The Post Coronavirus Disease-19 Pandora-Box: Future Directions for Critical Care in Low and Medium-Income Countries

Abstract

The novel Coronavirus disease-19, caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 virus posed a worldwide public health emergency and remains a large health burden till date in some continents, causing a significant morbidity and mortality among the critically-ill, not sparing the low and medium-income countries. The critical care surge in most countries exposed the unpreparedness and “struggling” health systems of these countries, including Low and medium-income countries in containing the epidemic. The suddenness of Coronavirus disease in China is suggestive that another “Pathogen X” epidemic may occur. In addition, the increasing global terrorism index may precipitate another epidemic secondary to a bioterrorism contagion. In mitigating this, however, lessons learnt from the management of the critically-ill patients with the Coronavirus disease may assist the low and medium-income countries in charting the future directions of critical care in the event of any Post Coronavirus disease public health challenge. The import of systems approach and collaboration with development partners cannot be over-emphasized, alongside increasing critical care beds and improving oxygen availability and accessibility. Finally, changing the narrative of “struggling” health systems of developing countries by addressing the major debilitating factors, including the issue of critical care workforce and training is needed. The new Essential and Emergency Critical Care training program is proffered. Furthermore, offering skilled healthcare workers adequate remuneration and other incentives to guard against their migration to “greener pastures” may help the low and middle-income countries retain critical care specialists in preparing for any sudden Post-Coronavirus disease public health emergency.