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Doctors in North Texas considered taking COVID-19 patients’ vaccination status into account when determining who gets ICU beds

Ashley Collman   

Doctors in North Texas considered taking COVID-19 patients’ vaccination status into account when determining who gets ICU beds
Science2 min read
  • The Dallas Morning News obtained an internal memo from a North Texas doctors group.
  • It said COVID-19 vaccination status could be taken into account when assigning ICU beds in a crisis.
  • A group leader later walked back the memo, saying vaccination status wouldn't be a factor in triage.

A North Texas doctors group released an email to members this week, telling them that vaccination status could be taken into account when determining which COVID-19 patients get beds in intensive care units if the region experiences another crisis.

The memo by the North Texas Mass Critical Guidelines Task Force was leaked to The Dallas Morning News, which published details of the memo on Thursday.

The memo boiled down to this: Since vaccination vastly improves the chances of survival from COVID-19, a patient's vaccination status could count as a plus or a strike when determining which patients get ICU beds. It could not be the sole determining factor, however.

The guidelines were designed for if the region goes into a Level 3 crisis stage, which Dr. Robert Fine, co-chair of the task force, told The Dallas Morning News could happen in two weeks. The guidelines themselves are not enforceable, but are generally followed, The Dallas Morning News noted.

Shortly after The Dallas Morning News published its story on the memo, a spokesperson for the task force walked back on the memo.

Dr. Mark Casanova, director of clinical ethics for Baylor University Medical Center, initially told NBC Dallas-Fort Worth on Thursday that the memo was meant to help guide doctors in triaging patients in limited situations.

But hours later, he told NBC the memo was merely a "homework assignment" that members could respond to with their own suggestions.

He said that going forward, vaccination status would not be among the factors that hospitals would be told to consider when triaging patients.

"In the midst of this reconvening, and exploration and discussion with various triage committee members, the consensus is vaccination status, or more specifically a lack of a vaccine will not be considered as part of any exclusion criteria for treating patients," he told the outlet.

Dr. Harold Schmidt, a professor of medical ethics and health policy at the University of Pennsylvania, told The Dallas Morning News he found the memo problematic, especially given its implications for disadvantaged groups.

The memo said that special considerations should be made for people who are not vaccinated for reasons "beyond" their "control," but Schmidt said that language ignored reasons some historically or economically disadvantaged groups were not vaccinated.

Those factors included not having the means to get to vaccination appointments, and being a person of color and having a distrust of medical authorities.

"This policy pretends that it is just focusing on objective medical knowledge, but it ignores societal injustices. In such cruel clarity, COVID-19 has exposed the consequences of the structural inequities that we've had so long. That's why it's critical that we don't add to that, and in this case, we risk that," Schmidt told The Dallas Morning News.

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