How Were Scarce Resource Allocation Plans Developed During COVID-19?
Friday, October 13, 2023
9:30 AM – 10:45 AM ET
Location: Laurel CD (Fourth Floor)
In response to the declaration of the COVID-19 pandemic, many states revised or crafted de novo plans for scarce resource allocation in the event crisis standards of care were triggered. Many of these plans came under scrutiny for being potentially discriminatory against older adults, persons with disabilities, and racial or ethnic minoritized groups. Little is publicly known about their development, including what steps were taken to ensure they reflected the values of the populace. We interviewed authors of state or regional plans from 34 states. Twenty participants described a pre-existing state plan, with 17 participants’ states revising the plan to meet the needs of the COVID-19 pandemic. Seven participants’ states crafted a plan de novo. The remainder of participants described efforts to develop or coordinate state-wide plans that ultimately stalled or were only adopted on a regional or institutional level. Some participants described extensive efforts before the pandemic to engage the public and solicit feedback on pandemic preparedness from a broad spectrum of stakeholders, whereas states with de novo or unpublished plans typically described a compressed timeline, limiting intentional inclusion of diverse authorship or community input. Several participants described policy revision in response to public controversy or complaints from the Office of Civil Rights. COVID-19 experiences suggest the optimal time for plan development is outside of periods of crisis for maximum community engagement. Our data suggest that proactively addressing political and cultural barriers is essential for effective crisis planning and to promote health equity in triage protocols.
Jackson Ennis, BA – Biomedical Ethics Research Program – Mayo Clinic; Nicholas Nguyen, BA – Biomedical Ethics Research Program – Mayo Clinic; Debra DeBruin, PhD – Center for Bioethics – University of Minnesota; Richard Sharp, PhD – Biomedical Ethics Research Program – Mayo Clinic; Erin DeMartino, MD – Biomedical Ethics Research Program – Mayo Clinic