Complicating this, however, are the various conflicting ethical and psychosocial issues relating to HCWs during an influenza pandemic: allocation and rationing of limited health resources, HCWs' professional versus family responsibilities, staff absenteeism and workforce issues, the risk to HCWs' personal safety, restrictions of personal liberties during quarantine, amongst others [ 7].
While purpose-built triage protocols focus on specific events (for example, pandemics), resource allocation decisions are part of everyday practice for critical care physicians worldwide.
These relate to decision making processes, justification for delineated actions, membership of pandemic planning committees, allocation of scarce resources, timelines for planned activities, border control and co-operation with development partners, among others.
The priority allocation of pandemic vaccines is shown in Figure 1, along with the evolution of vaccine coverage over time, by broad age categories.
Perhaps the aggressive campaigning and resource allocation reserved for pandemic influenza should be emphasized on an annual basis for SI.
Resource Allocation during an Influenza Pandemic To the Editor: Planning for pandemic influenza is accepted as an essential healthcare service and has included creation of national and international antiviral drug stockpiles and novel approaches to emergency vaccine development (1 ).
The adaptive strategy produced 2 20% additional reductions in deaths and hospitalizations when applied to the 1918 pandemic scenario, relative to the seasonal allocation strategy, for the range of parameters considered.
How are ethical issues associated with triaging and allocation of scarce resources during a pandemic dealt with in the NISSPI?
Lack of guidelines to ensure fair allocation of scarce resources during a pandemic, failure to justify proposals for procuring and stockpiling pharmaceuticals and other medical supplies, and failure to justify delineated preparedness actions are deficiencies.
Such information would be highly relevant for informing emergency department and primary care clinicians regarding risk stratification, resource allocation, and clinical disposition in future pandemics.
The numerous challenges posed by wide-scale infectious disease epidemics such as influenza pandemics and the various ethical paradigms for resource allocation during these events have been delineated in the published literature [ 5- 9].
