To the Editor:

As mentioned in “Rising Shortage of Dialysis Units Alarms Doctors” (front page, April 19), public health infrastructure is at risk. The hospitals of the world need an equivalent of the electrical power grid that reallocates power in response to demand. In our case, it is the patients who would be reallocated in times of extreme need.

Reallocation would be based on a broad-based tabulation of how close each hospital was to capacity. Before any prospective patient entered a hospital that was near capacity, he or she would be redirected to a secondary site. This would require a continuously updated allocation registry, somewhat akin to what is done for patients who need organ transplants.

In the moment of crisis, however, last-minute improvisations, exploratory telephone calls and so on seem destined to be catastrophic.

These thoughts are not specific to any city, state or country. If something like this proposal is not pursued, we will share an enormous public guilt when patients, nurses, staff and doctors died because one region was overwhelmed while spare capacity existed within reach.