December 11, 2020
HUD Secretary Ben Carson, former New Jersey Governor Chris Christie, and President Donald Trump are not the strongest candidates to survive the coronavirus: They are older, in some cases overweight, male, and not particularly fit. Yet all seem to have come through COVID-19—thanks to access to an antibody treatment that is in such short supply that some hospitals and states are doling it out by lottery, The New York Times reports.
Now RudyGiuliani, the latest member of President Trump’s inner circle to contract the coronavrius, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.
“If it wasn’t me, I wouldn’t have been put in a hospital frankly,” Giuliani, the president’s personal lawyer, told WABC radio in New York. “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.”
According to the Times report, Giuliani’s candid admission once again exposes that COVID-19 has become a disease of the haves and the have-nots. The treatment given to President Trump’s allies is raising alarms among medical ethicists as state officials and health system administrators grapple with gut-wrenching decisions about which patients get antibodies in a system that can only be described as rationing.
We should not have Chris Christie and Ben Carson—and in the case of Carson, with intervention by the president—get access,” said Arthur Caplan, a medical ethicist who works with drug companies on how to ration scarce medicines, referring to the secretary of housing and urban development’s admission that the president “cleared” him for the therapy. “That is not the way to secure public support for difficult rationing systems.”
The treatments — a monoclonal antibody developed by Eli Lilly and a cocktail of two monoclonal antibodies developed by Regeneron — won emergency use authorization, or an E.U.A., from the Food and Drug Administration last month for outpatients with “mild to moderate” disease who are at high risk for progressing to severe disease or for being hospitalized.
With cases soaring, the pool of potential patients is vast.
“One of the challenges is the E.U.A. criteria really are so broad, it could be half of the people with COVID could qualify, but there is clearly not enough,” Erin Fox, the senior pharmacy director for University of Utah Health, who has helped her state draft criteria to determine who is eligible for the drugs, told the Times. “Unfortunately, that leaves each hospital or each state to develop their own rationing criteria.”
Even some top officials at the F.D.A —both career employees and political appointee —have privately expressed concern in recent months that people with connections to the White House appeared to be getting access to the antibody treatments, according to three senior administration officials.
Giuliani, 76, appeared unaware of the scarcity issues, telling interviewers that politicians have taken masks and business closures too far now that COVID-19 is “a treatable disease.”
Research contact: @nytimes