Racial politics and COVID responses

The already polarized conversation around medical responses to the COVID-19 pandemic has had racial politics thrown into the mix. A Dec. 27 memo from the New York State Department of Health on the shortage of monoclonal antibody treatment products for COVID-19 seemed to say that racial and ethnic minorities should get preferential access. This was followed by news of similar measures in other states — and by conservative media charges of "woke" racism.

The real story is considerably more complicated. It involves demagoguery and sensationalism on one side and reckless progressive talking points on the other.

The shortage of monoclonal antibody drugs, which can prevent mild COVID-19 symptoms from developing into severe illness, is a real problem — especially since only one of several such drugs works with the now-rampaging omicron variant.

The Department of Health memo said that to be eligible, patients with mild or moderate symptoms must "have a medical condition or other factors" putting them at higher risk. One such factor, it specified, was "[n]on-white race or Hispanic/Latino ethnicity," since "longstanding systemic health and social inequities have contributed to an increased risk of severe illness and death from COVID-19."

While the memo didn’t say that "white people need not apply," as conservative New York Post columnist Karol Markowicz tweeted, it did seem to say that nonwhites and Hispanics would qualify automatically, while white people would need other risk factors. Even some liberal commentators criticized this race-based approach. In a Wall Street Journal op-ed, John B. Judis and Ruy Teixeira wrote that inequities were much better addressed by focusing on "class factors," since racial disparities in COVID-19 outcomes reflect socioeconomic gaps.

But a state DOH spokeswoman told me by email that "systemic poverty" is also considered a risk factor — and that the guidelines are intended merely to help clinicians make decisions based on "total knowledge of the patient" and of "the risks and the benefits" of treatments.

This was confirmed by Dr. Aaron Glatt of Mount Sinai South Nassau hospital in Oceanside, who stressed that, while group vulnerabilities exist, physicians shouldn’t distinguish between patients "based on what they look like" or based on overall distribution patterns: "I base my decisions on what is best for that patient in front of me right now."

The situation may be different in other states. In Minnesota, the racial aspect of the guidelines is far more specific. The Minnesota Department of Health recommends an "ethnical framework" for monoclonal antibody treatment allocation in which each patient gets a score, with points for age, medical conditions, pregnancy, and "BIPOC status" (Black, Indigenous, and People of Color). Under this system, a 54-year-old white COVID-19 patient with hypertension or cardiovascular disease would get a score of zero (those conditions only get points starting at 55), while a healthy nonwhite 30-year-old would get two points for "BIPOC status." (The BIPOC category includes Asian Americans, who have lower COVID-19 mortality than white people.)

There has been plenty of inflammatory, panic-mongering rhetoric on the subject from the right. But to some extent, progressives and even mainstream Democrats have invited this overreaction by not only hyping explicitly racial criteria for medical decisions — a troubling slippery slope — but linking this discussion to political ideas about systemic racism and to "woke" jargon such as "BIPOC."

Less politics, please — and more science and common sense.

Opinions expressed by Cathy Young, a senior fellow at the Cato Institute, are her own.

By Cathy Young

Cathy Young is a writer for The Bulwark.