Lingzi (Susan) Zhang1, Brooke Ellison2
1University of Pennsylvania, Philadelphia, PA 19104, 2 Center for Compassionate Care, Medical Humanities, and Bioethics, Health Science Center, Stony Brook University, Stony Brook, NY 11794
*Editors: Shivek Narang, Serena Yang, Jessica Guo
In times requiring extensive medical care such as the COVID-19 pandemic, a triage policy is often adopted to determine how and to whom scarce medical resources are allocated to. This allows hospitals to prioritize patients and maximize the number of people that receive effective care.[1] Various personalized components such as the patient’s age, medical history, and symptoms are factored into the level-assignment process to assist medical workers to determine the order and priority of treatment.[2]
As of July 2020, there were 361,125 reported cases of COVID-19 and 4,521 deaths due to COVID in Texas.[3] Although Texas stopped releasing information regarding the amount of medical resources available, evidence shows that the situation is not optimistic: Texas Children’s Hospital is currently admitting even adult patients for treatment.[4] Medical professionals in Texas also reported that shortages of staff have greatly limited their ability to offer care.[1]
Starr County Memorial Hospital, the only hospital serving the county, is overwhelmed by the number of COVID-19 patients and the insufficiency of medical resources.[3] As a result, the hospital set up an ethics and triage committee to review each patient’s case.[3] The hospital president, Jose Vasque, stated that patients who have significant underlying medical conditions, and therefore have lower recovery chances, will be sent home so resources can be spared to patients with more survival potential.[3] The intent behind this triage policy was to save the greatest number of patients with a limited amount of resources. But this policy marginalizes patients who suffer from chronic diseases, those who are born with disabilities and conditions, and those who are elderly.
Ultimately, the inequality in resource distribution only exacerbates the consequences of the pandemic because it causes certain demographics to be more vulnerable.[3] For example: Julia Lynch, a University of Pennsylvania professor researching health policy, believes that medical resources are constantly being rationed based on one’s ability to pay in the US.[1] Therefore, a community that has been suffering from poverty likely does not have access to appropriate healthcare and resources; as a result, people from that community may have a higher chance of being affected by pre-existing medical conditions, putting them more at risk for COVID-19.
Under a triage policy, some will not be able to receive the healthcare they need due to their limited ability to pay and their previous medical history. Thus, it is important that hospitals treat their patients fairly regardless of economic status and consider different voices from the triage committees before making the decision of “who gets care.”
References
[1] Parshley, Lois. “Who Gets to Live? How Doctors Make Impossible Decisions as COVID-19 Surges.” National Geographic, 24 July 2020,
www.nationalgeographic.com/science/2020/07/how-doctors-make-impossible-decisions-as-coronavirus-surges-cvd/.
[2] “Who’s Next In Line? The Emergency Center Triage System.” Texas Children’s Hospital, www.texaschildrens.org/blog/2013/07/whos-nextline-emergency-center-triage-system.
[3] Robinson-Jacobs, Karen. “’Ethics’ Panel In Covid Cases Will Help Pick Who Gets Aggressive Care, Texas Hospital Says.” Forbes, Forbes
Magazine, 24 July 2020, www.forbes.com/sites/karenrobinsonjacobs/2020/07/24/small-texas-hospital-says-ethics-panel-will-help-pick-who-getsaggressive-covid-care/#1312fd02405b.
[4] Alexander, Author: Chloe. “Texas Children’s Hospital Admitting Adult Patients to Free up Hospital Beds in Houston.” KHOU, 23 June 2020,
www.khou.com/article/news/health/coronavirus/texas-childrens-hospital-admitting-adult-patients-as-covid-19-cases-continue-to-rise/285-
5aa0a132-a318-4a41-81b3-6659086c2ef7.