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Racial Health Inequities Addressed by City Council in Regard to Ventilator Distribution & ICU Beds

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.

Figure from Massachusetts Department of Health’s “Crisis Standards of Care” guidelines.

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.

8 Replies to “Racial Health Inequities Addressed by City Council in Regard to Ventilator Distribution & ICU Beds

  1. These regulations also discriminate against people over 60 who have conditions like diabetes, high blood pressure and asthma/COPD not just against people of color

  2. I would really appreciate hearing from our City Councilor as to what is happening at the North End Nursing Home.

    Are they testing there? How many positives? How many deaths because of COVID-19 at the nursing home?

  3. I doubt that skin color has anything to do with the treatment people receive. These councilors who are just looking for people to throw darts at as they work their tails off and risk their own lives should be more involved with working to keep their district’s people out of the hospital and safe. Looks like they choose sitting around writing missives in Twitter.

  4. I may be a little off topic here , but here goes .The death count at the Holyoke Soldiers home now stands at 48. Someone or some people need to be held accountable and prosecuted for what happened there. And yes their needs to be transparency at the NE nursing home and every nursing home in the state. I read that in the state of MA 50% of the COVID -19 deaths have occured at nursing homes , soldiers or veteran homes and at assisted living sites. That is not acceptable.!!!

    1. Now that these antibody tests are coming out, a study in San Francisco found that many more people were infected, but showed no symptoms or felt sick. People in nursing homes have a higher risk and can’t be distanced. Private rooms are uncommon and many need help just getting out of bed. Managements in these facilities, one would hope would be checking workers as they come in for signs of sickness, but if they show no symptoms, these are essential workers. This is one of the more insideous issues with this virus. We are finding that some people get infected, but don’t get sick. Swab tests take days to process and they may have as much as a 30% miss rate. Something better is on the way, but still awaits FDA approval.

  5. These comments are enough to make a person puke. There are racial disparities–period. And no offense to the 60+ crowd cited, but if my 78 year old elderly Aunt and I both need a ventilator or bed, she knows to give it up to the younger person with a future. That’s reality. We are also not stupid morons who go to the hospital. That’s a last resort in this scenario. Hospitals kill. That’s reality. The 60+ crowd in this country is a boomer lot of idiots whom the 50s unfairly enriched. That’s reality. A bunch of North Enders are dim wits who got property rich and think they know something about life. Not all. That’s reality. Many amazing people like Jorge Mendoza. The North End is one big hand-out to too many people who are unfairly and anything but meritoriously enriched. Everyone in these comments sounds like a total whiner with an entitlement complex. Grow up and face yourselves. And use your real names, you stinking cowards. SHAME ON YOU!

    1. Brian , you admit that there are racial disparities “period” OK! You call people “dimwits” and “whiners with an entitlement complex” These are your own words”We are also not stupid morons who go to the hospital. That’s a last resort in this scenario. Hospitals kill. That’s a reality” Thank you I wasn’t aware of that. If we were entitled or whiners we would only think of ourselves and would not speak for the elderly & veterans in nursing homes or soldiers homes or for minorities that are dying due to the virus. That’s reality.

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