Midwest Catholic hospital system drops race-based COVID treatment process after legal threat

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A Catholic hospital chain based in St Louis, Missouri, has abandoned a COVID treatment policy that gave preferential treatment of potentially life-saving monoclonal antibodies to patients of color over white patients.

SSM Health, which has 23 hospitals across Illinois, Missouri, Oklahoma and Wisconsin, made the call after a conservative law firm threatened legal action, the Daily Mail reported.

“On Friday, attorneys for the Wisconsin Institute for Law & Liberty wrote to the hospital, asking that they end the ranking system used to determine which patients get priority for monoclonal antibodies — a popular method for reducing the risk of severe COVID symptoms,” the British tabloid reported.

The move comes on the heels of the state of Minnesota updating its policy, removing race as a preferential factor in deciding who gets monoclonal antibody treatments. A decision that came after America First Legal (AFL) threatened to sue for what they deemed to be an “appalling” system for determining who gets treatment.

Dan Lennington, an attorney with Wisconsin Institute for Law & Liberty, appeared on Fox News and explained the motivation behind the use of race.

“This is sort of a trend that’s going through health care, it’s called health equity,” Lennington said. “It’s the idea that there are racial disparities among patients and so, you should give preferences to certain races over another. This has actually come down from a lot of state departments of health and CDC guidance talking about racial disparities.”

The WILL letter cited an SSM Health email to physicians sent on December 31, which referenced a risk scoring calculator on deciding whether to prescribe MAb that gave non-white patients a seven-point lead out of a total of 20 points needed to qualify, according to the Daily Mail.

“For example, a 50-year-old white female (15 points) suffering from obesity (1 point), asthma (1 point), and hypertension (1 point) would not be eligible for mAbs because she does not receive the 20-point minimum score under the calculator,” the letter said. “On the other hand, an otherwise healthy 50-year-old African-American female (22 points), without any of these health risks, would be eligible.”

With attorney Rick Esenberg in the lead, the legal team wrote, “The approach taken by your calculator is not only profoundly unethical and immoral, it is illegal,” and added, “Federal law forbids race discrimination.”

SSM Health’s CEO, Laura Kaiser, responded to say that calculator cited in the letter was no longer in use, the Daily Mail reported.

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

The article noted that the Centers for Disease Control and Prevention has declared that racial and ethnic minority groups are “disproportionately affected by COVID-19.”

“Some of the many inequities in social determinants of health that may increase risk of severe illness (such as hospitalization, intubation, and death) from COVID-19 include access to quality healthcare, general health status, education, economic stability, and many other factors that affect health risks and outcomes. Because of these and other inequities, people from some racial and ethnic minority groups are less likely to be vaccinated against COVID-19 than non-Hispanic White people. COVID-19 vaccination reduces the risk of COVID-19 and its potentially severe complications. Discrimination, which includes racism, shapes social and economic factors that put people at increased risk of severe COVID-19 illness. Unfortunately, discrimination exists in systems meant to protect well-being and health. For example, discrimination within the healthcare system may deter people from seeking or receiving timely testing, vaccination, and treatment for health concerns, including COVID-19.”

 

The AFL went after both Minnesota and Utah, saying in a letter to the two states: “Using a patient’s skin color or ethnicity—rather than the unique and specific medical circumstances of an individual patient—as a basis for deciding who should obtain lifesaving medical treatment is appalling.”

“The color of one’s skin is not a medical condition akin to hypertension, heart disease, or obesity, which are known to aggravate the risk of death or severe illness among those infected with COVID-19,” the letter said. “Directing medical professionals to provide or deny medical care based on immutable characteristics like skin color, without regard to the particular health conditions of the individual patients who are seeking these life-saving antiviral treatments, is nothing more than an attempt to establish a racial hierarchy in the provision of life-saving medicine.”

Utah, which is facing a shortage of monoclonal antibody treatments, is reportedly reevaluating COVID-19 treatment qualifications.

Tom Tillison

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