New Conservative Target: Race as Factor in COVID Treatment

Some conservatives are taking aim at policies that allow doctors to consider race as a risk factor when allocating scarce COVID-19 treatments, saying the protocols discriminate against white people. 

The wave of infections brought on by the omicron variant and a shortage of treatments have focused attention on the policies. 

Medical experts say the opposition is misleading. Health officials have long said there is a strong case for considering race as one of many risk factors in treatment decisions. And there is no evidence that race alone is being used to decide who gets medicine.

The issue came to the forefront last week after Fox News host Tucker Carlson, former President Donald Trump and Republican Sen. Marco Rubio jumped on the policies. In recent days, conservative law firms have pressured a Missouri-based health care system, Minnesota and Utah to drop their protocols and sued New York state over allocation guidelines or scoring systems that include race as a risk factor.

JP Leider, a senior fellow in the Division of Health Policy and Management at the University of Minnesota who helped develop that state’s allocation criteria, noted that prioritization has been going on for some time because there aren’t enough treatments to go around.

“You have to pick who comes first,” Leider said. “The problem is we have extremely conclusive evidence that (minorities) across the United States are having worse COVID outcomes compared to white folks. … Sometimes it’s acceptable to consider things like race and ethnicity when making decisions about when resources get allocated at a societal level.”

Since the pandemic began, health care systems and states have been grappling with how to best distribute treatments. The problem has only grown worse as the omicron variant has packed hospitals with COVID-19 patients.

Considerable evidence suggests that COVID-19 has hit certain racial and ethnic groups harder than whites. Research shows that people of color are at a higher risk of severe illness, are more likely to be hospitalized and are dying from COVID-19 at younger ages.

Data also show that minorities have been missing out on treatments. Last week, the Centers for Disease Control and Prevention published an analysis of 41 health care systems that found that Black, Asian and Hispanic patients are less likely than whites to receive outpatient antibody treatment.

Omicron has rendered two widely available antibody treatments ineffective, leaving only one, which is in short supply.

The Food and Drug Administration has given health care providers guidance on when that treatment, sotrovimab, should be used, including a list of medical conditions that put patients at high risk of severe outcomes from COVID-19. The FDA’s guidance says other factors such as race or ethnicity might also put patients at higher risk. 

The CDC’s list of high-risk underlying conditions notes that age is the strongest risk factor for severe disease and lists more than a dozen medical conditions. It also suggests that doctors and nurses “carefully consider potential additional risks of COVID-19 illness for patients who are members of certain racial and ethnic minority groups.” 

State guidelines generally recommend that doctors give priority for the drugs to those at the highest risk, including cancer patients, transplant recipients and people who have lung disease or are pregnant. Some states, including Wisconsin, have implemented policies that bar race as a factor, but others have allowed it.

St. Louis-based SSM Health, which serves patients in Illinois, Missouri, Oklahoma and Wisconsin, required patients to score 20 points on a risk calculator to qualify for COVID-19 antibody treatment. Non-whites automatically got seven points.

State health officials in Utah adopted a similar risk calculator that grants people two points if they’re not white. Minnesota’s health department guidelines automatically assigned two points to minorities. Four points were enough to qualify for treatment.

New York state health officials’ guidelines authorize antiviral treatments if patients meet five criteria. One is having “a medical condition or other factors that increase their risk for severe illness.” One of those factors is being a minority, according to the guidelines.

The protocols have become a talking point for Republicans after The Wall Street Journal ran an op-ed by political commentators John Judis and Ruy Teixeira this month complaining that New York’s policy is unfair, unjustified and possibly illegal. Carlson jumped on Utah’s and Minnesota’s policies last week, saying “you win if you’re not white.”

Alvin Tillery, a political scientist at Northwestern University, called the issue a winning political strategy for Trump and Republicans looking to motivate their predominantly white base ahead of midterm elections in November. He said conservatives are twisting the narrative, noting that race is only one of a multitude of factors in every allocation policy.

