Age is just a number – and so is frailty: Strategies to inform resource allocation during the COVID-19 pandemic

As cases of critical COVID-19 patients have taxed their resources, hospitals in China and Europe have faced the difficult task of establishing criteria for which patients receive which level of care.Hospitals in Italy during this pandemic seem overwhelmed, leaving physicians with little guidance on how to triage patients and allocate therapeutic resources.1 Based on current rates of critical care admission in China and Italy, in a worstcase scenario, Canada would have a deficit of thousands of intensive care unit (ICU) beds in the peak of a national epidemic-a problem that will disproportionately affect older adults.This highlights the necessity of sound geriatric principles in the emergency department (ED) that incorporate the essential concept of frailty.We propose that a structured, evidence-based assessment of frailty, and not just noting the person's age, will help guide ED care during the COVID-19 pandemic.When the Italian College of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) released guidelines for the triaging of limited resources, they were criticized as being "age-ist."Although not based entirely on chronological age, they suggested that an age cutoff for ICU care may ultimately be needed.1 This was especially interesting in Italy, a country with one of the oldest populations in the world.Although they explicitly recognize that age should not be the