As Boston enters a period of surging COVID-19 cases, the City Council turned their attention toward the allocation of ventilators and Intensive Care Unit (ICU) beds in the event of limited medical resources.
Councilor Ricardo Arroyo (District 5) proposed a hearing to discuss the pre-existing racial health inequities suffered by Boston’s communities of color and how that would effect their eligibility for lifesaving resources during the pandemic.
According to guidelines recently published by Massachusetts Department of Public Health on April 7th, hospitals were instructed to score patients on their likelihood to survive in the short-term and long-term in order to determine the rationing of crucial medical resources. The guidelines state that “adhering to a first come, first served principle for those who were already receiving intensive care” could result in an “unjust allocation of resources.”
The scoring system, referred to as Sequential Organ Failure Assessment (SOFA), would take into account the presence of one or more chronic diseases or conditions. The assessment prioritizes those without illnesses that would “limit their life expectancy.” Those who score lower on the scale would be determined to benefit the most from critical care.
However, communities of color are more likely to have those pre-existing conditions that would qualify them as less eligible for critical care resources in the event of contracting the coronavirus. During a White House briefing on April 7th, Dr. Anthony Fauci stated that “health disparities have always existed for the African American community but, here again with the crisis, it’s shining a bright light on how unacceptable that is.” He addressed the fact that infection rate of communities of color was not the primary concern. It’s their underlying conditions—diabetes, hypertension, obesity, asthma—that “wind them up in the ICU and ultimately give them a higher death rate.”
Councilor Arroyo raised his concern over the Department of Health’s guidelines for allocating resources based off of pre-existing conditions and how that could disproportionately affect communities of color. He called for a timely hearing for a discussion that would ensure racism would not play a role, intentionally or unintentionally, in who would qualify for medical care during the COVID-19 pandemic.