Can I adapt previous frameworks for pandemic influenza to guide resource allocation for COVID-19?

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Many ethical frameworks have been produced for resource allocation, some of which have been included in plans. Those frameworks provide useful guidance in the current scenario. Yet, when applying them, we must take into account the type of care resource, the context, and the stage of the . That is, while the ethical principles that apply to resource allocation might be the same in different pandemics, they can lead to different decisions, given contextual circumstances. For example, this pandemic appears to significantly impact older adults (those 60 years of age or older), and such characteristics are relevant to shaping priorities for the allocation of resources during . As a result, it may be inappropriate to use critical care triage guidelines that have age cut-offs that deprioritize or exclude those aged over 60 years.

When applying ethical guidelines for resource allocation, we should consider the extent to which resources are overwhelmed in the current context. It would be inappropriate, for instance, to exclude population groups from being allocated a resource (for example, ventilators) at the outset of a when capacity remains. When resources are scarce, though – when there is an insufficient supply to meet everyone’s needs – resource allocation should be guided by well established, broadly applicable ethical principles, unless there are characteristics of the outbreak that justify different courses of action. Irrelevant characteristics of populations within countries, such as ethnicity, race or creed, should play no role in any resource allocation in any . This reflects our commitment to treating people with equal respect.

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