Session virtual link: Digital Session, Meeting ID: 949 8905 1030

Session objectives

  1. To review Africa’s critical care response to the COVID-19 pandemic
  2. To explore the ethical dilemmas in providing critical care

Session abstract

Although the surge of COVID-19 patients requiring healthcare services affected all aspects of the healthcare system, none was put to the test as critical care services. The gaps in critical care services lay bare as healthcare facilities experienced shortages in ventilators, oxygen, intensive care unit (ICU) beds among other critical care resources. Despite 5% of all COVID-19 patients necessitating critical care, African countries have a low capacity to provide these services and a global survey on critical care beds found that most African countries have less than 5 ICU beds per 100,000 population. Underfunding of the healthcare sector left it less prepared to absorb the pressures put upon it by the pandemic. This was aggravated by underfunding in other sectors such as energy with lack of a steady supply of electricity, particularly in rural areas, constraining the critical care response.

Compared to other regions, the mortality rate for COVID-19 critically ill patients is highest in Africa. The presence of comorbidities is a risk factor for ICU admission and mortality. African countries face a dual burden of infectious diseases, particularly HIV/AIDS and non-communicable diseases such as diabetes, chronic liver and chronic kidney disease which played a role in the observed excess mortality.

As the pandemic dragged on, with mounting numbers of patients spending several days in hospital, ethical dilemmas arose in determining allocation of these scarce services. ICU units developed admission criteria to make beds available, reserving these facilities for those who need critical care the most with the rest of the patients absorbed into other hospital units.

The pandemic leaves several lessons for countries in Africa. To lessen the impact from potential supply chain disruptions, national emergency preparedness plans need to prioritise building strategic reserves for critical care equipment, medicines and consumables, including personal protective equipment. Furthermore, critical care services need to be organized in a manner that allows scalability during emergencies such as rapid recruitment of additional staff and task shifting to cater for increased demand during public health emergencies. Digital solutions have also shown potential to improve consultation and monitoring among healthcare workers and to facilitate communication with family members.

Event Timeslots (1)

PD 13

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