COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic

Marcus S. Shaker, John Oppenheimer, Mitchell Grayson, David Stukus, Nicholas Hartog, Elena W.Y. Hsieh, Nicholas Rider, Cullen M. Dutmer, Timothy K. Vander Leek, Harold Kim, Edmond S. Chan, Doug Mack, Anne K. Ellis, David Lang, Jay Lieberman, David Fleischer, David B.K. Golden, Dana Wallace, Jay Portnoy, Giselle MosnaimMatthew Greenhawt

Research output: Contribution to journalReview articlepeer-review

137 Scopus citations


In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services. Recommendations and feedback were developed iteratively, using an adapted modified Delphi methodology to achieve consensus. During the ongoing pandemic while social distancing is being encouraged, most allergy/immunology care could be postponed/delayed or handled through virtual care. With the exception of many patients with primary immunodeficiency, patients on venom immunotherapy, and patients with asthma of a certain severity, there is limited need for face-to-face visits under such conditions. These suggestions are intended to help provide a logical approach to quickly adjust service to mitigate risk to both medical staff and patients. Importantly, individual community circumstances may be unique and require contextual consideration. The decision to enact any of these measures rests with the judgment of each clinician and individual health care system. Pandemics are unanticipated, and enforced social distancing/quarantining is highly unusual. This expert panel consensus document offers a prioritization rational to help guide decision making when such situations arise and an allergist/immunologist is forced to reduce services or makes the decision on his or her own to do so.

Original languageEnglish (US)
Pages (from-to)1477-1488.e5
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number5
StatePublished - May 2020


  • Allergic rhinitis
  • Allergy
  • Allergy immunotherapy
  • Angioedema
  • Asthma
  • Atopic dermatitis
  • COVID-19
  • Food allergy
  • Primary immunodeficiency
  • SARS-CoV-2
  • Urticaria
  • Venom allergy

ASJC Scopus subject areas

  • Immunology and Allergy


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