No protocol and no liability: a call for COVID crisis guidelines that protect vulnerable populations

J Comp Eff Res. 2020 Aug;9(12):829-837. doi: 10.2217/cer-2020-0090. Epub 2020 Jul 24.


The COVID-19 pandemic is revealing the unacceptable health disparities across New York City and in this country. The mortality rates of vulnerable and minority populations alone suggest a need to re-evaluate clinical decision making protocols, especially given the recently passed Emergency or Disaster Treatment Protection Act, which grants healthcare institutions full immunity from liability stemming from resource allocation/triage decisions. Here we examine the disparity literature against resource allocation guidelines, contending that these guidelines may propagate allocation of resources along ableist, ageist and racial biases. Finally, we make the claim that the state must successfully develop ones that ensure the just treatment of our most vulnerable.

Keywords: COVID-19; health disparities; health policy; public health; resource allocation.

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Clinical Decision-Making*
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / therapy*
  • Decision Making
  • Emergency Service, Hospital
  • Guidelines as Topic*
  • Health Policy
  • Health Status Disparities
  • Humans
  • Pandemics* / prevention & control
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / therapy*
  • Resource Allocation
  • SARS-CoV-2
  • United States
  • Vulnerable Populations*