He's not an elected official or front-line worker. He's not a resident of the community that the Georgetown hospital serves. He's obese. Why did the staff responsible for triage decide that he gets priority over someone more essential, or someone not obese with a better chance of survival.
From the article:
> A physician with experience administering the new monoclonal antibodies, who didn’t want to use his name because he’s not authorized by his hospital to speak publicly, said giving them to Giuliani “appears to be an inappropriate use outside the guidelines of the E.U.A. for a very scarce resource.” Very scarce indeed: According to the Department of Health and Human Services, as of Wednesday the entire country had about 77,000 total doses of the Regeneron cocktail and almost 260,000 doses of Eli Lilly’s monoclonal antibody treatment. That’s less than you’d need to treat everyone who’d tested positive in just the previous two days.
This is answered quite clearly in the article - because he's well connected. Largely that means people with money, but influence doesn't hurt either. He cut the line as a VIP.
Is that ethically wrong? Probably. Is it new? Not even remotely.
> This is answered quite clearly in the article - because he's well connected. Largely that means people with money, but influence doesn't hurt either. He cut the line as a VIP.
> Is that ethically wrong? Probably. Is it new? Not even remotely.
The story here is not that corruption is "new." The story is that there were a total of 108 doses of this treatment allocated to Washington, and one of them went to someone with self-admittedly "very mild symptoms," and had a history of reckless behavior to boot. That rare treatment might have been able to save someone's life, but it instead went to someone who didn't need it and probably didn't deserve it. It's worth noting that this instance corruption happened and who was involved, so maybe someday something can be done about it or this sort of thing more generally.
It's really weird: whenever there's a story like this, people seem to climb over each other for the opportunity to note that corruption wasn't invented yesterday, like they're making some kind of important point.
> and one of them went to someone with self-admittedly "very mild symptoms,"
In fairness, the monoclonal antibodies have been shown to be ineffective when given by the point symptoms are severe. To save any lives, you'll need to give them to people with mild to moderate symptoms but significant risk factors.
e.g. "...Casirivimab and imdevimab are not authorized for patients who are hospitalized due to COVID-19 or require oxygen therapy due to COVID-19. A benefit of casirivimab and imdevimab treatment has not been shown in patients hospitalized due to COVID-19. Monoclonal antibodies, such as casirivimab and imdevimab, may be associated with worse clinical outcomes when administered to hospitalized patients with COVID-19 requiring high flow oxygen or mechanical ventilation...." https://www.fda.gov/news-events/press-announcements/coronavi...
Of course, this really sucks, because there's nowhere near enough to give to everyone who's high risk and has early COVID, while there might eventually be enough to give to people with severe COVID.
> If there were a vaccine for AIDS, who should get it first, the sober person in a monogamous relationship or the IV drug user having unprotected sex?
Giuliani didn't get a vaccine, he got treatment for an active infection.
This is more like: you have one dose of an AIDS cure. Do you give it to the IV drug user who has unprotected sex with strangers at weekly orgies, or do you give it to the 10 year old kid who got it through a blood transfusion?
> OK so do you give the treatment to the 10 year old kid who has a 0.000% chance of dying or the 76 year old who has a 5% chance of dying?
You're jumping all over the place with your contrived hypotheticals. Are we still talking about AIDS?
Yeah, Giuliani is 76 years old, but he behaved recklessly and there are other old people who didn't. If we're contriving hypotheticals, why should he get it an not some elderly nurse that came back from retirement to help treat COVID patients [1]?
He got it because he was connected, and there was probably someone who had more need or was more deserving who didn't get it because of him.
[1] That is a thing: https://globalnews.ca/news/7481581/texas-nurse-covid-teacher...: "A 70-year-old nurse who gave up her retirement to train a new generation of front-line workers for the pandemic has died, after contracting COVID-19 in north Texas."
Does that mean other people should be treated in front of him? And if that is the case should that apply in other cases where people behave recklessly?
People who shoot IV drugs behave recklessly. People who have unprotected sex behave recklessly.
Are people who do not engage in those behaviours more deserving of treatment than people who do engage in those behaviours?
I've been asking you this question about three different ways and you won't answer the question.
