The coronavirus pandemic isn’t the first time that John Welch has been a first responder in a crisis. Welch, a nurse anesthetist, was off work the day of the Boston Marathon bombing in April 2013, but when news broke that hundreds of people were injured after terrorists detonated homemade bombs near the finish line, he rushed to Boston Children’s Hospital to provide extra support. He remembered that the “streets were empty” as he drove up to the hospital and that his coworkers “all started running in together without saying anything.”
Since the novel coronavirus began spreading across the United States this year, Welch has again been doing everything he can to be of service, including working with the nonprofit Partners in Health to direct contact tracing efforts in Massachusetts. As a medical provider who administers “two to three blood transfusions a week” in his general practice and sees medical providers going through “bags of blood like they were water,” he said the immediate inclination of health care workers always is to help.
But as a gay man working on the front lines of the COVID relief effort, Welch said federal policy has tied the hands of LGBTQ health care workers “behind our backs,” given that so many remain prevented from one of the most critical acts of public service: giving blood. Until this year, the Food and Drug Administration required men who have sex with men (MSMs) to refrain from same-sex intimacy for a year before donating blood and plasma, but after the American Red Cross warned of a blood shortage resulting from the cancellation of nearly 2,700 donor drives in mid-March, it shortened the deferral period to three months.
LGBTQ+ advocacy groups like GLAAD, which have called on the FDA to eliminate the abstinence requirements for MSM donors, have warned that the new rule will still prevent the majority of sexually active gay and bisexual men from donating blood.
Welch said the policy, while a step in the right direction, doesn’t change the fact that he can help by assisting with blood transfusions but can’t actually donate.
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“I was a lifeguard growing up,” he said. “You never would watch someone struggle in a swimming pool until they were actually drowning. You dive in the moment you see that they need help instead of saying, ‘Oh, well, I'll just sit back and wait.’ You can’t square that as a provider. It doesn’t work.”
Gay and bisexual men providing frontline care during the COVID-19 crisis said they bear the weight of the seeming double standard in public health policy. A recent report from the Human Rights Campaign showed LGBTQ people in the U.S. are disproportionately likely to work in the medical field: 7.5 percent all of queer and trans people work in hospitals. Even though their labor is essential in responding to a pandemic that has claimed nearly 60,000 lives domestically, large segments of the LGBTQ community remain prevented from full participation.
Carl Streed Jr., who works in internal medicine at the Boston Medical Center, said the situation at medical centers across the country has been “all hands on deck.” He normally works as a clinician-researcher but spent last week assisting in urgent care, seeing patients who have had heart attacks or strokes but avoided going to the hospital in fear of “getting infected.” When administering COVID-19 care, Streed said he hasn’t been able to test everyone because the center “didn't have adequate testing upfront.” Like so many healthcare workers across the country, he was forced to reuse masks because they are in short supply.
“It’s been a public health shit show,” Streed told VICE. “We trained as best we could for this, but we don’t necessarily have all the tools we were trained to be prepared with.”
Critics of the FDA’s donation guidelines said one of the most critical tools that doctors and medical professionals need to respond to the COVID-19 pandemic is an adequate supply of blood. Even as the Red Cross claims that the blood supply is beginning to stabilize following earlier shortages, the healthcare advocacy nonprofit Premier estimated in a recent report that “blood supply needs will increase by as much as 50 percent” as patients begin resuming elective surgeries after the curve of new COVID-19 cases flattens.
Streed argued that gay and bisexual men have a “civic duty” to help fill those critical needs given the potential impact. The Williams Institute, a pro-LGBTQ think tank at the University of California, Los Angeles, found in a 2014 report that allowing MSMs to donate without any deferral period would increase the pool of available blood by as many as 615,300 pints annually.
“You should be able to contribute in every way that you can,” Streed said. “You could argue it’s part of the social contract. It's a privilege and we should be allowed to exercise that privilege because we know it’s safe.”
The restrictions on gay and bisexual male donors date back to the HIV/AIDS crisis, when it was far more difficult to detect the virus’ presence in the bloodstream. In 1983, the FDA outright banned any man who had sex with another man since 1977 from donating blood. That lifetime deferral for gay and bisexual men persisted for 32 years; the window was finally was shortened to 12 months in 2015 and finally to three months earlier this year.
But Nick Cuneo, who is currently completing a combined residency in internal medicine and pediatrics at Brigham and Women’s Hospital and Boston Children’s Hospital, said medical professionals now “have the data to do things in a way that’s not based on fear and outdated prejudice.” For instance, he noted that countries like Italy and Spain have implemented individualized assessments that survey all potential donors on “high-risk activities,” such as unprotected sex with multiple partners, and have not seen an increase of HIV in the blood supply as a result.
Cueno, who has been in a monogamous marriage for seven years, said there’s no reason he shouldn’t be allowed to donate, since tests can “pick up on the presence of HIV within nine to 14 days of infection.” He added that it’s difficult not to feel “some level of moral outrage.”
“I’m a universal donor,” Cuneo told VICE. “I’m O-negative. Every time I see one of those emails that’s frantically calling for people to donate, particularly if they have O-negative blood, it’s very frustrating—especially if I’m already going into the hospital for a shift. It’s hard to see this outdated policy still be in practice and not really feel like you have the power to change it.”
But gay and bisexual health workers said they have been living with that frustration most of their lives—or at least since they were old enough to come to terms with their sexual orientation. Cuneo’s father had been a lifelong platelet donor and regularly visited the Boston Children’s Hospital to donate, but after Cuneo came out, he discovered he would not be able to follow in his father’s footsteps. Streed, who learned of the policy while organizing a blood donation drive in high school, described the realization as a “simmering rage in the background.”
As a child, Welch’s mother used to take him with her every time she went to donate blood. Not being allowed to do something that had been presented as so normal sent the message that people who are LGBTQ “are somehow slightly less than everybody else.” He said it was as if society was telling him, “OK, we acknowledge you. You can get married, but don’t ask for too much. Don’t push for too much.”
“It's something that I think a lot of people in our community struggle with from the day they realize they’re ‘different,’” he said. “It forces all of us to overcompensate in other ways. For me, it’s working harder and longer in other ways for the COVID response.”
But while gay and bisexual health care workers are doing their part to provide support during an unprecedented global crisis, Welch said these men shouldn’t have to keep proving themselves just to be treated the same as everyone else. “As a scientist, I always say the science will set us free, and we have the science that says to us this is a safe endeavor,” he said. “We're not putting people at any added risk.”
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