Getting Real: The Maryland Healthcare Ethics Committee Network's COVID-19 Working Group Debriefs Lessons Learned.

Area of Science:

• Public Health
• Healthcare Ethics
• Emergency Preparedness

Background:

• Major pandemics necessitate robust allocation of scarce resources (ASR) planning.
• Maryland lacks a state-endorsed ASR plan, despite prior public engagement.
• The COVID-19 response highlighted critical gaps in Maryland's preparedness.

Purpose of the Study:

• To review Maryland's COVID-19 response strengths and weaknesses.
• To assess the role of the Maryland Healthcare Ethics Committee Network (MHECN) in ASR planning.
• To identify lessons learned for future pandemic resource allocation.

Main Methods:

• Review of Maryland's pandemic response.
• Analysis of the Maryland Healthcare Ethics Committee Network's contributions.
• Identification of key "lessons learned" from the crisis.

Main Results:

• Deliberative democracy informed Maryland's ASR framework, but community consensus was not normative.
• Lack of transparency and political leadership led to a fragmented response.
• Effective pandemic response requires intergovernmental and inter-facility coordination and information sharing.

Conclusions:

• Maryland's ASR planning requires stronger political leadership and transparency.
• Coordination beyond acute care hospitals is crucial for pandemic preparedness.
• The MHECN can help bridge gaps in ASR plan implementation and crisis standards of care.