That's just the name of the game when you have someone high up in power looking out for you.
I wonder how the pressure from above manifested itself in that triage room. Probably something along the lines of "take extra good care of this person... or else"
Boris Johnson, PM of the UK, got his COVID care from the National Health Service, and while I imagine he got some VIP treatment, the delta between rich and poor in the US is the same as life and death. It's not an issue of an extra comfy pillow and a room with a view, it's being left to die because you can't afford treatment. Other countries don't do that.
There are many reports of people self-rationing insulin and dying as a result. That's as close to "left to die because you can't afford treatment" as it's possible to get without murder charges.
> It is not being left to die because you can’t afford treatment. It is bad enough that we don’t need to exaggerate.
If you don't have the money to pay, hospitals in the US are only required by law to stabilize you. So, for instance, if you can't afford cancer treatment, you'll likely die of untreated cancer.
In South Carolina, where I work for a hospital, you automatically qualify for Medicaid when you’re diagnosed with cancer.
This way people don’t die from untreated cancer.
Getting diagnosed early when uninsured is where we fail as a society. Our politicians cover up this failure by giving them Medicaid so we spend $500k treating advanced disease and they still die, rather than universal coverage.
People who can’t afford the cost or just don’t want to pay the exorbitant cost will avoid going, even if it means their lives.
Having chest pain? What if it’s just indigestion, you don’t want to go to the ER and have a $5000 bill. Oops, it was a heart attack and you’re dead. This is an actual discussion I had with one of my parents. Luckily, in that case it wasn’t a heart attack, but this is the patient-hostile system we’re working with.
The thing I always say is that when you allow health organizations and insurance companies to be for-profit, profit is going to be prioritized over health.
Very curious how monoclonal antibodies seem to be usable for a very wide range of applications.
I have been taking monoclonal antibodies every 2 weeks for more than a year now with Dupixent for atopic dermatitis. In my 30+ years on this earth only steroid creams ever worked to treat my eczema, that is until this monoclonal antibody treatment came along and for all intents and purposes completely cured me.
To know that a similar kind of treatment is used for covid is pretty mind boggling since both conditions have very little in common.
I can't wait until Biden takes office and idiots everywhere have to feel like idiots when faced with the conspicuous absence of this kind of reporting.
Meritocracies require extreme discipline to maintain. Like militaries. Hierarchic and authority driven. In something as casual, permissive, and political as a democratic republic, even with laws, it corrupts itself. Those with power decide what is meritorious, and inevitably lower ladders for their family and friends.
Minorities have never been on a level playing field, so I'd argue it never was nor could have been a meritocracy anyway. It was always corrupt from its founding. That would seem to be a necessary first step.
What is the problem here? A frail old geezer gets some medicine that can avert onset of pneumonia. All right, New York Times, I understand you want to be the judge who gets euthanized and who doesn't.
Maybe you don't like he's friends with Trump. If I had a friend who'd pull any strings to save my life, I'd be honored and humbled and prayed for him as long as I breathe.
It's a shame HN gets flooded with hateful journo tripe of the lowest degree.
35 comments
[ 5.8 ms ] story [ 91.3 ms ] threadFrom the article:
> A physician with experience administering the new monoclonal antibodies, who didn’t want to use his name because he’s not authorized by his hospital to speak publicly, said giving them to Giuliani “appears to be an inappropriate use outside the guidelines of the E.U.A. for a very scarce resource.” Very scarce indeed: According to the Department of Health and Human Services, as of Wednesday the entire country had about 77,000 total doses of the Regeneron cocktail and almost 260,000 doses of Eli Lilly’s monoclonal antibody treatment. That’s less than you’d need to treat everyone who’d tested positive in just the previous two days.
Is that ethically wrong? Probably. Is it new? Not even remotely.
> Is that ethically wrong? Probably. Is it new? Not even remotely.
The story here is not that corruption is "new." The story is that there were a total of 108 doses of this treatment allocated to Washington, and one of them went to someone with self-admittedly "very mild symptoms," and had a history of reckless behavior to boot. That rare treatment might have been able to save someone's life, but it instead went to someone who didn't need it and probably didn't deserve it. It's worth noting that this instance corruption happened and who was involved, so maybe someday something can be done about it or this sort of thing more generally.
