• Jean Abbott, Kelly Ferraro, Daniel Johnson, Barbara Statland, John Massone, Carol Fowler, Peggy Budai, and Stephen V Cantrill.
• Center for Bioethics and Humanities, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA. Electronic address: jabbott49@gmail.com.
• J Pain Symptom Manage. 2021 Jun 1; 61 (6): 1287-1296.

AbstractPalliative care (PC) and hospice services have experienced shortages before 2020, and during the initial phases of the current pandemic, more critical gaps are expected with future surges, much as scarcity in intensive care unit services may recur during the COVID-19 pandemic. Although ethical allocation of ventilators and intensive care unit care is the subject of important discussions during this pandemic, caring for those at the end of life and those not desiring or qualifying for critical interventions must not be neglected, as critical care and comfort-focused care are intertwined. We review state and regional gaps already recognized in planning for scarcity in PC and hospice services during this pandemic and describe the planning initiatives Colorado has developed to address potential scarcities for this vulnerable and diverse group of people. We hope to encourage other state and regional groups to anticipate needs in the coming surges of this pandemic or in public health crises to come. Such planning is key to avoid the degradation of care that may result if it is necessary to invoke crisis standards of care and ration these essential services to our communities.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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