State resolves complaint over old ventilator guidelines


Alabama agreed to remove old ventilator triage guidelines from state websites that advocates said discriminated against the elderly and disabled, the U.S Department of Health and Human Services announced Wednesday.

The Alabama document in question was created a decade ago during the H1N1 pandemic and allowed items like profound intellectual disabilities and severe dementia to be part of the decision-making. The Alabama Department of Public Health said a new plan had since been created, but federal investigators expressed concern that it was “still available on some state webpages, and it was not clear whether any of their potentially problematic provisions could still be applied under the new guidelines.”

The difficult decisions about who could get a ventilator if there is not enough to go around has taken on new urgency amid the COVID-19 pandemic and concerns that intensive care units would be overwhelmed.

Roger Severino, director of the Office of Civil Rights at the U.S Department of Health and Human Services, said they are looking into complaints involving several states but did not specify how many. Alabama agreed to remove all links to the outdated document and continue to publicly clarify that those guidelines don’t apply.

“These triage policies cannot discriminate on the basis of disability or age. They cannot be based on stereotypes or about a judgment about a person’s worth relative to others on the basis of disability,” Severino said.

The triage document was not a directive on handing out ventilators but a suggestion for providers in making decisions, state officials said.

“All people deserve compassion and equal respect, and, the allocation of care cannot discriminate based on race, color, national origin, disability, age, sex, exercise of conscience or religion. This includes the use of ventilators during medical emergencies in addressing the needs of at-risk populations in Alabama,” State Health Officer Dr. Scott Harris said.

Alabama on Wednesday had more than 2,400 coronavirus cases and 66 reported deaths, with state numbers continuing to show a racial disparity

A little more than 52% of the confirmed COVID-19 deaths in Alabama have been in African Americans, even though about a fourth of the state’s population is black, data released by state health officials showed.

Of 48 verified deaths in the state, 25 were in African American patients and 18 were white. The state is investigating additional deaths reported in COVID 19 patients but have not confirmed those fatalities yet.

Although national data is limited, other states also have reported disparities. Mississippi health officials said African Americans account for more than 50% of COVID-19 deaths in that state although they make up about 38% of the population.

Infectious disease expert Dr. Anthony Fauci said Tuesday during the White House COVID-19 briefing that the pandemic is shining a “bright light” on unacceptable health disparities.

Fauci said conditions like diabetes, hypertension and asthma are disproportionately affecting minority populations, and those are the same conditions that increase risk for a “bad outcome with coronavirus.”

“Black people in Alabama and other places have what I call a triple whammy. Poverty is a factor. Lack of health insurance is a factor, and underlying health conditions are a factor,” former state Sen. Hank Sanders of Selma said Tuesday.

Health care workers in hospitals and doctor’s offices accounted for 351 of the state’s COVID-19 cases.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the highly contagious virus can cause severe symptoms or be fatal.

Republished with the permission of the Associated Press.