Intensive care accessibility and outcomes in pandemics

Excerpt

Limited access to intensive care units (ICU) during pandemics can be a contributor to excessive mortality. While lots of attention is given to individual ICU’s performance focusing on staffing, organizational features and adherence to best care management protocols [1, 2], there are few discussions as to how to optimize access to ICU at a regional level taking into account population densities [3]. Such efforts could theoretically result in a more homogeneous distribution of patients and a lower risk of overloading units in a given geographical area. In this issue of Intensive Care Medicine, Bauer and coworkers provide an in-depth study of accessibility to ICU beds in 14 European countries during the coronavirus disease 2019 (COVID-19) pandemic [4]. They demonstrate that great variability exists in geographical access to intensive care in different European countries, and also imply that this may be associated with case fatality ratio (CFR) from COVID-19 (that is, the ratio of deaths due to COVID-19 to the number of COVID-19 cases during a given time). Any attempt to provide clear data on this question is to be commended. There are, however, many challenges to such efforts that are recognized and discussed by the authors. …