COVID-19 will not only have a disparate impact on historically under-resourced and marginalized communities, but also carries the risk of deepening pre-existing racial inequities in health care access, treatment, and social service delivery. Even a health care system striving to provide fair and equal treatment to all persons is not immune to structural racism and the other inequities that exist throughout society. To achieve equitable access and distribution of care, critical race theory must be a part of the process utilized to create broad, population-focused guidelines. This is particularly true in the face of the COVID-19 pandemic which is stressing both our health care system and society.
Both the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) have recently published articles attempting to provide an ethical framework by which to allocate scarce medical resources during the COVID-19 pandemic. Unfortunately, neither article acknowledged the structural racial inequities that inherently bias its proposals, nor did either piece adequately acknowledge how its care rationing plan might worsen already racially disparate health outcomes. (author introduction)