ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2024
COVID-19 critical care triage across Canada: a narrative synthesis and ethical analysis of early provincial triage protocols.
Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Resource allocation decisions faced by health care providers during the COVID-19 pandemic in a community intensive care unit in Ontario, Canada: a qualitative study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- When ethics is not enough: institutional governance of critical care allocation under crisis conditions.Acute and critical care · 2026Article
- Impact of the COVID-19 pandemic on cardiac magnetic resonance imaging practices: insights from the MRCT registry.European radiology · 2025Article
- Article
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Authors and funding
3 authors.
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Abstract
purposeThe COVID-19 pandemic created conditions of scarcity that led many provinces within Canada to develop triage protocols for critical care resources. In this study, we sought to undertake a narrative synthesis and ethical analysis of early provincial pandemic triage protocols.
methodsWe collected provincial triage protocols through personal correspondence with academic and political stakeholders between June and August 2020. Protocol data were extracted independently by two researchers and compared for accuracy and agreement. We separated data into three categories for comparative content analysis: protocol development, ethical framework, and protocol content. Our ethical analysis was informed by a procedural justice framework.
resultsWe obtained a total of eight provincial triage protocols. Protocols were similar in content, although age, physiologic scores, and functional status were variably incorporated. Most protocols were developed through a multidisciplinary, expert-driven, consensus process, and many were informed by influenza pandemic guidelines previously developed in Ontario. All protocols employed tiered morality-focused exclusion criteria to determine scarce resource allocation at the level of regional health care systems. None included a public engagement phase, although targeted consultation with public advocacy groups and relevant stakeholders was undertaken in select provinces. Most protocols were not publicly available in 2020.
conclusionsEarly provincial COVID-19 triage protocols were developed by dedicated expert committees under challenging circumstances. Nonetheless, few were publicly available, and public consultation was limited. No protocols were ever implemented, including during periods of extreme critical care surge. A national approach to pandemic triage that incorporates additional aspects of procedural justice should be considered in preparation for future pandemics.
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