Race-based rationing of COVID treatment is real and dangerous

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The stock market plummeted, wiping out hundreds of billions of dollars of household wealth in a matter of weeks. War in Ukraine is a distinct possibility and not simply a worst-case scenario. Stakes this high tend to focus the mind. As a result, the ongoing and seemingly endless debates over “revival” — for lack of a better term for how a powerful section of the left discusses race and identity — seem strange and even unimportant.

Every day, social media explodes about a new excess of language policing, the latest unwitting infraction of elite morals, or the most recent eruption of cancel culture on campus. I too participate in these discussions. For several months, however, I have made a conscious effort to limit my tweeting, writing, and speaking about these cultural battles. Treating them as the global crisis of the moment can distort the sense of reality. For most ordinary Americans, at least those without children in school, these concerns are not at the forefront. Social and political elites, however, are another matter. Because they are highly educated, disproportionately online, and free from everyday fears of financial catastrophe, they tend to be more ideological and attached to abstract, utopian goals. Because I am part of this group – and therefore part of the problem – I have a duty to try to resist the undeniable pleasures of perpetual outrage at ultimately ridiculous things such as the use Latinx in the place of latin.

And yet, the influence of the worldview of the cultural left goes beyond mere terminology. During the coronavirus pandemic, the instinct to place crude generalizations about race at the center of every discussion is seeping into public policy on some pretty consequential issues. What happens, for example, when in the name of racial equity, belonging to a particular ethnic group can mean the difference between receiving and not receiving potentially life-saving medical care? This may seem like a wild assumption. Except that’s not the case.

In a series of articles this month, Washington’s Free BeaconAaron Sibarium of , reported that hospitals in Minnesota, Utah, New York, Illinois, Missouri and Wisconsin have used race as a factor in which COVID-19 patients first receive treatments. by rare monoclonal antibodies. Last year, SSM Health, a network of 23 hospitals, began using a point system to ration access to Regeneron. The drug would only be given to patients if they scored 20 points or more. Being “non-white or Hispanic” counted for seven points, while being obese only got you one point, even though, according to the CDC, “obesity can triple the risk of hospitalization due to infection. to COVID-19”. Based on this scoring system, a perfectly healthy 40-year-old Hispanic male would be given priority over an obese, diabetic 40-year-old white female with asthma and hypertension.

Meanwhile, the Minnesota Department of Health used a scoring calculator that counted “BIPOC status” as equivalent to age 65 and older in its risk assessment. (BIPOC is a shortcut for Black, Indigenous and People of Color.) New York abolished the point system entirely; people of color are automatically deemed to be at high risk of harm from COVID – and are therefore given a higher priority for treatments – regardless of their underlying health conditions. Sibarium’s reports in the Free tag spread to various right-wing outlets, causing significant pushback. Under threat of legal action, SSM Health announced on January 14 that it “no longer” uses racial criteria. On January 11, Minnesota public health authorities removed the BIPOC reference, leaving no trace of the previous wording. New York State, however, has yet to change its guidelines.

Racial disparities in COVID outcomes are a matter of record, but to suggest that race causes these negative results is a classic case of confusion between correlation and causation. This is how facts, although true, are misused and weaponized. Rather than race itself, it is race-correlated variables, such as socioeconomic status, access to health care, geography, and higher rates of obesity or diabetes, that affect patient’s health. Those who probably know better, like the Food and Drug Administration, have contributed to the confusion by pointing out that race — alone — can put individuals at greater risk from COVID.

Focusing on race or ethnicity as a determining factor in risk assessment also raises the question of Who race. Presumably, not all people of color are the same. Should all non-whites – Hispanics, blacks, Arabs, South Asians, East Asians, natives – be lumped together into an undifferentiated whole? To put a finer point on this, I am not white. Should I be prioritized for COVID treatments over an obese, asthmatic, diabetic white person? The fact that I’m not white – an accident of birth – defines me as opposed to whiteness, but that says next to nothing about me being at higher risk for hospitalization due to COVID.

Proponents of radical policies to promote equity tend to dismiss objections like mine as statistical errors or, even worse, as a sign of hostility toward historically oppressed groups. But the possibility that a person’s race could, quite literally, affect their eligibility for life-saving COVID treatment isn’t just another downside. In theory as in practice, it is a matter of life or death. Racial triage in the hospital setting is a reminder that “symbolic” ideas, no matter how abstract or fantastical, can extend their reach and impact far beyond the rarefied corridors of elite universities.

The battles fought over culture and identity are felt deeply and intensely precisely because they are rather abstract. On matters of pure principle, it is impossible to split the difference – which is why so many of us can’t help but obsess over these disputes. But they don’t to stay abstract. As with race-conscious drug rationing, the tangible effects of mere tokenism come later, when few pay attention.

Ration rules in New York and elsewhere are not the product of anything like conventional political persuasion. No party would – certainly not overtly – support the essentialization and instrumentalization of race in medicine. Few are willing to defend policies like these on substance, because what exactly would they say? Tellingly, these controversies have received limited mainstream media coverage. Recently, the Associated Press published an article describing the racial triage allegations as right-wing propaganda. “Medical experts say the opposition is misleading,” the article said. (I asked the AP for comment on its coverage. A spokesperson replied, “AP does not do editorial commentary, nor does it have an opinion agenda. It is an organization of independent, non-partisan and factual press.”)

To argue that reality isn’t real just because it’s a Republican talking point is gaslighting. Ideas, even good ones, become destructive when they require people to prioritize advocacy over truth. At the heart of what I and others call woke ideology are notions that racial identity is all-encompassing and the primary driver of politics; that systemic prejudices alone explain the disparities between ethnic groups; and that any action taken to correct these results is presumed justifiable and cannot be questioned in good faith.

Democrats and liberals now find themselves under considerable pressure to accept this way of seeing the world. Going against the norm is just too expensive if you want to remain a tribe member in good standing. Unfortunately, there is no end to this way of thinking, and we are all sensitive to it. In a zero-sum political struggle, anything that might undermine morale on your side is seen as helping the other side. And the other side, the argument goes, is an existential threat.

In theory, awakened the ideology should not matters so much, but it will matter in practice, including in ways unforeseen just a few years ago. What public health officials and hospital administrators have done with racial criteria, probably with the best of intentions, is just the starkest example of how seemingly symbolic positions become tangible. As I write this, standardized tests and entrance exams are being canceled due to the intriguing notion that doing well on tests is a form of white privilege. Crime rates are rising across the country, but prominent Democrats are calling the problem “hysteria” or avoiding talking about it altogether. Fighting crime and protecting those at risk requires policing, which in turn requires funds and resources that progressive elites — but not genuine Democratic voters — are offering to divert from law enforcement.

Somehow, progressives have fallen foul of a set of ideas so off-putting that they threaten progressivism itself. Those of us who aren’t white aren’t just “non-white.” We are not interchangeable. We are not always and forever victims. We are individuals, first and foremost, not simply members of a group to be associated with by the good intentions of others.

Sometimes I fear letting my own aversion to awakening – few things seem more anathema to my understanding of what makes us who we are – distort my otherwise progressive commitments on substantive political issues such as reducing mass incarceration, reform of the criminal justice system, and boosting immigration to counter depopulation. And yet the reason to speak out against emerging conformity on the left is that its ideas, if enough people look the other way, lead to destructive policies that cost lives and livelihoods. Because outrage is so tempting, those of us who oppose bad ideas should probably save our frustration and anger for when it matters most. One of those times is now.


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