The authors of this article identified that during times of crisis, the demands may exceed the resources available. 

Additionally, if care were to be triaged, and potentially denied to seriously ill patients due to resource constraints, all triage systems should guarantee palliative care for those denied critical care. However, plans to meet the palliative care demands have not been developed.  The authors discuss the consequences of the failure to have a palliative care plan for both patients and health care providers.  They outline the critical elements of a palliative care pandemic plan, modeled after critical care for providing surge capacity during a crisis.  These elements include:  stuff (sufficient equipment, medications, and supplies), staff (palliative care trained staff, education, treatment protocols), space (dedicated space or “palliative” wards), and systems (triage systems, consultation, identification of patients with the greatest need of direct specialists).  Ethical considerations include: protecting the public from harm, proportionality, duty to provide care, reciprocity, equity, and trust.

The proposed plan was presented in anticipation/ preparation for an influenza pandemic, and created prior to the current global COVID-19 pandemic. However, the concepts are relevant today.

Downar, J., Seccareccia, D., & Associated Medical Services Inc. Educational Fellows in Care at the End of Life. (2010). Palliating a pandemic:“all patients must be cared for”. Journal of pain and symptom management, 39(2), 291-295.