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The coronavirus disease 2019 (COVID-19) pandemic has led to more than 956 000 hospitalizations in the United States as of February 5, 2021,1 bringing hospital systems close to exhausting available critical care resources during surges in infection rates. In an attempt to ensure the fair allocation of scarce resources, hospital systems have developed crisis standards of care (CSC) guidelines. Health equity experts have raised concerns that indiscriminate implementation of these guidelines will exacerbate racial and ability-based inequities that have plagued our current health care system. In their study, Gershengorn et al2 sought to determine whether the application of proposed CSC guidelines during a surge of COVID-19 cases at 2 urban hospitals in Miami, Florida, would be associated with an unanticipated increase in resource allocation disparities across race and ethnicity. Reviewing 5613 patient-days of data from 1127 patients who required or were at risk of requiring mechanical ventilation during admission at their hospitals, they found no association of race or ethnicity with the priority scores that guided their CSC resource allocation policy.
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Published: March 19, 2021. doi:10.1001/jamanetworkopen.2021.4527
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Cleveland Manchanda EC et al. JAMA Network Open.
Corresponding Author: Emily C. Cleveland Manchanda, MD, MPH, Department of Emergency Medicine, Boston Medical Center, 800 Harrison Ave, BCD Bldg, First Floor, Boston, MA 02118 (firstname.lastname@example.org).
Conflict of Interest Disclosures: Dr Rodriguez reported having served on the Biden/Harris coronavirus disease 2019 advisory board. No other disclosures reported.
Additional Contributions: We are grateful to the many researchers, ethicists, clinicians, and advocates who have dedicated their energy to ensuring that crisis standards of care equitably safeguard our health system’s resources.
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