Fair Allocation of Scarce Medical Resources in the Time of COVID-19

The authors review health impacts of moderate to severe pandemics, health system capacity, and ethical values for rationing health resources in a pandemic. They offer six recommendations to address the question of who should get health resources during the COVID-19 pandemic: 1) maximizing benefits, 2) targeting critical interventions to those caring for ill patients and operating critical infrastructure first, 3) randomizing allocation for those with similar prognoses, 4) differing prioritization guidelines by intervention and altering those guidelines based on changing scientific evidence, 5) prioritizing interventions to reward those willing to assume personal risk by participating in safety and effectiveness research, and 6) allocating scarce resources to patients with COVID-19 and those with other conditions in the same way.