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Should being nonwhite count as a COVID risk factor?

Donald Trump was really on a roll during his Saturday rally in Arizona:

This is ridiculous. At the same time, it's true that in the state of New York they count being nonwhite as a "risk factor" that increases your chances of getting COVID meds if supplies are limited. These figures from the CDC make it clear that this is justified:

Wait. What's going on here? I went over to the CDC site to grab a number for the increased risk of being nonwhite, and instead I got the chart above. For most of 2021 the Black and Hispanic communities did indeed have a higher risk than the white community of dying from COVID. But that risk started to plummet in October, and today the death rate is nearly the same for all three. Only the American Indian community is significantly higher.

(Note that this chart is for age 30-39, which I picked as an illustration. This is because the white, Black, and Hispanic populations have very different age distributions, so you need to compare within age groups. However, nearly all age groups look roughly like this one. In fact, among the elderly the Black death rate is now lower than the white death rate.)

This is news to me. But maybe it means that being nonwhite should no longer be considered a risk factor after all?

FOOTNOTE: COVID deaths by race and age are here. Population by race and age group are here.

66 thoughts on “Should being nonwhite count as a COVID risk factor?

  1. golack

    Overall, vaccinations in minority communities have caught up with vaccinations in the white community. That's not always the case in a given city--but it's hard to tease out differences due to age groups.

    Risk evaluations are historical--and maybe they need to be updated.

    The question is, should risk factors take into account others? Should the treatments go to the sole provider/single mom who doesn't have access to childcare should she need hospitalization vs. a retired anti-vaxxer? Hmmm...

  2. iamr4man

    As I understand it being unvaccinated is considered a risk factor. That means a Trumpian anti-vaxxer/anti-masker would get priority for therapeutics over a vaccinated person who follows masking rules. It seems to me that it should be the other way around.

    Isn’t it so typical that Trump and his minions get to talk out of both sides of their mouths and people like Kevin find some portion of their comment to ponder about? Trumpian anti-vaxxers are outraged that someone else gets to be in front of them to get the vaccine? And we have to wonder if they have a point? Just tell them to take their fake outrage and put it where the sun don’t shine.

    1. Mitch Guthman

      I agree with you completely. We are in a triage situation where scarce medical resources needed to be allocated appropriately. Being unvaccinated for ideological or idiosyncratic reasons should put one at the back of the line.

        1. Mitch Guthman

          Obese people are not bringing the health care system to the point of collapsing. They are not endangering others. Neither are they preventing the economy from reopening nor preventing life from slowly returning to pre-pandemic normal.

  3. James B. Shearer

    "Wait. What's going on here? .."

    What's going on is that Trump is correct, the rule is motivated by anti-white animus not by logic. What else explains giving Asians priority over whites?

    1. Jasper_in_Boston

      Maybe, at the end of the day, the policy of NY State being discussed isn't justified (or maybe it was justified six months ago but is no longer). I'd guess reasonable people could disagree on this score.

      But concern about racial disparities and inequities hardly equates to "anti-white animus."

      1. KawSunflower

        Or a white man who stabbed another man multiple times, causing his death, receiving a pig's heart to save his own life?

        Medical care is supposed to disregard "race" & other factors of "worth." And triage is supposed to be determined by who is most in need or most likely to be saved, as I understand it.

        The shrill trump lies never stop, & neither does that troll, but there appear to be new ones.

        1. James B. Shearer

          "Medical care is supposed to disregard "race" .."

          But they aren't disregarding race, they are favoring Asians over whites although by their own logic whites are more at risk and should be favored over Asians.

          1. KawSunflower

            First, skin color is not race. And simply declaring one ethnic group - although of course "Asian" includes many ethnic groups - more vulnerable does not make a policy of denying "whites" like me medical care.

            You really chose to deliberately miss both points. What you - & many people supporting politicians spouting such views - is for people of European lineage to reign supreme over others - here, in a land stolen by the Spanish & English from the actual native peoples.

        2. MontyTheClipArtMongoose

          I always think of Mickey Mantle's second liver & David Crosby's second **AND** third livers.

          How does that make any sense?