“It does gin up their people, gives them a chance in elections,” Tillery said. 

After the Wisconsin Institute for Law and Liberty, a conservative law firm based in Madison, sent a letter to SSM Health on Friday demanding that it drop race from its risk calculator, SSM responded that it already did so last year as health experts’ understanding of COVID-19 evolved.

“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,” the company said in a statement. “As a result, race and gender criteria are no longer utilized.”

America First Legal, a conservative-leaning law firm based in Washington, D.C., filed a federal lawsuit Sunday against New York demanding that the state remove race from its allocation criteria. The same firm warned Minnesota and Utah last week that they should drop race from their preference factors or face lawsuits.

Erin Silk, a spokeswoman for New York state’s health department, declined to comment on the lawsuit. She said the state’s guidance is based on CDC guidelines and that race is one of many factors that doctors should consider when deciding who gets treatment. 

She stressed that doctors should consider a patient’s total medical history and that no one is refused treatment because of race or any other demographic qualifier.

Minnesota health officials dropped race from the state’s criteria a day or two before receiving America Legal First’s demands, Leider said. They said in a statement that they’re committed to serving all Minnesotans equitably and are constantly reviewing their policies. The statement did not mention the letter from America Legal First. Leider said the state is now picking treatment recipients through a lottery. 

Utah dropped race and ethnicity from its risk score calculator on Friday, among other changes, citing new federal guidance and the need to make sure classifications comply with federal law. The state’s health department said that instead of using those as factors in eligibility for treatments, it would “work with communities of color to improve access to treatments” in other ways.

Leider finds the criticism of the race-inclusive policies disingenuous. 

“It’s easy to bring in identity politics and set up choices between really wealthy folks of one type and folks of other types,” he said. “It’s hard to take seriously those kinds of comparisons. They don’t seem very fair to reality.”

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More Women, Minorities Take Up Truck Driving Due to High Demand

A shortage of truck drivers in the U.S. has led to all kinds of troubles for consumers and businesses. That has led to some trucking companies doing all they can to get new drivers on the road. VOA’s Aunshuman Apte has more from New York City.

Camera: Aunshuman Apte                       Produced by: Aunshuman Apte 

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California Nursing Homes Use Robotic Pets to Help the Elderly

In a California senior care community, very special pets are helping residents keep their spirits up, fight anxiety and feel loved. Officials say these animals are therapeutic, low-maintenance and never get moody. Angelina Bagdasaryan has the story, narrated by Anna Rice.

Camera: Vazgen Varzhabetian             

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US Orders Departure of Family Members of Ukraine Embassy Staff

The State Department on Sunday ordered the departure of eligible family members from the U.S. Embassy in Kyiv and authorized the voluntary departure of U.S. direct hire employees due to the continued threat of Russian military action against Ukraine.

The State Department also is asking U.S. citizens in Ukraine to consider departing the country now using commercial or other privately available transportation options.

The State Department reissued its Level 4 Travel Warning for Ukraine, saying “Do not travel to Ukraine due to the increased threats of Russian military action and COVID-19.”  Previously, the travel warning had also been at Level 4, due to COVID-19.

The State Department also reissued a travel advisory Sunday night regarding travel to Russia: “Do not travel to Russia due to ongoing tension along the border with Ukraine, the potential for harassment against U.S. citizens, the embassy’s limited ability to assist U.S. citizens in Russia, COVID-19 and related entry restrictions, terrorism, harassment by Russian government security officials, and the arbitrary enforcement of local law.”

Asked about the timing of these actions on Sunday evening in Washington, a senior State Department official told reporters they come against the backdrop of reports Russia is planning significant military action against Ukraine. 

The State Department official said security conditions, particularly along Ukraine’s borders, in Russia-occupied Crimea and in Russia-controlled eastern Ukraine, are unpredictable and can deteriorate with little notice. 

