• Lisa M Koonin, Satish Pillai, Emily B Kahn, Danielle Moulia, and Anita Patel.
• Lisa M. Koonin, DrPH, MN, MPH, is with Health Preparedness Partners, LLC, a subcontractor of General Dynamics Information Technology (GDIT); Danielle Moulia, MPH, is a Public Health Scientist with General Dynamics Information Technology (GDIT); and Anita Patel, PharmD, MS, is Senior Advisor, Pandemic Medical Care and Countermeasures Lead; all in the Influenza Coordination Unit, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish Pillai, MD, MPH, MS, is CDR, US Public Health Service, and Deputy Director, Division of Preparedness and Emerging Infections; and Emily B. Kahn, PhD, MPH, MA, is Senior Epidemiologist/Modeler, Division of Preparedness and Emerging Infections; both in the National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.
• Health Secur. 2020 Mar 1; 18 (2): 69-74.

AbstractDuring a severe pandemic, especially one causing respiratory illness, many people may require mechanical ventilation. Depending on the extent of the outbreak, there may be insufficient capacity to provide ventilator support to all of those in need. As part of a larger conceptual framework for determining need for and allocation of ventilators during a public health emergency, this article focuses on the strategies to assist state and local planners to allocate stockpiled ventilators to healthcare facilities during a pandemic, accounting for critical factors in facilities' ability to make use of additional ventilators. These strategies include actions both in the pre-pandemic and intra-pandemic stages. As a part of pandemic preparedness, public health officials should identify and query healthcare facilities in their jurisdiction that currently care for critically ill patients on mechanical ventilation to determine existing inventory of these devices and facilities' ability to absorb additional ventilators. Facilities must have sufficient staff, space, equipment, and supplies to utilize allocated ventilators adequately. At the time of an event, jurisdictions will need to verify and update information on facilities' capacity prior to making allocation decisions. Allocation of scarce life-saving resources during a pandemic should consider ethical principles to inform state and local plans for allocation of ventilators. In addition to ethical principles, decisions should be informed by assessment of need, determination of facilities' ability to use additional ventilators, and facilities' capacity to ensure access to ventilators for vulnerable populations (eg, rural, inner city, and uninsured and underinsured individuals) or high-risk populations that may be more susceptible to illness.

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