A Study to Evaluate Health Behavior and Access Impacts Due to COVID-19 and for Community Engagement of Stakeholders Surrounding Scarce Resource Allocation Policy.

Background:

COVID-19 has led to significant disruptions to usual operations of the health care system and routines of millions of people. Regular medical appointments have been preempted or converted to telemedicine, dietary changes have occurred due to food supply chain strain, and exercise regimens altered by physical distancing policies, all of which may affect preventive care and chronic illness management. Additionally, anxiety about risk of developing COVID-19 and the availability of health care resources may alter care-seeking behaviors even for serious conditions, e.g., heart attacks.

Understanding personal health and protective behaviors under threat of COVID-19 is an epidemiologic imperative and can inform immediate public health response as well as planning for population health needs post-crisis.

Critical care capacity during COVID-19 is also a matter of extreme concern. Limitations in capacity, particularly mechanical ventilators have necessitated scarce resource allocation (SRA) policies, which outline triage protocols while observing ethical principles of distributive justice, transparency, and equitability.

In practice, these policies determine which patients are most likely to benefit from intensive care, and some patients with a significantly heightened risk for mortality are less likely to be prioritized in critical care allocation decisions. The uncertainty around prioritization and threat of rationing of care has generated public attention and anxiety evident in medical journals, news outlets, and on social media.