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During a surge in severe cases, standard care procedures may need to be altered to accommodate insufficient health care staff or limited resources.

  • Institutions should consider how to anticipate and address staffing shortages because the alteration of staff members’ regular responsibilities may result in increased stress for the affected staff or a decreased quality of the usual care. Indiana University
  • Alternate care sites are to be used only when hospitals lack sufficient capacity; alternate staffing procedures are to be used only during a staffing shortage; and documentation procedures are to switch to truncated procedures only when current standards are impossible to maintain given a large patient influx. Indiana University
  • Public engagement and involvement of relevant stakeholders should be part of all aspects of plan­ning (3). Policy decisions and their justifications should be publicized and open to public scrutiny. WHO Ethics in Pandemic Flu
  • There is a commitment to transparency throughout the pandemic influenza planning and response process. The reasoning behind choices made is fully articulated (in language appropriate to particular audiences) and the values and principles justifying those decisions are clearly identified and open for examination. P3, Commitment to transparency. CDC Ethics in Pandemic Flu
  • All facilities must publish their clear and explicit new guidelines for treatment and the options available for those who will not receive acute treatment. Indiana University
  • Promote openness among the government, nongovernmental entities, and the public regarding resource allocation and performance improvement. APHA Code of Ethics, 4.12.3.
  • Ensure that resulting interventions do not have a disproportionately negative impact on minority or otherwise vulnerable populations (including children and elders) and that there is an effort to enhance the resilience of populations and ecosystems to prevent future harm. APHA Code of Ethics, 4.2.9.
  • Recognize and act upon the fact that the ethical obligation to provide access to health care is not limited to persons with citizen status only. APHA Code of Ethics, 4.7.6.
  • It is strongly recommended that hospitals in certain regions – for example a health district or set of counties, or the state, etc. – abide by the same triage and altered standards of care protocols in order to ensure a more fair distribution of scarce resources and to discourage patients from traveling desperately among hospitals seeking extended care. Indiana University
  • Information should be consistent, transparent, and widely shared within each community and within each state. Indiana University
  • All facilities should have the means to respond to emotional and spiritual needs of the public and professionals involved. Indiana University
  • Discussions with citizens and faith-based communities regarding potential barriers to adherence to funeral and burial procedures will prepare these communities for potential delays and alterations that may occur while attempting to follow cultural practices. Indiana University