The US Food and Drug Administration (FDA) has issued emergency use authorizations (EUAs) for monoclonal antibodies (mAbs) for nonhospitalized patients with mild or moderate coronavirus disease 2019 (COVID-19) disease and for individuals exposed to COVID-19 as postexposure prophylaxis. EUAs for oral antiviral drugs have also been issued. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (eg, the Omicron variant) emerge, further rationing may be required. We identify relevant ethical principles (ie, benefiting people and preventing harm, equal concern, and mitigating health inequities) and priority groups for access to therapies based on an integrated approach to population health and medical factors (eg, urgently scarce healthcare workers, persons in disadvantaged communities hard hit by COVID-19). Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical exclusion or inclusion rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors.

中文翻译：

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2019 年冠状病毒病 (COVID-19) 稀缺疗法的公平分配


美国食品和药物管理局 (FDA) 已发布单克隆抗体 (mAb) 紧急使用授权 (EUA)，用于患有轻度或中度 2019 冠状病毒病 (COVID-19) 疾病的非住院患者以及暴露于 COVID-19 的个人作为暴露后预防。口服抗病毒药物的 EUA 也已发布。由于 Delta 变种导致需求增加，联邦政府恢复了对供应的控制，并要求各州实行剂量配给。随着未来变体（例如 Omicron 变体）的出现，可能需要进一步配给。我们根据人口健康和医疗因素的综合方法（例如，紧急稀缺的医护人员、受 COVID-19 重创的弱势社区）。使用优先类别来分配稀缺疗法可以有效地实施重要的道德价值观。该策略优于当前基于疫苗接种、免疫功能低下状态或老年或临时考虑临床风险因素的分类排除或纳入规则的方法。