A priority system has traditionally been the protocol of choice for the allocation of scarce life-saving resources during public health emergencies. COVID-19 revealed the limitations of this allocation rule. Many argue that priority systems abandon ethical values, such as equity, by discriminating against disadvantaged communities. We show that a restrictive feature of the traditional priority system largely drives these limitations. Following minimalist market design, an institution design paradigm that integrates research and policy efforts, we formulate pandemic allocation of scarce life-saving resources as a new application of market design. Interfering only with the restrictive feature of the priority system to address its shortcomings, we formulate a reserve system as an alternative allocation rule. Our theoretical analysis develops a general theory of reserve design. We relate our analysis to debates during COVID-19 and describe the impact of our paper on policy and practice. This paper was accepted by Axel Ockenfels, behavioral economics and decision analysis.

Diversity and financial aid concerns often lead schools to "reserve" some slots for specific types of students or tuition contracts. Students only care about their school assignments and contractual terms---they are indifferent among slots within a school. These indifferences can be resolved in multiple ways. As we illustrate using the cases of Chicago and Boston public schools, the method of indifference resolution impacts the eventual allocation, and thus presents a novel opportunity for market design.