The U.S. Food and Drug Administration has faced backlash after recommending that clinicians use race and ethnicity, among other factors, to guide allocation and use of novel monoclonal antibodies for COVID-19 treatment. These guidelines are similar to recommendations from health departments in states like New York, Utah, and Minnesota to prioritize high-risk individuals who are elderly, pregnant, immunocompromised, have medical comorbidities, and are non-White for access to scarcely available COVID-19 medications like nirmatrelvir/ritonavir (Paxlovid) and molnupiravir. As clinicians and researchers who have studied and witnessed firsthand the unequal trajectory of this pandemic from the very beginning, we want to counter this pushback with an evidence-based perspective.
Explicitly race-based guidelines have marred the historical and current practice of medicine. Even today, race-based medicine exacerbates delays in access to timely treatment, inequitable rationing of ventilators, and widening chronic disease disparities.
While race-based guidelines that harm patients should be dismantled, we believe the FDA and state health department decisions to consider race have noble intentions: to advance equitable access to care and redress the impacts of racism, rather than worsen disparities with “colorblind” policies. (author introduction)