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Pandemics rarely affect all age groups equally. Historically, pandemic influenzas have disproportionately impacted children. Coronavirus disease 2019 (COVID-19) primarily threatens adult populations. Yet in many hospitals, critical care resources are shared between adult and pediatric patients. Most ventilators can be used to treat both adults and children. Other resources—including medications, physical space, and staff—can be shared too.
Most protocols for resource allocation in the setting of scarce critical care resources urge hospitals to enact policies that apply to all patients in need of critical care resources—for example, a patient with a congestive heart failure exacerbation should compete for the same resources as a patient with respiratory failure related to COVID-19. According to this framework, critically ill neonates and children, regardless of COVID-19 status, must be accounted for in hospital resource allocation protocols.
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Corresponding Author: Monica E. Lemmon, MD, Department of Pediatrics, Duke University School of Medicine, DUMC 3936, Durham, NC 27710 (email@example.com).
Published Online: December 14, 2020. doi:10.1001/jamapediatrics.2020.5215
Conflict of Interest Disclosures: Dr Lemmon reported receiving salary support from the National Institute of Neurological Disorders and Stroke and compensation for medicolegal work. Dr Truog reported receiving compensation as a consultant on data safety monitoring boards for Sanofi and Covance. No other disclosures were reported.
Additional Contributions: We thank David A. Turner, MD (Duke University), for his thoughtful review and input on this manuscript. He received no financial compensation for his contribution.
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