New York City will take a patient’s race into account when distributing potentially life-saving COVID treatments, the Department of Health and Mental Hygiene revealed on their website.
The city will “consider race and ethnicity when assessing individual risk,” reads the agency’s official guidance from Dec. 20, which adds that “longstanding systemic health and social inequities” can contribute to an increased risk of dying from COVID-19.
The guidance applies to both the distribution of monoclonal antibodies and oral antivirals like Paxlovid and Molnupiravir.
“Monoclonal antibody treatments have averted at least 1,100 hospitalizations and at least 500 deaths among people treated in New York City,” the city said in October.
The race-based approach in treatment has already begun to have real-world consequences. One Staten Island doctor said he filled two prescriptions for Paxlovid this week and was asked by the pharmacist to disclose the race of his patients before the treatment was authorized.
“In my 30 years of being a physician I have never been asked that question when I have prescribed any treatment,” said the doctor, who requested anonymity. “The mere fact of having to ask this question is a slippery slope.”
Both patients, who are white, were ultimately granted their prescriptions.
A recent “Request for Proposals,” form on behalf of the city Department of Health and Mental Hygiene stressed the agency’s commitment to “racial equity.”
“The … DOHMH is committed to improving health outcomes for all New Yorkers by explicitly advancing racial equity and social justice. Racial equity does not mean simply treating everyone equally, but rather, allocating resources and services in such a way that explicitly addresses barriers imposed by structural racism (i.e. policies and institutional practices that perpetuate racial inequity) and White privilege,” it read.
It is unclear if the new “race” guidance has yet to exclude whites from getting treatment, but observers and doctors fear that a system is being created that could lead to racial exclusions in the future during a drug shortage or case surge.
“We are collecting demographic data on COVID antivirals at the request of the city for anonymized data reporting purposes only, as is commonly done with COVID tests and vaccines,” Michael Krueger, a pharmacy rep said. For now, the city is participating exclusively with Alto Pharmacy to distribute the new drugs.
Medical experts said it is correct for COVID treatment to be allocated based who is at the highest risk, but stressed that race was not a biological risk factor.
“I have not seen [race] as one of the risk factors for severe disease and death,” Martin Kulldorff, a Harvard epidemiologist and professor, told The Post. “The reason that a lot of African Americans have died in New York — which is true — is because the rich people and more affluent were working from home while the working class were exposed.”
“The lockdowns have discriminated against minorities. Basically they have discriminated against the working class, and minorities are a bigger proportion of the working class.” Kulldorff added.
In a public notice, the state Department of Health said last week that “Non-white race or Hispanic/Latino ethnicity should be considered a risk factor” — putting it in a class with other COVID risk factors like age and obesity.
“There are severe supply shortages for all COVID-19 outpatient therapeutics,” warns city health officials, who urge providers to follow the state guidelines.
The directives follow slew of new laws signed by Gov. Hochul aimed at “addressing discrimination and racial injustice.” One of the new edicts formally declares racism to be a public health crisis.
“It’s just absurd and it shows this is not about public health. This has not been about the health of New Yorkers from the get-go,” Andrew Giuliani, a GOP candidate for governor. told The Post. “Politics before the health and safety of New Yorkers. It continues from the Cuomo administration to the Hochul administration with these new laws.”
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“New Yorkers of color have borne the brunt of this pandemic due to structural racism and the legacy of disinvestment in many minority communities,” Michael Lanza, a city Health Department spokesman, told The Post. “Doctors are advised to consider the disproportionate impact felt by these communities in addition to systemic health disparities when prescribing treatments for people who are at highest risk for severe COVID-19 outcomes.”
Lanza added the data was only being collected “to assess equitable distribution” and that race would never be used as a reason to deny treatment.
Antiviral treatment for coronavirus infection represents the cutting edge of treatment for the virus. Interest in the therapeutics has peaked with the arrival of the new Omicron variant and its widespread ability to evade the vaccine.
On Dec. 22, the federal Food and Drug Administration approved an emergency useauthorization for Paxlovid “for the treatment of mild-to-moderate coronavirus disease” for anyone 12 and older. Molnupiravir received its emergency use authorization a week later.