Reserve System Design for Allocation of Scarce Medical Resources in a Pandemic: Some Perspectives from the Field

The Covid-19 pandemic has brought renewed attention to rationing guidelines for scarce medical resources. This paper describes the benefits of using a reserve system over a priority system in operationalizing compromises between certain ethical goals. In the last two years, more than a dozen states and local jurisdictions have adopted reserve systems in initial phases of vaccine distribution. We highlight several design issues arising in some of these implementations.