COVID -19 Challenges

Coronavirus disease (COVID-19) continues to spread. While nations that were hit early are now seeing a flattening of the curve from mitigation strategies, countries that have been hit more recently continue to suffer. It is true that the majority of the population experiences mild symptoms of the disease, but age, comorbidity, and male sex are important risk factors that are still resulting in poor outcomes in patients who get severely ill with COVID-19.

Clinicians have learned quite a bit regarding the course of the disease, its clinical characteristics, and supportive treatment. But questions still remain regarding vaccines, potential drug treatment, immunity, and when mitigation strategies could be relaxed, if at all.

Our cover story, COVID-19 Challenges, talks about the response to COVID-19 by critical care workers across the world - from China to Italy to the US and UK, Belgium, South Africa, and Switzerland. We include input and observations from critical care experts around the globe.

In an exclusive interview with ICU Management & Practice, Prof. Maurizio Cecconi talks about the COVID-19 critical care response in Italy while I discuss the various treatment strategies that are being proposed and why caution must be exercised, and scientific evidence must be given priority.

Prof. Elizabeth De Waele and colleagues discuss adaptive strategies for intensive care during the spread of COVID-19 in Brussels, and John Nosta also highlights the need to develop an adaptive response to manage the COVID-19 crisis.

Andy Higgs, Martin Udberg, and Gethin Hopkin explain how tracheal intubation can be made safe for both patients and healthcare providers while Adrian Wong, Olusegun Olusanya, Jonathan Wilkinson, and Cian McDermott discuss the clinical utility of ultrasound modalities in the COVID-19 patient.

Emma Ridley, Lee-anne Chapple, and Kate Fetterplace talk about the nutritional implications for COVID-19 critically ill patients while Armin Quispe Cornejo and Ana Alves Cunha discuss masks and the most effective strategies that healthcare workers can use to protect against airborne particles.

Chunyao Wang shares his experience about daily care and supportive therapies for COVID-19 used in Wuhan, China, while Kuban Naidoo, David Kloeck, and Lufano Mathivha share their COVID-19 intensive care experience from South Africa.

Hatem Ksouri and colleagues highlight the importance of keeping collective intelligence intact when facing stressful and challenging situations in the ICU while Joanna Poole shares her experience from the UK and talks about the lessons we can learn from similar diseases over the last few centuries. Adrian Wong also shares his experience while battling COVID-19 in the UK.

The world is going through a terrible healthcare crisis - a crisis that has stunned most healthcare systems 

around the globe. Amidst the numerous flow of patients, we have seen healthcare workers rise to the occasion and delivering essential healthcare services despite the risk of transmission and infection. We have seen clinicians around the world connect and collaborate, and a display of team spirit never seen before. These are challenging times, but the healthcare community has shown that together they can surpass any challenge. The COVID-19 pandemic will pass, but with it, healthcare systems will learn how to become stronger and how to be more prepared if such a thing happens again.

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