Initial reports suggest that COVID-19 is associated with severe disease that requires intensive care in approximately 5% of proven infections. Given how common the disease is becoming, as in prior major severe acute respiratory infection outbreaks—SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), avian influenza A(H7N9), and influenza A(H1N1)pdm09—critical care will be an integral component of the global response to this emerging infection.

The rapid increase in the number of cases of COVID-19 in Wuhan, China, in late 2019 highlighted how quickly health systems can be challenged to provide adequate care. Case-fatality proportions were 7-fold higher for patients in Hubei Province compared with those outside of the region, 2.9% vs 0.4%, emphasizing the importance of health system capacity in the care of patients who are critically ill with COVID-19.

This article discusses issues pertaining to regions where critical care units have the capacity to provide mechanical ventilation, acknowledging that this capacity does not exist in many regions and that capacity could be exceeded in many places.

This differential ability to manage the disease will likely have a substantial influence on patient outcomes.

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