The official said President Joe Biden has said a Russian military invasion of Ukraine could happen at any time, and if there is an invasion, the U.S. Embassy in Kyiv would have limited ability to assist Americans who might want to leave the country.

The State Department officials who briefed reporters declined to give any estimates of the number of Americans working at the embassy in Kyiv or of the number of Americans living in Ukraine.

The State Department officials said these orders are being taken as a “prudent precaution” that in no way undermines U.S. support for the government of Ukraine, and the U.S. Embassy in Kyiv will continue to operate.

The State Department also asked all U.S. citizens in Ukraine to complete an online form so that the State Department may better communicate with them, saying this is especially important for citizens who plan to remain in Ukraine.

Earlier Sunday, U.S. Secretary of State Antony Blinken warned Russia that Washington knows “all of the tactics and techniques” that Moscow can deploy to undermine the Ukrainian government but will continue to engage in diplomatic talks in hopes of easing tensions in eastern Europe.

Watch related video by Arash Arabasadi:

“It is certainly possible that the diplomacy the Russians are engaged in is simply going through the motions and it won’t affect their ultimate decision about whether to invade or in some other way intervene, or not in Ukraine,” Blinken said on NBC’s “Meet the Press” show. “But we have a responsibility to see the diplomacy through for … as far and as long as we can go because it’s the more responsible way to bring this to a closure.” 

In a separate interview on CNN’s “State of the Union” show, Blinken ruled out the United States immediately imposing severe economic sanctions on Moscow, which it has vowed to do if Russian President Vladimir Putin invades Ukraine. Russia has massed 127,000 troops just across its border with Ukraine, a former Soviet republic. 

“If they’re triggered now,” Blinken said of the possible sanctions, “you lose the deterrent factor.” 

Republican Senator Joni Ernst of Iowa, following Blinken on CNN, accused the administration of President Joe Biden of a “doctrine of appeasement” in dealing with Russia over threats to Ukraine. 

“The sanctions need to be imposed now,” Ernst said. “President Putin only understands strength and power. We need to have firm resolve.” 

Blinken declined to comment on a British intelligence report that Russia was seeking to replace Ukraine’s government with a pro-Moscow administration. Moscow rejected the claim.

“The disinformation spread by the British Foreign Office is more evidence that it is the NATO countries, led by the Anglo-Saxons, who are escalating tensions around Ukraine,” Russian Foreign Ministry spokeswoman Maria Zakharova said on the Telegram messaging app. “We call on the British Foreign Office to stop provocative activities, stop spreading nonsense.” 

Blinken, on NBC, said that aside from the world’s awareness of Russia’s massive troop deployment near Ukraine, “It’s also important that people around the world, whether it’s in Europe, the United States or beyond, understand the kinds of things that could be in the offing: a false flag operation to try and create a false pretext for going in. It’s important that people know that that’s something that’s in the playbook too,” as well as cyberattacks and other disruption targeting Ukraine. 

The top U.S. diplomat said that aside from diplomatic engagement with Russia, “We are building up defense, we’re building up deterrence; we’ve now provided to Ukraine more security assistance this year than in any previous year.”  

 

Some material in this report came from the Associated Press. 

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Yellowstone Park Visits Hit Record in 2021, Straining Staff

A record number of visitors flocked to Yellowstone National Park last year despite fewer hotel rooms and campsites being available because of the coronavirus pandemic and construction projects.

About 4.86 million visits were tallied in 2021, breaking the prior record set in 2016. It’s a million more people than visited in 2020. 

Known worldwide for its wolves, bears and other wildlife and thermal features such as the Old Faithful geyser, Yellowstone will mark its 150th anniversary in 2022. It straddles the borders of northwestern Wyoming, southern Montana and eastern Idaho.

Visits to national parks across the U.S. have been trending up in recent years. Others such as Utah’s Zion National Park also set new visitor records in 2021 as tourism bounced back from the shutdowns imposed during the early days of the pandemic.

At Yellowstone, a rush of people from May through September last year strained employees and park services. It came as the park was understaffed through the summer because of worker housing caps and difficulty recruiting new employees, park officials have said.

