What role, if any, should race play in medically treating Americans who have contracted the CCP Virus or could be likely victims? The question has gotten awfully important given that the virus’ highly infectious Omicron variant is greatly multiplying the number of cases (though because of asymptomatic spread and a shortage of reliable tests, no one knows how greatly); because for reasons ranging from those much higher case (and therefore hospitalization) numbers to the impact of illness and vaccine mandates on healthcare workers, the hospital system is strained; and because of shortages in treatments.
And the answer that seems best supported by the data is “some role” – because the most comprehensive data does show that race (along with ethnicity) does significantly affect the odds of suffering the most serious infection outcomes (symptoms severe enough to require hospitalization, along with of course death). But by no means should race or ethnicity play a major role – because so many other factors, and above all age, are much stronger determinants of the worst virus consequences.
The argument for prioritizing age begins with the aggregate data – which comes from the U.S. Centers for Disease Control and Prevention (CDC). Here’s what’s shown by the latest numbers measuring weekly CCP Virus deaths per 100,000 Americans for the week of January 15 by age group (for the most vulnerable) and by race and ethnicity for non-hispanic whites, non-hispanic blacks, and hispanics (the country’s three largest groups according to this typology).
By age group:
non-Hispanic whites: 0.22
non-Hispanic blacks: 0.35
As is obvious, senior citizens (65 and over) of all racial and ethnic groups are by far the most likely to die from the virus – which argues strongly for focusing prevention and treatment tightly on them.
The same holds for CCP Virus-related hospitalizations (keeping in mind what should be the well-known qualification that the government does a lousy job of making the critical distinctions between deaths and hospitalizations caused by the virus, and deaths and hospitalizations of infected victims that were caused by something else).
In this case, the CDC offers not weekly admissions figures per 100,000, but total statistics for the period March 1, 2020 to January 8, 2022 per identical numbers of Americans belonging to these categories. And helpfully, breakdowns are provided for both age and race/ethnic group. Here are the results:
non-Hispanic whites 65-plus years: 1,938.5
non-Hispanic whites 50-64 years: 811.9
non-Hispanic whites 18-49 years: 287.4 8
non-Hispanic whites 0-17 years: 46.9
non-Hispanic blacks 65-plus years: 3,835.4
non-Hispanic blacks 50-64 years: 2,165.0
non-Hispanic blacks 18-49 years: 886.3
non-Hispanic blacks 0-17 years: 126.7
Hispanic or Latino 65-plus years: 3,550.1
Hispanic or Latino 50-64 years: 2,053.3
Hispanic or Latino 18-49: 924.6 6
Hispanic or Latino 0-17: 115.0
The clear conclusion is that a national public health policy focused on preventing CCP Virus-related hospitalization would focus not on any single racial or ethnic group as a whole, but on the following groups in this (descending) order: Non-hispanic blacks over 65, hispanics and latinos over 65, blacks between 50 and 64 years, hispanics and latinos between 50 and 64 years, and non-hispanic whites over 65.
But these figures make another, comparably important point: The differences between blacks over 65 and hispanics and latinos over 65 are pretty modest. So even between these highly vulnerable groups, targeting treatment or prevention strategies according to race and ethnicity doesn’t seem to provide very useful advice. The differences between blacks among blacks from 50 to 64 years of age, hispanics and latinos of the same age group, and white 65 and over are even smaller, and therefore focusing on racial and ethnic considerations seems that much less warranted.
The CDC has also presented mortality data by age and racial/ethnic group simultaneously, but in a slightly different way – with these statistics showing how their virus-related deaths as a percentage of all deaths for these categories compare with that group’s share of the U.S. population overall. Groups whose shares of virus-related deaths are higher than their shares of the population as a whole are more vulnerable than average, and groups whose shares of virus-related deaths are lower than their shares of the total population are less vulnerable than average. Here’s that breakdown for senior citizens (the over 65s), drawn from Figure 3b in the link above) along with their total numbers as of 2019 (from the Census Bureau according to Table 1 in this link):
85-plus years: 5.89 million
non-Hispanic whites: 0.6 percent below
Hispanics: 1.3 percent higher
non-Hispanic blacks: 1.0 percent higher
75-84 years: 15.41 million
non-Hispanic whites: 7.6 percent below
Hispanics: 5.0 percent above
non-hispanic blacks: 3.8 percent above
65-74 years: 31.49 million
non-Hispanic whites: 14.60 percent below
Hispanics: 8.5 percent above
non-Hispanic blacks 6.7 percent above
As should be obvious, when it comes to the oldest seniors, non-Hispanic whites, non-Hispanic blacks, and Hispanics are experiencing CCP Virus-related deaths closely related to their shares of the overall population, there’s little if any reason to discriminate along racial and ethnic lines for virus-fighting policymakers.
The spreads are wider for Americans between 75 and 84, but mainly for non-hispanic whites. The difference between Hispanics and non-Hispanic blacks is anything but dramatic.
The situation changes more dramatically for the younger seniors, but again, mainly for non-hispanic whites. Hispanics’ and non-Hispanic blacks’ seem in the same ballpark.
Interestingly, if you look at the charts, black over-vulnerability stays level from there on for the 55-64 and 45-54 age groups, but keeps rising for Hispanics until the 25-34-year cohort . Non-Hispanic whites’ under-vulnerability stabilizes at the same point.
Even more interesting – for a change, the (rightly) embattled CDC seems to have gotten it about right. Although the agency notes urge healthcare providers and the state governments that regulated them to “carefully consider potential additional risks of COVID-19 illness for patients who are members of certain racial and ethnic minority groups,” it specifies that “Age is the strongest risk factor for severe COVID-19 outcomes” and its relevant guidance on major risk factors for severe virus outcomes concentrates on medical conditions.
CDC also recommends paying some attention to those who “live in congregate settings, and face more barriers to healthcare,” among other “social determinants of health” that can influence risk, and that “include neighborhood and physical environment, housing, occupation, education, food security, access to healthcare, and economic stability.”
Such Americans of course are disproportionately black and Hispanic. At the same time, the agency also admits that “we are still learning about how conditions that affect the environments where people live, learn, and work can influence the risk for infection and severe COVID-19 outcomes.” Plus, there’s no shortage of whites facing similar challenges.
Given those uncertainties, the aforementioned healthcare provision shortages, and given that Census pegs the numbers of Americans over 65 at nearly 53 million, it’s clear that protecting the elderly – whatever they look like – should be the unquestioned Job One for U.S. healthcare policy and healthcare providers.