COVID-19 and Inequities in Access to Treatment

“Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane,” Martin Luther King Jr. said in 1966.

I have COVID-19. As of this writing, I am one of 326 million people who have contracted this disease worldwide.

As a pulmonary sarcoidosis fighter who is taking prednisone to manage the disease, I am immunocompromised and at a higher risk for complications from COVID-19. Because of this, I long ago received my third shot of Pfizer’s COVID-19 vaccine, and while I remain physically active, I have maintained physical distancing, mask-wearing, and sanitizing habits since the pandemic began.

Nevertheless, I still have COVID-19. Sometimes we can do all the right things and remain vigilant, yet bad things happen anyway. For me, what’s most important is knowing what to do once I am sick.

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Making a plan in advance

Fortunately, I had a doctor-approved treatment plan in place in case I contracted COVID-19. Considering that I tested positive on a Friday night before a long holiday weekend, it was important to have had one beforehand. I wasn’t able to reach my doctors over the weekend, but I knew what to do next.

My doctor at the Johns Hopkins Sarcoidosis Clinic crafted a rather straightforward COVID-19 plan that recommended the following: Isolate, rest, monitor my symptoms, go to the emergency room only if my symptoms worsened, and obtain monoclonal antibodies treatment as soon as possible.

To support that plan, I already had cold medicine, a thermometer, and a pulse oximeter at home. I was ready, except for the antibodies. Getting that would be a problem. If I had tested positive earlier in the day or the week, I could have worked with my doctors and hopefully found a treatment location. But most facilities didn’t open again until Tuesday because of MLK Day, and I was supposed to get the treatment as soon as possible.

Current guidance is to get monoclonal antibodies therapy within seven days of the appearance of COVID-19 symptoms, but my doctor wanted me to get treated as soon as I tested positive. When you are high-risk, a single day of waiting can make a life-changing difference. So, rather than wait four days, I committed to finding treatment immediately.

Supply and demand

The good news: I was able to obtain treatment within 18 hours of my positive COVID-19 test. The bad news: I was only able to do so because I had the access, privilege, and means to work around the system and obtain private, or “concierge,” care.

I found a small center that had the treatment and gave me an appointment on the same day. They were even within walking distance of my Brooklyn apartment. The catch was that I had to pay out of pocket — I won’t disclose the amount, but it wasn’t insignificant — as the company didn’t accept insurance plans. This is a legitimate company and was listed by the City of New York as an official treatment location.

Please note that I am not trying to pick on treatment centers. After all, I went there, and if not for them, I likely wouldn’t have been treated the same day.

I called about a dozen different locations and hospitals. Some said they could see me a few days later, and others said I could wait in the emergency room for possible treatment, which was out of the question, according to my doctor’s plan. But none of the others could guarantee treatment on the same day.

As I write this a few days later, my symptoms are minor. The facility likely saved me from a bigger struggle with COVID-19. So, I am grateful and feel blessed, as I truly needed the treatment.

Healthcare access for the privileged

That said, as easy as it was for me to get treatment, countless others cannot do the same. Right now, there are others with high-risk COVID-19 who don’t have the same access or resources as I did. For them, a quick, 45-minute antibodies IV would make all the difference. But they can’t get treatment, and that’s not fair.

Even if they do have insurance, they likely will find, as I did, that many facilities are struggling with treatment appointments. And that’s not fair.

And then they may find it hard to find a treatment location that takes their insurance and has supply waiting for them. And that’s not fair.

I don’t have the answers to these problems. Frankly, there usually aren’t simple answers for such complex problems. And again, I truly am grateful that a treatment location was there for me.

But as we continue to find ways to live through this ongoing pandemic, I hope we can all find ways to better support our most vulnerable. My experience this weekend has shown, once again, that those with access, privilege, and resources have a huge advantage.

I just wish that my experience was the norm, and not so unusual. Because that’s just not fair.

Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to sarcoidosis.