The current Pandemic has exposed the crisis in the health system and the urgency that, once the trance is over, structural problems be addressed to increase the quality and opportunity of access to the health system. This article seeks to analyze whether, during the pandemic, the principles of universality, solidarity and integrality, established in the General System of Social Security in Health and that respond to the content of the Political Constitution of 1991, were ignored. For the above, the proposed objectives correspond to the review of the current state of health care and the elements available to the State in the face of the health crisis, to understand the dangers that a global crisis such as Covid-19 can represent for compliance with the principles of the Social Security System in Health in Colombia, as well as the implications in the paradigm shift from a health model as a public policy to a fundamental right, to finally analyze the right to health of the elderly in the face of the pandemic. The social security health system in Colombia was not designed to deal with crises like the current one, and fortunately there have not been the mortality rates that were expected. However, it is necessary to rethink the rights around the health care of the vulnerable population in catastrophic situations, since the government risk of violating the enjoyment of life in decent conditions is latent, given the potential prioritization of intermediate care. and intensive in health centers in the face of the crisis generated by the Coronavirus pandemic.