There were also 20% fewer campsites and hotel rooms in 2021 compared to previous years. That meant hundreds of thousands of visitors left the park at night and would re-enter after staying elsewhere. Each time they entered the park counted as a separate visit.

Park officials said they are trying to find a way to differentiate between new visits and people who enter the park multiple times on the same trip.

Yellowstone’s road corridors and parking lots can get crowded, but they make up less than one-tenth of 1% of its 8,903 square kilometers (3,400 square miles) — an area about 150 times the size of New York’s Manhattan Island. 

Most visitors stay within a half-mile of those roads, according to park officials. Park crowds drop sharply during winter when much of it is inaccessible except by snowmobile or skiing.

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Thousands March in Washington Against Mask, Vaccine Mandates

Thousands of anti-mask and vaccine mandate protesters rallied on the mall in Washington, D.C., on Sunday to voice opposition to the Biden administration’s COVID-19 mask and vaccine policies.

Gathering at the base of the Washington Monument, and then marching to the Lincoln Memorial, the protesters held signs saying, “Make Love Not Mandates!!” and “Coercion is Not Choice.”

COVID-19 has killed more than 860,000 people in the United States – and more than 5.5 million globally — over the two-year-long pandemic and has weighed heavily on the economy.

On January 13, the U.S. Supreme Court blocked President Joe Biden’s COVID-19 vaccination-or-testing mandate for large businesses — a policy the conservative justices deemed an improper imposition on the lives and health of many Americans — while endorsing a separate federal vaccine requirement for health care facilities.

Many U.S. companies have implemented mandatory mask-wearing policies to protect their workers, as have various municipalities and cultural organizations.

Masks remain polarizing. Biden, a Democrat, recently urged people to wear masks and noted that about a third of Americans report they do not wear masks at all. Many Republican-leaning states have no mask requirements. Some Democratic-governed states such as California have reimposed indoor mask mandates.

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US Weighs Options on Ukraine

The United States began shipments of lethal aid to Ukraine after U.S. President Joe Biden recently said that any Russian troop movement into Ukraine would be considered an invasion. President Biden’s comments come as Russian President Vladimir Putin stations more than 100,000 troops along Ukraine’s border. Russian and U.S. diplomats so far have agreed to keep working to lower tensions. VOA’s Arash Arabasadi has more.

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Afghan Students in the US Face Uncertain Future

Afghan students studying at universities in the U.S. through scholarship programs face a more uncertain future since the Taliban took over and many say they cannot return to their home country because of concerns for their safety.

 

More than 100 Afghan students came to the United States through the Fulbright program last academic year, some of them only days before the Taliban took power in Afghanistan and the U.S. embassy in Kabul was abruptly shut.

 

Under the terms of the Fulbright scholarship program, recipients are required to return to their home countries at the end of their academic programs.

 

Several Afghan students interviewed by VOA said their status as students studying abroad in America endangers their lives under a Taliban regime in Afghanistan.

 

“I have come to terms with the reality that is going back to my beloved Afghanistan and working there is no longer possible,” said Maryam Rayed who left Afghanistan last August to pursue a master’s degree in democracy and governance at Georgetown University in Washington.

 

The U.S. government has evacuated tens of thousands of Afghans who had worked for or had affiliation with the U.S. in Afghanistan out of fear that the Taliban will target them.

 

Immediately after seizing power on Aug. 15 last year, the Taliban announced a general amnesty for all Afghans who worked for the previous Afghan government and for the U.S. and its allies in Afghanistan.

 

Human rights groups, however, accuse the Taliban of targeting and killing Afghans who had ties to the U.S. and to the former Afghan government.

Before coming to the U.S. to study international affairs at the State University of New York in Albany, Ahmad Raheb Radfar worked as a foreign service officer at the Ministry of Foreign Affairs of what was until August 2021 the Islamic Republic of Afghanistan.

