Race as a factor in the treatment of COVID

MADISON, Wis. – Some conservatives are taking aim at policies that allow doctors to consider race as a risk factor when allocating scarce COVID-19 treatments, saying the protocols discriminate against White skin-man.

The wave of infections caused by the omicron variant and the shortage of treatments has focused on policies.

Medical experts say the opposition is misleading. Health officials have long said there is a strong case for considering race as one of many risk factors in treatment decisions. And there’s no evidence that race alone is used to decide who gets the drug.

The issue came to the fore last week after Fox News host Tucker Carlson, former President Donald Trump and Republican Senator Marco Rubio jumped on the policies. In recent days, conservative law firms have pressured the Missouri, Minnesota, and Utah-based healthcare system to abandon their protocols and sue New York state over its dispensing guidelines. allocation or scoring system that includes 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 that state’s allocation criteria, noted that prioritization has been going on for some time because There are not enough treatments available.

“You have to choose who comes first,” Leider said. “The point is that we have incredibly convincing evidence that (minorities) across the US are having worse COVID outcomes than whites. … It is sometimes acceptable to consider things like race and ethnicity when making decisions about when resources are allocated at the societal level. ”

Since the pandemic began, health care systems and states have struggled to find ways to distribute the best treatments. The problem only got worse when the omicron variant packed hospitals with COVID-19 patients.

Substantial evidence suggests that COVID-19 has hit some racial and ethnic groups harder than whites. Research shows that people of color have a higher risk of severe illness, hospitalization and death from COVID-19 at a younger age.

The data also shows that minorities are missing out on treatments. 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 to receive foreign antibody treatment. more resident than whites.

Omicron has rendered two popular antibody treatments ineffective, leaving only one in short supply.

The Food and Drug Administration has provided guidance to healthcare providers on when to use the treatment, sotrovimab, including a list of medical conditions that put patients at risk high risk of a serious outcome from COVID-19. FDA guidance says other factors such as race or ethnicity may also put patients at higher risk for the disease.

The CDC’s list of high-risk underlying conditions notes that age is the strongest risk factor for severe illness and lists more than a dozen medical conditions. It also suggests that doctors and nurses “carefully consider the potential risks of COVID-19 disease to patients who are members of certain racial and ethnic groups.”

State guidelines often recommend that doctors prioritize medications for those most at risk, including cancer patients, organ transplant recipients, and people with lung disease or who are pregnant. Some states, including Wisconsin, have implemented policies that consider racing a factor, but others have allowed it.

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

State health officials in Utah adopted a similar risk calculator to give people two points if they are not white. Minnesota health department guidelines automatically assign two points to minorities. Four points are eligible for treatment.

Guidelines from New York state health officials allow antiviral treatment if a patient meets five criteria. One is having “a health condition or other factors that increase your risk of severe illness.” According to the guidelines, one of those factors is the minority.

These protocols have become a topic of conversation among Republicans after The Wall Street Journal published an article by political commentators John Judis and Ruy Teixeira this month, complaining that New York’s policy is unfair, unreasonable and possibly illegal. Carlson jumped on the policies of Utah and Minnesota last week, saying “you win if you’re not white.”

Alvin Tillery, a political scientist at Northwestern University, calls the issue a winning political strategy for Trump and Republicans looking to bolster their predominantly white base ahead of the election. midterm elections in November, he said conservatives are turning the narrative, noting that race is just one of many factors in any allocation policy.

“It helps their people, gives them a chance in elections,” Tillery said.

After the Wisconsin Institute of Law and Freedom, a conservative law firm based in Madison, sent a letter to SSM Health on Friday asking it to remove racing from its risk calculator, SSM responded that it did so last year to the knowledge of medical professionals. COVID-19 has evolved.

“While early versions of the nationwide risk calculator included racial and gender criteria based on initial results appropriately, SSM Health has continued to evaluate and update protocols. our weekly to reflect the most up-to-date clinical evidence available,” the company said in the statement. “As a result, the criteria for race and gender are no longer used.”

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

Erin Silk, a spokeswoman for the New York State Department of Health, declined to comment on the lawsuit. She said state guidance is based on CDC guidelines, and race is one of many factors doctors should consider when deciding who should get treatment. She stressed that doctors should consider a patient’s overall medical history and that no one should be denied treatment because of race or any other demographic criteria. Race as a factor in the treatment of COVID

Huynh Nguyen

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