It's really weird: whenever there's a story like this, people seem to climb over each other for the opportunity to note that corruption wasn't invented yesterday, like they're making some kind of important point.
In fairness, the monoclonal antibodies have been shown to be ineffective when given by the point symptoms are severe. To save any lives, you'll need to give them to people with mild to moderate symptoms but significant risk factors.
e.g. "...Casirivimab and imdevimab are not authorized for patients who are hospitalized due to COVID-19 or require oxygen therapy due to COVID-19. A benefit of casirivimab and imdevimab treatment has not been shown in patients hospitalized due to COVID-19. Monoclonal antibodies, such as casirivimab and imdevimab, may be associated with worse clinical outcomes when administered to hospitalized patients with COVID-19 requiring high flow oxygen or mechanical ventilation...." https://www.fda.gov/news-events/press-announcements/coronavi...
Of course, this really sucks, because there's nowhere near enough to give to everyone who's high risk and has early COVID, while there might eventually be enough to give to people with severe COVID.
If there were a vaccine for AIDS, who should get it first, the sober person in a monogamous relationship or the IV drug user having unprotected sex?
Giuliani didn't get a vaccine, he got treatment for an active infection.
This is more like: you have one dose of an AIDS cure. Do you give it to the IV drug user who has unprotected sex with strangers at weekly orgies, or do you give it to the 10 year old kid who got it through a blood transfusion?
You're jumping all over the place with your contrived hypotheticals. Are we still talking about AIDS?
Yeah, Giuliani is 76 years old, but he behaved recklessly and there are other old people who didn't. If we're contriving hypotheticals, why should he get it an not some elderly nurse that came back from retirement to help treat COVID patients [1]?
He got it because he was connected, and there was probably someone who had more need or was more deserving who didn't get it because of him.
[1] That is a thing: https://globalnews.ca/news/7481581/texas-nurse-covid-teacher...: "A 70-year-old nurse who gave up her retirement to train a new generation of front-line workers for the pandemic has died, after contracting COVID-19 in north Texas."
>> he behaved recklessly
Does that mean other people should be treated in front of him? And if that is the case should that apply in other cases where people behave recklessly?
People who shoot IV drugs behave recklessly. People who have unprotected sex behave recklessly.
Are people who do not engage in those behaviours more deserving of treatment than people who do engage in those behaviours?
I've been asking you this question about three different ways and you won't answer the question.
I wonder how the pressure from above manifested itself in that triage room. Probably something along the lines of "take extra good care of this person... or else"
If you don't have the money to pay, hospitals in the US are only required by law to stabilize you. So, for instance, if you can't afford cancer treatment, you'll likely die of untreated cancer.
This way people don’t die from untreated cancer.
Getting diagnosed early when uninsured is where we fail as a society. Our politicians cover up this failure by giving them Medicaid so we spend $500k treating advanced disease and they still die, rather than universal coverage.
What? Emergency rooms can't refuse people in the US.
Having chest pain? What if it’s just indigestion, you don’t want to go to the ER and have a $5000 bill. Oops, it was a heart attack and you’re dead. This is an actual discussion I had with one of my parents. Luckily, in that case it wasn’t a heart attack, but this is the patient-hostile system we’re working with.
The thing I always say is that when you allow health organizations and insurance companies to be for-profit, profit is going to be prioritized over health.
That won't be the case for much longer.
I have been taking monoclonal antibodies every 2 weeks for more than a year now with Dupixent for atopic dermatitis. In my 30+ years on this earth only steroid creams ever worked to treat my eczema, that is until this monoclonal antibody treatment came along and for all intents and purposes completely cured me.
To know that a similar kind of treatment is used for covid is pretty mind boggling since both conditions have very little in common.
America has long ceased to be a meritocracy.
Minorities have never been on a level playing field, so I'd argue it never was nor could have been a meritocracy anyway. It was always corrupt from its founding. That would seem to be a necessary first step.
Maybe you don't like he's friends with Trump. If I had a friend who'd pull any strings to save my life, I'd be honored and humbled and prayed for him as long as I breathe.
It's a shame HN gets flooded with hateful journo tripe of the lowest degree.