Uncovering Disparities in COVID-19 Hospital Treatment

Speakers: Dr. Jose Iglesias, Dr. Paul Marik, Dr. Joseph Varon

“There are a fair number of disparities between racial and ethnic groups for a variety of reasons.” – Dr. Jose Iglesias

It’s almost hard to recall a time before the COVID-19 pandemic reshaped the landscape of healthcare. Yet one fact remains unchanged: disparities in health outcomes among racial and ethnic groups have long been entrenched in our healthcare system. These inequities, though largely overlooked, have silently influenced lives for decades, only to be thrust into the spotlight by the pandemic.

Rooted in unequal access to care, systemic socioeconomic barriers, and a legacy of mistrust in medical institutions, these disparities converged with the pandemic’s challenges. As Dr. Jose Iglesias observes, the data paints a stark picture: COVID-19 mortality rates, hospital stays, and overall health outcomes disproportionately affected minority populations.

“There are significant racial disparities in COVID-19 morbidity,” Dr. Iglesias explained. Today, alongside fellow FLCCC co-founders Dr. Paul Marik and Dr. Joseph Varon, Dr. Iglesias will share key findings that were initially presented at the CHEST Annual Meeting, a premier conference focused on advancements in pulmonology, critical care, and sleep medicine.

Septic Shock Outcomes Predicted COVID-19 Inequities

Before the pandemic, his team had been investigating disparities in septic shock outcomes among critically ill patients. This work became the foundation for understanding broader inequities during COVID-19.

“Septic shock was the initial clue,” Dr. Iglesias explained.

The rise in severe COVID-19 cases exposed these disparities on an unprecedented scale. Minority groups faced higher rates of severe illness and death, often stemming from vulnerabilities that developed long before hospitalization. “The drivers of these disparities,” Dr. Iglesias emphasized, “occur way before the patient gets critically ill and ends up in the ICU.”

Analyzing Mortality Rates by Race and Ethnicity

“The data showed clear disparities, even when accounting for socioeconomic and clinical factors.” – Dr. Iglesias

When Dr. Iglesias and his colleagues analyzed data from the National Inpatient Survey (NIS) and other sources, they found that Black, Hispanic, American Indian, and Alaska Native patients experienced disproportionately higher COVID-19 mortality rates compared to non-Hispanic White patients.

Even after adjusting for socioeconomic factors and pre-existing health conditions, non-White patients faced worse outcomes—a sobering reminder of how deep these inequities run. The findings pointed to systemic issues in healthcare delivery, resource allocation, and access to care, painting a stark picture of health inequity.

Declining Trust in the Healthcare System

“Historical events like Tuskegee have left a lasting scar on trust.” – Dr. Iglesias

One of the most insidious factors driving these disparities is a lack of trust in the healthcare system. For many, this mistrust is based in historical injustices, like the infamous Tuskegee syphilis study, where minority populations were exploited and deceived by medical authorities.

Dr. Iglesias noted that during the pandemic, trust in physicians and hospitals fell sharply, from 71% in April 2020 to just 40% by January 2024. This decline had real consequences: patients delayed seeking care and often arrived at hospitals only when severely ill.

Dr. Varon reflected, “By the time patients came to us, they literally had to be dying before they came to the hospital.” Undocumented patients, for example, avoided care out of fear—fear of financial ruin, deportation, or even mistreatment.

These patterns of avoidance only deepened the health inequities exposed by the pandemic.

The Role of Financial and Systemic Factors

“Financial incentives often overshadow patient care.” – Dr. Paul Marik

The pandemic also revealed troubling systemic issues within healthcare. As Dr. Marik noted, financial incentives often took precedence over patient welfare, resulting in profit-driven policies and protocols that failed to prioritize equity or health outcomes.

According to Dr. Igelsias, poor quality of care, influenced by racial and cultural biases, compounded these issues. Minority patients often reported inadequate communication, dismissive attitudes, and insufficient attention to their concerns. Combined with external factors like crowded living conditions, limited access to healthy foods, and systemic barriers to healthcare, these dynamics made a bad situation worse for many minority groups.

Building Toward Equity in Healthcare

“The driving factors influencing these outcomes likely develop long before patients are hospitalized.” – Dr. Iglesias

The pandemic has helped us to understand many of the once hidden cracks in our healthcare model. Medical care disparities represents yet one more crack to deal with. Achieving health equity requires addressing the root causes of disparities—early and comprehensively. Structural inequalities and deep-seated mistrust must be tackled head-on.

As Dr. Iglesias remarked, “It’s time to at least bring honest medicine back.” Rebuilding trust between patients and providers is critical. This means prioritizing transparency, fostering patient-physician relationships that bridge cultural divides, and ensuring that financial incentives do not compromise care quality.

“It’s been a long road,” said Dr. Marik as he reflected on his pandemic journey, fraught with challenges, but he emphasized the importance of using this experience to inform systemic change. From rethinking hospital protocols to addressing community-level vulnerabilities, the journey toward health equity is far from over.

Turning Lessons Into Action

The disparities laid bare by COVID-19 are not anomalies; they are symptoms of a broken system. Moving forward, healthcare must adopt a holistic approach—one that considers the socioeconomic and environmental factors shaping health risks, restores trust through honest communication, and implements policies to ensure equitable outcomes.

One important consideration: if healthcare was cheaper and more effective, wouldn’t that do a great deal to bridge the gap? If patients could get a cheap prescription for a repurposed medicine like ivermectin or hydroxychloroquine, perhaps they could stay out of the hospital all together.

If today’s webinar has provided valuable insights, we encourage you to support the FLCCC Alliance. Your contributions allow us to continue advancing critical research, sharing cutting-edge medical science, and advocating for equitable healthcare solutions. Whether you’re a healthcare professional, a patient advocate, or someone passionate about health equity, your support helps ensure that lifesaving knowledge reaches those who need it most.