Covid Meds Are Scarce, but Not for Trump Cronies
Rudy
Giuliani got monoclonal antibodies. You probably can’t.
Opinion
Columnist
- Dec. 10, 2020
According to a document from the Department of Health and Human Services, a total of 108
doses of Regeneron’s monoclonal antibody cocktail have been allocated to
Washington, which had 265 new coronavirus cases on Wednesday alone. Somehow
Rudy Giuliani, Donald Trump’s lawyer, got one of those doses. In an interview
with a New York radio station on Tuesday, Giuliani did us all the favor of
explaining why he qualified for privileged treatment.
“I had very mild symptoms,” he told
the radio station, WABC. “I think if it wasn’t me, I wouldn’t
have been put in the hospital. 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.” He said on another show on the same station that the president’s physician was
involved in his care.
Giuliani, of course,
is not the only presidential crony to get access to highly rationed
experimental therapies. Trump himself was among the very first people to get
the Regeneron treatment outside of a clinical trial, before it received an
emergency use authorization from the F.D.A. on Nov. 21.
In October, Chris
Christie, the former New Jersey governor and an informal adviser to the
president, got a different monoclonal antibody treatment, one produced by Eli
Lilly. Housing Secretary Ben Carson wrote on Facebook that Trump “cleared” him to
receive monoclonal antibody therapy when he was hospitalized with Covid-19 last
month.
Some of these men
received their treatments before they were available to the public. Giuliani
may have got his instead of a member of
the public. His case sheds light on two kinds of corruption. There’s the
corruption of an administration that appears to be using government power to
procure potentially lifesaving favors for the president’s friends. And there’s
the corruption of a for-profit medical system in which V.I.P. patients can
receive extraordinary levels of care, sometimes at the expense of the less
connected.
Chris Christie got a monoclonal
antibody treatment.
So did Ben Carson.
Both the Regeneron and Eli Lilly
therapies are meant for people who are at risk of getting sick enough with
Covid to be hospitalized, not those who are hospitalized already. The emergency
use authorization for
the Regeneron treatment specifically says that it is “not authorized” for
“adults or pediatric patients who are hospitalized due to Covid-19.”
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.
Right now, the criteria for
distributing these drugs can be murky. Robert Klitzman, co-founder of the
Center for Bioethics at Columbia, said that the federal government allocates
doses to states, states allocate them to hospitals and hospitals then decide
which patients among those most at risk will get treated. Some states have
developed guidelines for monoclonal antibody treatment, “but my understanding
is that most states have not yet done that,” Klitzman said.
Hospitals try to come up with ethical
triage frameworks, but Klitzman told me there are often workaround for V.I.P.s.
He said it helps to know someone on the hospital’s board, bodies that typically
include wealthy philanthropists. Often, he said, when these millionaires and
billionaires ask hospital administrators for special treatment for a friend,
“hospitals do it.”
Why? “Hospitals have huge financial
problems, especially at the moment with Covid,” he said. They’ve had to shut
down profitable elective surgeries and treat many people without insurance.
More than ever, he said, they “need money that is given philanthropically from
potential donors.”
In other words, Giuliani was right:
Celebrities have access to better care than ordinary people. “When someone is
in the public eye, or if someone is a potential donor, or has already been a
donor to a hospital, then there’s folks in the hospital hierarchy, in the
administration, who are keenly aware if they’re coming in, if they’re present,
if they need something,” said Shoa Clarke, a cardiologist and professor at Stanford
University School of Medicine. Covid, which is leading to rationing of medical
resources, only magnifies this longstanding inequality.
But like so many in Trump’s orbit,
Giuliani combines unusual candor with unusual deceptiveness. He’s honest about
trading on his fame, but uses his ultra-elite experience to play down the
dangers of Covid for everyone. “If you get early treatment nothing’s going to
happen to you,” he said on WABC, adding, “You totally eliminate the chance of
dying.”
This is wildly untrue. Even if
monoclonal antibody therapies were a foolproof cure — and there’s no evidence
they are — most people who listen to Giuliani won’t have access to them. They
might not learn that until it’s too late.
“This message that’s
been delivered, that maybe we don’t need to be so worried about Covid, that has
been a deadly message, and it’s part of a bigger package of misinformation
that’s been spread across our country, and it’s why we’re in the position we’re
in right now,” said Clarke.
When I spoke to him on Wednesday, he’d
just learned that one of the hospitals in his area had reached capacity. “We’re
expecting the others to follow suit in the next few weeks, to the point where
we don’t have I.C.U. beds available anymore,” he said.
But don’t worry. If
friends of Trump need one, they’ll surely find a way.
