Rationing of Health Care During a Flu Pandemic

INTRODUCTION: The re-emergence of the H1N1 flu virus strain in 2009 brought to light the population’s vulnerability to new virus strains. The 2009 pandemic reached 214 countries. In the United States, the Centers for Disease Control and Prevention estimated that there were over 12,000 fatalities. This number is believed to be a low estimate, as more deaths were not tested for H1N1 or not recognized as being related to the virus. Most local and state governments have flu pandemic preparedness plans but the vast majority does not address what will happen in the event that resources become scarce and rationing becomes a necessity. The purpose of this research is to determine what plans currently exist across the country and to introduce the use of a triage system similar to the kind used by the military for the purpose of rationing care. METHODS: A review of published flu preparedness plans was conducted. Emphasis was placed on ethical considerations and proposed methods of determining rationing decisions. RESULTS: Only one state has a published flu preparedness plan that directly addresses rationing of resources during a pandemic and includes rationing criteria. CONCLUSION: Local and state governments need to plan for a pandemic that will tax all resources and must prepare for the difficult task of rationing resources. The plan must consider ethical, legal, pre-hospital and acute care, personnel, equipment, alternative care sites and palliative care issues during a flu pandemic. Rationing criteria must be decided to ensure that resources are used in meaningful ways