New York’s Race-Based Preferential Covid Treatments New guidelines say whites may not be eligible for antibodies and antivirals, while nonwhites are. By John B. Judis and Ruy Teixeira
New York state recently published guidelines for dispensing potentially life-saving monoclonal antibodies and oral antivirals like Paxlovid to people suffering from mild to moderate symptoms of Covid-19. These treatments are in short supply, and they must be allocated to those most in need.
According to these guidelines, sick people who have tested positive for Covid should be eligible to receive these drugs if they have “a medical condition or other factors that increase their risk for severe illness.” These include standard criteria like age and comorbidities like cancer, diabetes and heart disease—but, startlingly, they also include simply being of “non-white race or Hispanic/Latino ethnicity,” which “should be considered a risk factor, as longstanding systemic health and social inequities have contributed to an increased risk of severe illness and death from COVID-19.”
Consider the following cases: A middle-aged investment banker born in Colombia shows up at a physician’s office in Manhattan; a laid-off middle-aged worker of Italian ancestry shows up at a doctor’s office in Rochester, N.Y. Neither has medical risk factors, but both have mild to moderate symptoms of Covid-19. The wealthy Colombian-American could be given Paxlovid; the laid-off auto worker would be turned away. You can construct thousands of these comparative cases using well-off Hispanics, Asians or blacks and working-class whites.
This is unfair and possibly illegal. With these kinds of regulations, the Democrats who control New York reinforce the racial and ethnic divisions that grew during Donald Trump’s presidency. These state officials have been abetted by social scientists who collect survey data in a manner that, intentionally or not, confirms their presuppositions.
There is no question that medical factors can increase the risk of certain individuals getting diseases. Living or working in proximity to a toxic environmental site can also increase this risk. There are also certain racial-ethnic groups that are especially prone to certain diseases. African-Americans are susceptible to sickle-cell anemia; Ashkenazi Jews are often lactose-intolerant. There isn’t any study we have seen that, controlling for other factors, such as income, education and residence, shows clearly that Americans of Hispanic, African or Asian ancestry are at greater risk for severe Covid-19. There is no valid medical argument to justify New York state’s criteria.
That is not to deny that social scientists have produced studies that show that there is a proportionally greater incidence of severe Covid-19 in Hispanic and African-American communities than white communities. These studies are based either on disaggregating different communities or on data from questionnaires that ask people being vaccinated or tested about their race, ethnicity and gender. When you limit the question to those possibilities, you get the answer you asked for.
But when you ask about the relationship between income and the incidence of Covid-19, you get an answer that suggests that the laid-off auto worker might also deserve some consideration from the New York health officials. Researchers from Stanford’s Department of Epidemiology and Population Health found a positive correlation between income inequality and county-level Covid-19 cases and deaths in the U.S. Emory University researchers found a similar correlation with poverty levels.
Findings like these aren’t definitive, but they are suggestive. It is probable that a good part—perhaps most—of the observed racial disparity in Covid effects is attributable to factors that can be loosely grouped under class: income, education, poverty status, occupation, health-insurance status, housing and so on. The way to test this would have been to collect individual-level data on such variables in addition to race, ethnicity, age and gender. But that has not been done, so only racial disparities, uncontrolled for class factors, have been reported.
As one example of what such studies might find, Kaiser Family Foundation survey data on vaccination rates revealed that black and white college graduates were vaccinated at roughly equal (high) rates, while there was a yawning chasm between these college graduates and their noncollege counterparts of the same race. Clearly then, the observed disparities in vaccination rates between blacks and whites have a lot to do with the higher noncollege proportion among the black population.
All this suggests that the racial lens on Covid disparities is inadequate. A broader lens that included class factors would be unlikely to suggest to public health officials that the Indian-American CEOs of Alphabet and Microsoft ought to get priority over white Walmart clerks and hospital orderlies. Who should receive scarce Covid treatments should be based on genuine medical risk factors such as age and comorbidity, but class disparities can be relevant to deciding where to spend money to increase access to public-health benefits including vaccination and testing.
Liberal political scientists and many Democratic officials seem determined to ignore class divisions and instead divide the country up by race and ethnicity. This practice, which is unpopular outside elite media, universities and nonprofits, contributed to the rise of Mr. Trump. If it continues, Democrats could pay a lasting political price, which could threaten the welfare of groups Democrats want to help.
Mr. Judis is the author of “The Politics of Our Time.” Mr. Teixeira is a co-editor of the Substack newsletter the Liberal Patriot.
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