LAUSR

Numerous publications have sought to further our understanding of how crisis standards of care (CSOC) strategies might perform, with specific attention to excessive deaths or exacerbating existing social disparities, during the coronavirus disease (COVID-19) pandemic. We write to raise an important concern with many CSOC studies to date, that simulate patient cohorts by synchronizing patients’ presentation to a single time point, rather than the reality where patients present continually over time.1–4 This collapsed model may not accurately reflect patient throughput and dynamic resource strain, which would preclude identifying those patients affected by CSOC policies. Understanding how CSOC might perform remains important as areas within New Hampshire, Arizona, New Mexico, Idaho, Alaska, and Maryland have activated their own crisis standards of care protocols.