Colorado doctors finalize guidelines for who would get treatment if hospitals become overrun

Posted at 6:21 PM, Apr 01, 2020
and last updated 2020-04-01 20:48:36-04

DENVER -- Colorado doctors are preparing for difficult decisions such as who gets a ventilator and who doesn't, and potentially, who lives and dies, as the coronavirus pandemic continues to spread in our state.

Experts are finalizing statewide guidelines that would help doctors make those choices and prioritize who would and wouldn't get care if hospitals become overrun with COVID-19 patients.

"These are decisions we hope to never have to make, but it would be irresponsible given what has happened in the rest of the world including Seattle, in New York and New Orleans, and other places around the U.S., to assume that we are never going to see that kind of a situation here," said Dr. Matthew Wynia, the Director of Bioethics at the University of Colorado.

Wynia is a part of the Governor's Expert Emergency Epidemic Response Committee, a team of doctors helping finalize guidelines for patient care if supplies and ICU beds become in short supply.

"We're trying to put together a set of guidance documents that would allow for a level of equity and fairness across the whole state," he said.

Wynia said the guidelines are focused on clinical criteria and would be based on trying to identify patients who are clearly going to die if they don't get the medical resource and will clearly survive if they do get the resource.

"We're not planning to use age as a specific cutoff for who gets access to resources," he said. "The Italian Critical Care Society did set an explicit age based cutoff and I think that's one of the things that we have learned since then is that, that is probably not the most effective way."

He also stressed Colorado is not yet considering using one ventilator on two patients, but said if resources became more scare it could be looked at as an option.

"We'd have to run out of ventilators. It's quite risky. The Critical Care Societies in the U.S. put out guidance less than a week ago really arguing against trying this because it could well be that you end up with two dead people instead of one," said Wynia.

"We need to have clear guidance for doctors on what to do in these situations," said Govind Persad, a bioethics medical expert at the University of Denver.

Persad recently co-authored a journal article about fair allocation of resources amid the novel coronavirus pandemic and stressed the importance of medical ethics during this time.

"I think they're crucial because they can help to protect patients against being treated arbitrarily or unfairly or inconsistently," he said.

Wynia also said no Colorado hospitals have yet reached capacity or run out of ventilators but many are seeing a surge in potential COVID-19 patients and those in need of critical care.

"We should plan for the worst while we hope for the best," he said.

Experts hope to have the guidelines finalized by early next week.

"I think we could be ready to issue these, the state could be ready to issue these very early next week," said Wynia.