In Response to COVID-19 Pandemic Physicians Already Know What to Do

Efficacy of clinical evaluations for COVID-19 on the front line

“…This case series from an urban medical center suggests that despite the rapidly evolving body of knowledge around COVID-19 illness and its variable presentations among affected patients, clinical provider assessment of high versus low probability of active infection can be relatively reliable. This case series further supports the hypothesis that a well-informed clinical assessment, with or without concurrent access to rapid point-of-care SARS-CoV-2 testing, could be leveraged to more efficiently triage patients [ 5 ]—even those with medical comorbidities whose chronic illness burden may appear to pose a diagnostic challenge at the outset. In effect, a clinical evaluation that does not rely on viral testing results may be very accurate and substantially aid in ongoing efforts to conserve and appropriately prioritize the use of medical resources.…”

What is common and what is different: recommendations from European scientific societies for triage in the first outbreak of COVID-19

“…McCullough, for example, considers that the criteria for allocating scarce resources in the ICU are well established and new ones are not needed during a pandemic. 10 For this author, ethics in intensive care is a management trial for the initiation / discontinuation of treatment based on justified criteria of beneficence, and where biological criteria are the most important for clinical decision 10 and sufficient even in very scarce scenarios.…”

“…The biological screening criteria, indeed, would ensure that the patient’s morally irrelevant characteristics, such as race, gender or social value, were not considered in the decisions. 10 On the other hand, the standard approach is based on the order of arrival and it is possible that a patient most likely to benefit from the ICU would be denied treatment if arriving later.…”

“… 8 In these documents, the clinical focus is to reduce mortality while preserving at least some interactive capacity in a population of patients. 10 There are two major approaches within this utilitarian category: save as many lives as possibleand save people with better prognosis or more years of life ahead.…”

The COVID-19 Pandemic: Critical Care Allocated in Extremis

“…Professor McCullough, a distinguished scholar in bioethics and the history of bioethics, wisely exhorts us to learn from past experience as we confront the COVID-19 pandemic (McCullough 2020). We should not rush to develop brand new criteria for allocating scarce resources in intensive care units (ICUs), says McCullough, but should instead rely on what we have learned over many years.…”