A century ago, the Soviet dissident writer Yevgeny Zamyatin novelized a future dystopia in which equality was taken so seriously that peculiarly athletic people might have one of their limbs lopped off by the state, to even things up. New York State is now trying something similar: In the cause of racial equality, it advises doctors to deny white people life-saving medicine for Covid-19. To do so, it insultingly treats non-whiteness as a serious medical malady.
A memo from the state Health Department, approved by Governor Kathy Hochul, stated that, along with considerations of age, weight, and severity of symptoms, race should be a factor in the rationing of Pfizer’s Paxlovid pill and monoclonal antibody treatments:
Non-white race or Hispanic/Latino ethnicity should be considered a risk factor as longstanding systemic health and social inequities have contributed to an increased risk of severe illness and death from COVID-19.
To be clear, white people in New York can still be prescribed these treatments if they are available. However, non-white patients are presumed, because of their non-whiteness, to suffer from social inequalities that exacerbate their likelihood of illness and death, and are therefore instantly eligible for them. If Sundar Pichai, the CEO of Alphabet, should fall ill from Covid in New York, and be in similar straits to those of a white New York City streetsweeper, New York’s guidance suggests that Pichai (net worth: approximately $600 million), should be given priority in the name of equality. Or at least that Pichai’s race should be weighted in rationing decisions as a serious co-morbidity.
Strangely, this is not the first time in the pandemic that public-health bodies have tried overt and blunt forms of racial discrimination — as if their job weren’t to stop the pandemic, but to smooth out the distribution of social outcomes between racial groups. In 2020, the CDC’s Advisory Committee on Vaccines suggested racial preferences for the distribution of the vaccine. This form of madness was thankfully abandoned. But in overwhelmingly white Vermont, a Republican governor defended racial preferences for vaccines. New York City’s guidance also calls for racial preferences, and doctors there have been asked to report the race of those receiving life-saving Covid treatments.
While it can be argued that some racial groups have suffered more during the pandemic, it is usually because they are more likely to live in crowded housing, to be essential workers, or to have comorbidities such as severe obesity. Prioritizing a public-health response to meet people in those situations — in a racially neutral manner — can be appropriate policy.
What New York State has proposed is something else, something more like the positive discrimination preached by Ibram X. Kendi: All government policy must actively discriminate against whites until equality is achieved. Be anti-racist, deny anti-virals to the sick.
It should suffice to point out this form of egalitarianism defies New York State’s own constitution, which forbids corporations, institutions, and state agencies to discriminate on the basis of “race, color, creed or religion.”
But the policy is also stupid and immoral. Like most forms of affirmative action, it would not solve inequalities, but confuse and flummox administrators who seek to do their job fairly and ethically, while benefitting most those members of racial minority groups who are privileged enough to game the system. Worse, by treating racial status as an inherent disability, or disqualification for treatment, it trespasses on the most ancient principle of medical ethics: Do no harm or injustice.