      2. James B. Shearer

        "But concern about racial disparities and inequities hardly equates to "anti-white animus.""

        Sure it does as implemented in this case. If the same logic had indicated that whites should be treated first do you think that is what they would have done? Of course not, this was just an excuse to discriminate against whites.

        1. mostlystenographicmedia

          Lol.

          1. Uh…news flash, there isn’t a shortage of vaccines, dumbsh*t, so nobody is being denied any.

          2. By common sense, people who are too stupid to get vaccinated should be last in line for therapeutics. But contra this, anti-vaxxers (majority Trump people) are actually being placed in front of the line.

          3. So crawl back to Stormfront until you have an actual grievance.

    2. MontyTheClipArtMongoose

      I thought the Democrat Party hated Asian-Americans for proving that being nonwhite isn't a hindrance to academic & occupational success.

      Shouldn't the Radical Left & Shit Neoliberals want Asians to join unvaccinated rural Trump voters in dying at a disproportionate rate?

    3. Solar

      No one is being given priority over whites. As usual this is just one more case of right winger fake outrage at the notion that a non-white may be given equal treatment as a white person, which is what pisses off so many of the Trumpublicans, and Trump as usual, is just being his typical rabble rousing idiot without a clue of what he is talking about.

      Here are all the things you seem completely unaware:
      1. For all COVID treatments, being unvaccinated is actually the No 1 priority on the list, which is a completely bonkers idea, since the idiots who refuse to get vaccinated for ideological reasons should be the very last ones to be treated. Idiocy should not be rewarded.

      2. Any type of prioritization only comes into play in the event that there are enough drugs to treat everyone, which is not the case right now.

      3. Of all the potential treatments, the only one that asks physicians to consider race as one of the factors, is the use of outpatient (meaning when the person is good enough to stay at home during treatment) oral antivirals.

      4. In the case above, the person still needs to meet all the requirements (age, type of symptoms, when positive test occurred, and medical history). The guidelines don't say "Give priority to non-whites no matter what", they only mention that when evaluating each person's medical history (which is one of the things to consider), to consider that race and ethnicity may contribute to an increased risk when assessing the medical history and other factors that increase risk of severe illness or death.

      5. That increased risk consideration is not something NY decided to shoehorn on their own, that is actually part of the CDC risks factor guidelines for COVID that have been in place since when Trump was still in office.

      1. Solar

        2. Any type of prioritization only comes into play in the event that there are NOT enough drugs to treat everyone, which is not the case right now.

        Missed the "NOT" there on my original comment.

  4. akapneogy

    Providing medical care should be color blind, whether in combating a pandemic or providing routine health care. Exploiting the quirks of the policies of a state government to sow disunity for political gain, especially by an ex-president, is despicable.

      1. akapneogy

        'Should be, but isn't.'

        Indeed. That's why a quirky state policy should be viewed in the context of overall discrimanation.

    1. Jasper_in_Boston

      Providing medical care should be color blind, whether in combating a pandemic or providing routine health care...

      That's an excessively broad statement. There are a whole host of medical problem that affect certain racial groups disproportionately. Often to a very considerable degree.

      It may be that our resentment-driven politics means making appropriate, science-based policies that acknowledge these disproportionate impacts is difficult, or often simply infeasible. But this dynamic doesn't change the underlying reality. Nature doesn't care about our psychological fragility and irrational animus.

      1. Lounsbury

        Well.... the problem with non colour blind "racial groups" falls into non-science based action.

        Science-based policies should in fact be recognising that for most cases racial groups are not biologically coherent and so it's either culture or as likely racial group, unless well-sampled and controlling well for income, as a large bucket is in fact acting as a proxy for real sources rooted in socio-economic factors. This excepting some particularly ethno-racial specifics such as blacks in the Americas being heavily drawn from west and central African sub-populations with elevated risk factors for malaria driven blood diseases.

        It is likely much minority based analysis could non politically be reframed socio-economically (as being poor and in an lower income dense housing area is a risk factor).

