New Conservative Target: Race as a Factor in COVID Treatment | Missouri News


By TODD RICHMOND, Associated Press

MADISON, Wis. (AP) — Some conservatives are taking aim at policies that allow doctors to consider race as a risk factor when assigning rare COVID-19 treatments, saying the protocols discriminate against white people.

The wave of infections caused by the omicron variant and the shortage of treatments have drawn political attention.

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

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 politicians. In recent days, conservative law firms have pressured a Missouri, Minnesota and Utah-based health system to drop their protocols and sued New York State for award guidelines or scoring systems that include race as a risk factor.

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JP Leider, a senior researcher in the University of Minnesota’s Division of Health Policy and Management who helped develop that state’s award criteria, noted that prioritization has been going on for some time because there are not enough treatments for everyone.

“You have to choose who comes first,” Leider said. “The problem is that we have extremely conclusive evidence that (minorities) across the United States have worse COVID outcomes than white people. … Sometimes it is acceptable to consider factors such as race and ethnicity when making decisions about when resources are allocated at the societal level.

Since the beginning of the pandemic, health systems and states have wondered how best to distribute treatments. The problem only got worse as the omicron variant filled hospitals with COVID-19 patients.

Considerable evidence suggests that COVID-19 has hit certain racial and ethnic groups harder than white people. Research shows that people of color are at higher risk of serious illness, are more likely to be hospitalized, and die of COVID-19 at younger ages.

The data also shows that minorities have been denied treatment. Last week, the Centers for Disease Control and Prevention released an analysis of 41 healthcare systems that found black, Asian and Hispanic patients are less likely than whites to receive outpatient antibody treatment.

Omicron has rendered two widely available antibody treatments ineffective, leaving only one, which is in short supply.

The Food and Drug Administration has given healthcare providers guidance on when this treatment, sotrovimab, should be used, including a list of medical conditions that put patients at high risk for serious consequences from COVID-19. 19. FDA guidelines say other factors such as race or ethnicity could also put patients at higher risk.

The CDC’s List of High-Risk Underlying Conditions notes that age is the strongest risk factor for serious illnesses and lists more than a dozen medical conditions. It also suggests that doctors and nurses “carefully consider the potential additional risks of COVID-19 disease for patients who are members of certain racial and ethnic minority groups.”

State guidelines generally recommend that doctors prioritize drugs for those most at risk, including cancer patients, transplant recipients, and people with lung disease or who are pregnant. Some states, including Wisconsin, have policies in place that prohibit race as a factor, but others have allowed it.

St. Louis-based SSM Health, which serves patients in Illinois, Missouri, Oklahoma and Wisconsin, required patients to score 20 points on a risk calculator to qualify for COVID antibody treatment -19. Non-whites automatically got seven points.

Utah state health officials have adopted a similar risk calculator that awards people two points if they are not white. Minnesota Health Department guidelines automatically assigned two points to minorities. Four points were enough to qualify for treatment.

Guidelines from New York state health officials allow antiviral treatments if patients meet five criteria. One is having “a medical condition or other factor that increases their risk of serious illness.” One of those factors is being a minority, according to the guidelines.

The protocols became a talking point for Republicans after the Wall Street Journal this month published an op-ed by political commentators John Judis and Ruy Teixeira complaining that New York’s policy is unfair, unwarranted and possibly illegal. . Carlson jumped on the politics of Utah and Minnesota last week, saying “you win if you’re not white.”

Alvin Tillery, a political scientist at Northwestern University, called the issue a winning political strategy for Trump and Republicans seeking to motivate their predominantly white base ahead of the midterm elections in November. He said the Conservatives were twisting the narrative, noting that race was just one of many factors in every benefit policy.

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

After the Wisconsin Institute for Law and Liberty, a conservative law firm based in Madison, sent a letter to SSM Health on Friday demanding that it drop the run of its risk calculator, SSM responded that it had. already done last year as health experts understood COVID-19 has evolved.

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

America First Legal, a conservative-leaning law firm based in Washington, D.C., filed a federal lawsuit against New York on Sunday demanding that the state remove race from its award criteria. The same company warned Minnesota and Utah last week that they would have to drop their preference factors race or face lawsuits.

Erin Silk, spokeswoman for the New York State Department of Health, declined to comment on the lawsuit. She said state guidelines are based on CDC guidelines, and race is one of many factors doctors must consider when deciding who gets treatment. She stressed that doctors must consider a patient’s entire medical history and that no one is denied treatment based on race or any other demographic criteria.

Minnesota health officials dropped out of the state criteria race a day or two before receiving applications from America Legal First, Leider said. They said in a statement that they are committed to serving all Minnesotans fairly and are constantly reviewing their policies. The statement did not mention the letter from America Legal First. Leider said the state is now selecting treatment recipients through a lottery.

Utah removed race and ethnicity from its risk score calculator on Friday, among other changes, citing new federal guidelines and the need to ensure classifications comply with federal law. The state health department said instead of using them as treatment eligibility factors, it would “work with communities of color to improve access to treatment” in other ways.

Leider finds criticism of race-inclusive policies dishonest.

“It’s easy to introduce identity politics and establish choices between really rich people of one type and people of another type,” he said. “It’s hard to take these kinds of comparisons seriously. They don’t seem very realistic.

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