Abstract
Pandemics such as that caused by COVID-19 can lead to a surge in demand for health care
services, including palliative and end-of-life care. Some people who become seriously ill will
have advance directives in place that stipulate comfort measures are to be emphasized if
they become seriously ill. And in conditions of absolute resource scarcity, some patients may
be triaged to receive comfort-focused care, including some who may have not improved with
mechanical ventilation and are subsequently extubated to focus on comfort care. As a result,
during disasters, the potential need for palliative and comfort care services might increase
very substantially, potentially far outstripping capacity.