        1. KenSchulz

          Granting your point about ‘race’, many risk groups are quite heterogeneous. I have atrial fibrillation, which was one of the first high-risk conditions identified. But my condition is very mild, easily controlled with a minimum dosage of medication. Two friends of my wife and myself have much more severe cases, which impact their daily activities (One finally found relief after a second surgery). Is there sufficient data and robust analysis to support differentiating among levels of severity? In the moment, the treating physician must use her best judgment and available information.

      2. MontyTheClipArtMongoose

        Jews should get the same treatment for Tay-Sacks as non-Jews, & Blacks aren't in need of different standards of care for Sickle Cell.

        1. Jasper_in_Boston

          Exactly. The jaw-dropping idiocy of the anti-science right is hardly worth responding to. But sometimes I can't help myself.

  5. cld

    A grain of truth wingnuts will express a beautiful, priceless baby pearl of baby madness around that will grow and grow until it's a great big adult shambolic shit fit.

    1. iamr4man

      Because when Trump says something stupid, liberal commenters are forced to say “If Trump meant …… then he might have a point.”

    2. Spadesofgrey

      Because the state of New York are morons. Cuomo is missed......sad to say. Poor representation of the party. Expelled they should be.

  6. bebopman

    Well, how long has “nonwhite” been a risk factor in New York? Could it be that the death rate in that chart became more even in October only because “nonwhite” was counted as a risk factor? And maybe that policy needs to continue to keep the rate relatively even . Maybe ….

    Anecdotally, I’ve observed, in my small sample size in Denver, that even anti-vaxxers seem to act differently by race. The black and Hispanic folks I’ve seen who don’t trust the vaccine seem to at least take other measures to protect themselves, social distance, masks, etc, But many of the white folks I’ve seen just don’t care or don’t believe in the virus and act like there is no pandemic.

    Prime example in Denver: We are in the middle of the annual National Western Stock Show in north Denver. Kind of a super size county fair and rodeo with people from all over the state and beyond. I usually go to get my annual minimum requirement of dogs herding sheep and deep discussions with horses in their stalls while feeding them treats. As you might expect from my description, the place is 99.9 percent white (except for Bill Pickett day at the rodeo featuring black cowboys), and it’s a lousy place to ask someone for a spare mask since almost no one wears one. Maybe everyone there is vaccinated and boosted?

    1. KenSchulz

      Quite likely that you and bebopman have it. Death rate here is what economists call an endogenous variable - doctors seeing the data showing higher death rates for Black and Hispanic patients treat their cases more aggressively, so that the measure is also a driving factor for what is being measured.

  7. golack

    fyi: CDC has updated its graphics. They're doing overall weighted distributions, accounting for the age factor, etc. now too. But I'm only seeing a plot over time when looking at rural v urban results.
    https://www.cdc.gov/nchs/nvss/vsrr/covid19/health_disparities.htm#RaceHispanicOrigin
    The vaccination data has also been replotted:
    https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic
    Harder to see over time now. For vaccinations, "multi" receiving one dose is much larger than the percent identified as "multi" in the population. The US really doesn't have a good handle on changing demographics and the use of labels.

  8. Krowe

    So there were disparities in Aug-Nov and they're gone now, and we haven't updated policy to react to the change by January? Shocking.

  9. politicalfootball

    Doctors have identified race as a risk factor, and allegedly altered treatment decisions accordingly. So now we get the argument: Because current treatment decisions have rendered death rates that are similar, we should change treatment decisions so that more blacks die. I see a problem with this logic.

    1. MontyTheClipArtMongoose

      Last sentence is actual eugenics.

      But the Fauxgressive Left has so diluted that word that no one would believe it.

  10. ejfagan

    I don't know of any publicly available data to test this hypothesis, but it sure looks like a confounding variable to me. Poor access to care, comorbidities and low vaccination rates are all likely worse among non-white groups. Those seem more likely to cause worse COVID outcomes than race.

    1. Jerry O'Brien

      That's why public agencies should hesitate to push any racial preference for medical care. But you might look at the ABA article linked to by iamr4man:
      https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/
      The article points to a study indicating that members of a racial minority get lower quality of health care even after accounting for several of the confounding issues.

      I don't think it makes a clear-cut case for there being a large discriminatory effect, but at least physicians ought to know that unconscious prejudices might weigh on their treatment approach, and try to counter that consciously.