 

“My plan was to return to Afghanistan and resume my work at the ministry upon the completion of my program. But now, given the current situation of Afghanistan, I cannot do that,” Radfar told VOA.

 

Hopes lost

Since 2003, more than 950 Afghans have received Fulbright scholarships, mostly 2-year master’s degree programs. Many others earned sponsored educational opportunities at undergraduate and graduate levels at various U.S. academic institutions. The expectation was that these highly educated Afghans would contribute to the building of a stable democratic system in Afghanistan.

“The return of Taliban rule in Afghanistan has fundamentally altered my personal and professional trajectory and took all my hopes and plans and aspirations for the future,” said Rayed, adding that she wanted to serve as a governance specialist in Afghanistan after her U.S. education.

 

Under the Taliban, Afghan women have been effectively fired from all government jobs except those working in the health and education sectors.

 

The Taliban have institutionalized large-scale and systematic discriminatory policies which “constitute a collective punishment of women and girls,” a group of three dozen U.N.-appointed experts warned last week.

 

“Taliban deprive women of livelihoods and identity,” Human Rights Watch said in a joint report with the Human Rights Institute at San Jose State University on Jan. 17.

 

One former Fulbright scholar, who did not want to be named out of fear of Taliban reprisal, said she was fired from a prominent job at the Afghan Ministry of Agriculture, Irrigation and Livestock because of her gender.

 

“My education, work experiences, skills and dedication to my country don’t matter for the Taliban. They’re only obsessed with my gender,” she said.

 

Respect for women’s rights, including the right to education and work, is a major condition set forth by the U.S. and many other countries for a possible recognition of the Taliban’s self-declared Islamic Emirate of Afghanistan.

 

Taliban officials have said the regime is working to facilitate an “Islamic environment” for Afghan girls and women to return to schools and universities but have not committed to giving any representation to women in the government. The Taliban’s leadership, cabinet and senior government posts are entirely occupied by men.

 

Students in limbo

The U.S. government has offered special immigration and entry procedures to help Afghans settle in the U.S., including a humanitarian parole program which allows individuals to enter the U.S. without travel documents.

 

Spokespeople at the Department of State and the Institute of International Education, which administers the Fulbright program, could not confirm to VOA whether there was a plan to waive the Fulbright requirement for the Afghan students to return to their home country after their studies are completed.

 

“We have been in touch with the [Fulbright] program administrators and have shared our concerns with them, but so far, they have not offered any assurance about our future,” said Radfar. 

 

Two other students echoed similar concerns and added they were looking for an extension to their studies, primarily through PhD scholarships, in order to remain in the U.S.

 

“This ambiguity has affected our academic performance negatively and has taken any motivation from us,” said Rayed.

 

“We desperately need some clarity on what our future will be. This limbo status is hurting us,” said another student who did not want her name to be mentioned.

 

While the Afghan Fulbright scholars who made it to the U.S. in the past two years complain about their uncertain future, those selected for the 2022 scholarships are stuck in Afghanistan with no guarantees they will start their classes in the U.S. in the coming fall.

 

There is no U.S. Embassy in Afghanistan to process visas, and travel from the country is extremely restricted and complicated.

 

“We are reviewing the significant safety, logistical, and programmatic constraints which must be overcome to successfully implement the 2022-23 Fulbright Program. We are committed to remaining in communication with the semi-finalist group about the status of the program, understanding they must pursue the choices that make the most sense for themselves and their families,” a State Department of official told VOA.

 

It’s also unclear whether the Fulbright program will continue for Afghan students in the future because of the broken relations between the U.S. and Afghanistan’s de-facto Taliban rulers.

 

Until the U.S. and Taliban figure out what kind of relations, if any, they will have in the future, everything remains shrouded in uncertainty for Afghans who have studied or aspire to study in the U.S.

 

“I cannot foresee anything right now and like most Afghans, I am facing an uncertain future,” said 28-year-old Radfar. 

Nike Ching contributed to this story.

 

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