CHEST Guidelines-Reserve-System-Implementation-During-the-COVID-19-

Reserve-System-Implementation-During-the-COVID-19-

Pdf Summary

The document discusses the implementation of reserve systems to equitably allocate resources during the COVID-19 pandemic. Reserve systems divide a total supply into categories, each allocated based on different criteria, aiming to balance multiple ethical considerations and reduce disparities. During the pandemic, the U.S. National Academy of Medicine recommended reserving 10% of COVID-19 vaccines for socially vulnerable areas, leading cities and states to adopt similar systems for resource allocation, such as vaccines and monoclonal antibodies (mAb).<br /><br />Rubin et al. examined a reserve system used by the Mass General Brigham health system, where 20% of mAb infusion appointments were reserved for patients from high Social Vulnerability Index (SVI) areas or those with high COVID-19 incidence. This resulted in a higher proportion of infusions allocated to socially vulnerable communities than through a lottery system alone. However, the uptake was hindered by various socioeconomic barriers, which highlighted the need for better outreach and education.<br /><br />The document emphasizes the importance of understanding participants' psychological responses to reserve systems. While these frameworks aim to ensure fair access and signal expert decision-making, those in nonprioritized categories may feel less advantaged. Participant-reported experiences should be distinguished from allocation outcomes to assess health equity fulfillment.<br /><br />It calls for further research to understand how reserve systems are experienced by individuals in both prioritized and nonprioritized categories, suggesting that this model could guide future resource allocation efforts. The findings may contribute to broader applications of reserve systems beyond the pandemic context, in both U.S. and global health systems.

Keywords

reserve systems

resource allocation

COVID-19 pandemic

ethical considerations

Social Vulnerability Index

vaccine distribution

health equity

socioeconomic barriers

Mass General Brigham

psychological responses