I got interesting news from the fedora accessibility room today! this concerns blind and visually impaired #linux users exclusively, however: For a bit of time, specifically pipewire >=1.4, one can start pipewire as root. That includes the regular daemon and the alsa layer, because jack emulation...
Artix, basically Arch. Replaced Pulseaudio with Pipewire as user service. Same issue with PA tho.