  11. Solar

    Kevin, something that everyone, including yourself seems to be missing is that the racial/ethnic consideration as a risk factor that NY has in their guidelines is actually a CDC guideline that has been in place for a long time. Also, the higher risk assessment is not just based on risk of death, but also of severe illness, so just looking at death rates as you are doing here is as short sighted as saying that you are going to evaluate various car models just by looking at the specs of the engines. Yes, the engine is a big deal but it is not the only thing that matters for a car. Same here.

    It is also worth mentioning that this risk factor consideration only applies for outpatient oral antivirals if there were to be be a shortage of them, and that the racial/ethnic consideration is not an automatic one. The guideline only states that physicians should take that into account when doing their assessment of risk factors because it MAY lead to an increased risk of severe illness or death. The patient still needs to be fully assessed and meet all requirements.

    No one is being given a free pass here.

  12. rational thought

    First, in order to possibly justify any such preference, you need to be able to show that it is the race itself that is a contributing factor in chance of death , and not just due to that being correlated with other factors. Or, possibly, that maybe race is not itself a contributing factor but is correlated with other contributing factors which you cannot easily measure and use, so you use race as a sort of proxy for those factors.

    Thus, if blacks or Hispanics are dying because they have more comorbities, that is 100% NOT a justification for any racial preference because you can just prioritize on comorbidities ( which is done and nobody complains about that even if result is more minorities get that preference). And same for vaccinations. That status can easily be determined and preferenced on that basis, so no reason to preference minorities if they are dying because they are less vaccinated.

    And the correct analogy with Republicans there is not a preference for unvaccinated, but a preference for being republican itself . If both minorities and republicans are dying more BECAUSE they have chosen not to get vaccinated, then any preference for minorities per se should also mean a preference for Republicans should also occur.

    Then you have things like blacks and Hispanics perhaps dying at greater rates due to other behaviors, such as not socially distancing and masking as much . Which is also likely true for Republicans. You possibly could justify a racial preference there, along with a preference for Republicans, as a proxy for hard to measure other things. But only if you think it is fair to give a preference due to chosen behaviors, which is questionable.

    Second , the disparity in death rates should only matter after they are already sick, not in total. If any group is dying at greater rates simply due to a higher chance of catching covid itself, that is irrelevant for any priority for treatment after you get sick. What would be rekevant are death rate % ages among those that do get sick.

    And likely any disparity due to things like not masking as much shows up mostly or all in different rates of catching covid , not different chances of dying if you catch it.

    Kevin, in casting doubt because relative death rates are now near equal assumes that a disparity before did justify a racial difference. It never did by itself as it could be due to only correlation with things like comorbidities. Plus that is measuring chance of death from total population, not just those who get sick.

    But, if there really was a true racial genetic factor, that could still be a justification today for a preference even if death rates now are the same. Maybe Hispanics are still more likely to die if sick just by being Hispanic, after controlling for other factors . And death rate only sane today because there was so much covid abs death earlier that few left to get sick and die.

  13. rational thought

    And to justify racial discrimination, there really should be a compelling case that ot is race itself that is a factor causing any difference, not correlations with other behaviors.

    And perhaps evidence from other nations that supports that . And some reasonable theory why that might be.

    For Ameriindians , a good case can be made . There is a scientific basis for expecting higher vulnerability there due to genetics and an inherent inferior immune system re such viruses, especially those coming from animals. Although diminished from 1500s die off due to evolutionary selection, you would expect some disparity to remain.

    And to a lesser extent with Hispanics of mixed amerindian and white ancestry. And that is backed up because Hispanic nations like peru were hit the hardest.

    For blacks there just is no such thing . Their immune systems should be a good or maybe better than whites for fighting such viruses. And Sub-Saharan Africa has done surprisingly well.

    There also might be some basis for south asians and maybe Slavs as there has been a recent study seeming to find a gene issue which is more prevalent in those groups and those are areas hit harder .

  14. illilillili

    So, what you're saying is that when New York started treating PoC as having a risk factor for dying, that extra attention reduced the risk factor, so we can stop treating PoC as having a risk factor.

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