such as race or ethnicity, may also put patients at higher risk, the FDA guidance said.

The CDC’s List of High-Risk Potential Conditions states that age is the strongest risk factor for serious illness and lists more than a dozen diseases. It also advised doctors and nurses to “carefully consider the potential additional risk of COVID-19 disease for members of certain racial and ethnic minority groups.”

National guidelines generally recommend that doctors prioritize drugs for those at highest risk, including cancer patients, transplant recipients and people with lung disease or pregnancy. Some states, including Wisconsin, have implemented policies that prohibit race as a factor, but others allow it.

St. Louis-based SSM Health, which serves patients in Illinois, Missouri, Oklahoma and Wisconsin, requires patients to score 20 points on a risk calculator to be eligible for COVID-19 antibody therapy. Non-whites automatically get seven points.

State health officials in Utah employ a similar risk calculator that gives them two points if they’re not white. Minnesota health department guidelines automatically assign two points to minorities. A score of four is enough to qualify for treatment.

Guidelines from New York state health officials authorize antiviral treatment if a patient meets five criteria. One is that “physical conditions or other factors increase their risk of serious illness.” According to the guidelines, one of the factors is a minority.

The deals have become the talk of Republicans after The Wall Street Journal published an op-ed this month by political commentators John Judith and Rui Teixeira complaining that New York’s policies were unfair, unreasonable and potentially illegal. Carlson jumped out of Utah and Minnesota policies last week, saying “if you’re not white, you win.”

Alvin Tillery, a political scientist at Northwestern University, called the issue a successful political strategy Trump and Republicans hope to galvanize their predominantly white bases ahead of the November midterm elections. He said conservatives were distorting the narrative, noting that race was only one of many factors in every distribution policy.

“It really inspired their people and gave them a chance to vote,” Tillery said.

After the Wisconsin Institute for Law and Freedom, a conservative law firm based in Madison, sent a letter to SSM Health on Friday asking it to remove the question of race from its risk calculator, SSM responded that it had already done so last year because health experts knew about COVID-19. -19 evolved.

“While earlier versions of the nationwide risk calculator duly included race and gender criteria based on initial results, SSM Health continues to evaluate and update our protocols on a weekly basis to reflect the latest clinical evidence available,” the company said in a statement. statement. “Therefore, race and gender standards are no longer used.”

America First Legal, a conservative law firm based in Washington, D.C., filed a federal lawsuit against New York on Sunday asking the state to remove race from its distribution criteria. The same company warned Minnesota and Utah last week that they should drop their racial preferences or face lawsuits.

Erin Silk, a spokeswoman for the New York State Department of Health, declined to comment on the lawsuit. The state’s guidance is based on CDC guidelines, and race is one of many factors doctors should consider when deciding who gets treatment, she said. She stressed that physicians should consider a patient’s full medical history and that no one was denied treatment because of race or any other demographic qualifying factor.

Ryder said Minnesota health officials removed race from the state’s criteria a day or two before they received a request for U.S. legal precedence. They said in a statement that they are committed to serving all Minnesotans fairly and are constantly reviewing their policies. The statement made no reference to the U.S. Law First letter. Ryder said the state is now using a lottery to select people for treatment.

Utah on Friday removed race and ethnicity from its risk score calculator, among other changes, citing new federal guidance and the need to ensure classifications comply with federal law. Rather than factor these factors into treatment eligibility, the state health department said it will “work with communities of color to improve access to treatment” in other ways.

Ryder believes criticism of racial inclusion policies is dishonest.

“It’s easy to introduce identity politics and create a choice between one type of really wealthy person and another type of person,” he said. “It’s hard to take these comparisons seriously. They don’t seem fair to reality.”

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