How does the distribution of resources work?
A triage team makes decisions on who gets what resources. They have a set of guidelines to follow and help ensure that there is fair distribution. However, at the beginning of the coronavirus pandemic, the triage team was unsure of how to distribute such few resources when so many people needed them. Deciding who to protect was a major bioethical issue, and they had to be strategic about who to give resources to. All throughout bioethics, we studied 4 principles that determine if something is ethical: autonomy, or the right for a patient to make their own decisions, nonmaleficence, or the need for the patient to not be harmed, beneficence, or the right for the patient to have a positive outcome with the treatment that they receive, and justice, or the need for resources to be fairly allocated. When it comes to the distribution of scarce resources during the coronavirus pandemic, justice is the main principle that comes into play, although the decision will certainly affect the other 3 principles as well.
What does PPE include? What are the scarce resources?
How were resources allocated during the COVID-19 pandemic?
In the US, bioethicists main goal when distributing PPE was to allocate the resources based on need. Places such as hospitals that were basically guaranteed to have coronavirus cases at all times with little social distancing allowed were given PPE. State departments of health distributed scarce N95s to doctors as well, and there were typically not enough for nurses to be given the same masks. They were given surgical masks which still worked but nowhere near as well as N95s. This shows that there was some distribution based on power as well because doctors have more authority than nurses, so they were given better quality masks. One way that the FDA attempted to keep supply of protective equipment high is by encouraging hospitals and those who need PPE to reuse and conserve their equipment. They also recommended the use of expired surgical gowns and masks if no other supply was available. While neither of those recommendations were ideal, it was better than no protection. Distribution of PPE and masks was a difficult task of its own, but now, the most recent issue with resources available and coronavirus is the distribution of the vaccine. There were 3 major phases before the vaccine was rolled out to the public. It was first allocated to essential workers, such as those who work in healthcare and those who are in long-term residential homes. Next, it was allocated to other essential workers, such as firefighters, police officers, paramedics, etc. and anyone over the age of 75. It was then allocated to those with preexisting conditions that would have negative effects if COVID-19 is contracted and anyone over 65.
For the most part, I think that the allocation of resources when it comes to the coronavirus pandemic was fair. Obviously, doctors and nurses should be the first group of people to get PPE, masks, etc. because they are the frontline workers who are risking the most exposure. For practically every resource that was scarce, healthcare workers were the first to get the resource, and I totally agree with that. However, hospitals were not given enough resources because there was not enough. I think that as soon as the first COVID case came to America, the government should have contacted suppliers and had them produce more than they normally would so that doctors and nurses were not put in the position that they were in. They also could have found other high quality masks to use, such as providing healthcare workers with K-N95s or masks like the one my mom’s boyfriend made. For the vaccine, I somewhat agree with the distribution. I agree that doctors should be the first to get it along with those who live in long term residential facilities as they are the ones who are at the highest risk of getting the virus. However, I think that the next phase should have also included those with preexisting conditions. They are just as at risk of having a bad reaction to COVID as the elderly, so I think that phase 2 should have included the elderly, essential workers, and those with preexisting conditions. I do agree with the remainder of the distribution though. Overall, there was no real way to figure out how to distribute resources with the coronavirus pandemic. It came fast and unexpectedly, so there was no time to prepare. I mostly agree with how bioethicists distributed the limited resources.