HSR&D Investigator’s Model for Equal COVID Treatment Widely Disseminated

January 29, 2021

Takeaway: Dr. Somnath Saha’s article on avoiding unequal treatment during the COVID-19 pandemic was included in briefing materials for the Oregon Governor's Medical Advisory Panel's meeting about allocating Remdesivir for COVID patients, and with the Senior Health Advisors at the Oregon Health Authority (OHA) working on the COVID response in Oregon.

COVID-19 has imposed on hospitals and health systems around the world the threat of having to ration scarce resources, as demand outstrips the supply of testing, hospital beds, and ventilators. As the pandemic wears on, there may be shortages of other resources needed to keep people alive, including hospital staff, blood products, and drugs (i.e., medications to support blood pressure or palliative treatment for pain and shortness of breath). Demand will also likely exceed the supply of emerging COVID treatments, such as antiviral medications and convalescent plasma. HSR&D investigator Somnath Saha, MD, MPH, wrote an article, "A Model for Avoiding Unequal Treatment During The COVID-19 Pandemic," in which he answers two key questions: How do we ensure truly fair resource allocation, free of both conscious and unconscious bias? And how do we bolster public trust that decisions will be made fairly?

Based on his research experience in health equity and his prior leadership of the Oregon Health Evidence Review Commission, Dr. Saha describes a model for making unbiased decisions in allocating resources for testing for and treating COVID-19. This model features several recommendations, including but not limited to:

• Establish a scarce resource allocation committee for each healthcare institution and system;
• Explicitly consider the potential effects of the decision-making process on vulnerable populations;
• Incorporate public values, ideally with input from diverse constituencies, to ensure that the guidelines are protected against implicit biases; and
• The application of resource allocation guidelines in individual cases, particularly for the most difficult decisions (i.e., diverting ventilatory support) should be carried out by triage officers or teams not involved in the care of the individual patients.

Impact

Dr. Saha’s article was included in briefing materials for the Oregon Governor's Medical Advisory Panel's meeting about allocating Remdesivir for COVID patients, and with the Senior Health Advisors at OHA working on the COVID response in Oregon.

Saha S and Beach C. A model for avoiding unequal treatment during the COVID-19 pandemic. Health Affairs. May 14, 2020.

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