Our view: The election wasn’t rigged. Is the medical system?
In the four days that former New York City Mayor Rudy Giuliani was treated for COVID-19 at Georgetown University Hospital last week, more than 7,000 Americans died from the disease.
Yet Giuliani, who is now President Donald Trump’s personal attorney, was healthy enough to call WABC Radio from the hospital to make an appalling assertion: “If it wasn’t me, I wouldn’t have been put in a hospital frankly.”
“Sometimes when you’re a celebrity, they’re worried if something happens to you; they’re going to examine it more carefully and do everything right,” Giuliani added, unconsciously echoing his client’s famous Access Hollywood tape assertion that “when you’re a star ... you can do anything.”
Life-and-death situations bring out the best in some people and the worst in others, particularly those who would emulate the men who tried to elbow aside the women and children when the Titanic was sinking and the lifeboats were filling. The coronavirus has already taken a disproportionate toll on lower-income people who can’t work from home, and blatant favoritism in treatment is a recipe for social unrest.
Giuliani, 76, said he was given the antiviral medication remdesivir, which has been in short supply in recent months, and dexamethasone, a corticosteroid. It’s unclear if he received a monoclonal antibody, which has had limited availability since the Food and Drug Administration approved it for emergency use last month.
A hospital spokeswoman, citing privacy laws in declining to discuss Giuliani’s case, told us that no patients get preferential treatment. But Giuliani isn’t the first member of Team Trump who appears to have received therapies that are largely unavailable to other mortals.
Former New Jersey Gov. Chris Christie, who was admitted to intensive care for seven days, said he was treated with remdesivir and Eli Lilly’s monoclonal antibody therapy. Last month, Housing and Urban Development Secretary Ben Carson said the president approved him to receive Regeneron Pharmaceuticals’ monoclonal antibody. And, of course, Trump himself received an experimental antibody cocktail when he was hospitalized at Walter Reed with COVID-19.
At the same time, a Center for Infectious Disease Research and Policy report cited shortages of critical drugs needed to treat COVID patients as the pandemic’s second wave began to build this fall. So, as hospitals across the country are overwhelmed with COVID patients and deaths have topped 300,000, it appears to pay to be a member of the president’s inner circle.
We’re glad that Trump and his associates recovered quickly. But the perception of VIP treatment for the rich, famous and powerful — particularly people who ostentatiously flouted health guidelines such as mask wearing — feeds public cynicism about the nation’s health care system.
The issue is especially relevant as the first round of Pfizer’s COVID-19 vaccine is distributed this week. Certain leaders and role models should get early doses as a way to build public trust. But bioethicists already have expressed concerns that doses will be siphoned to the well-to-do and the wellconnected — and away from the frontline medical workers and nursing home residents who are first in line.
Some medical institutions have set up ways to ensure that medications in short supply are distributed equitably. The New York University School of Medicine and Janssen Pharmaceuticals, for example, created a Compassionate Use Advisory Committee to review requests for experimental drugs.
But Leonard Fleck, acting director of the Center for Ethics and Humanities in the Life Sciences at Michigan State, says it largely falls on doctors and nurses to object if they think a patient is receiving special treatment because of wealth or status. That’s a difficult stand if it’s a hospital executive, a big donor or a crony of the president who’s pushing for VIP care. “It’s where moral courage comes in,” Fleck says.
With courage and trust in as short supply as monoclonal antibodies these days, it’s up to brave health care professionals to ensure that the treatment you get is based on fair criteria, not on who you know.