Abstract
Planning the delivery of health services in poor countries, in the wake of the COVID pandemic has drawn considerable interest. The world media has highlighted the shortage or near absence of intensive care units and ventilators in several countries in Sub Saharan Africa and a disproportionate amount
of focus has been paid on developing intensive care services- including mechanical ventilation, as an urgent priority for these countries. While mechanical ventilation and other critical care services are an important part in the management of a small group of very unwell patients, the overall
mortality of such patients remains high even in centres with considerable experience in providing such services. In the wake of a pandemic wave, a much larger proportion of patients admitted to hospitals will require oxygen therapy, and many of these countries are currently ill-equipped to provide this very basic intervention which has the potential to save many more lives. Ensuring
uninterrupted oxygen supply and planning to provide titrated oxygen therapy to multiple patients simultaneously perhaps in large field hospitals must be prioritised in health delivery planning in poor countries in the global south. An over-emphasis on ventilators and advanced organ support that may benefit a significantly smaller cohort of victims by developing ad-hoc intensive care units
with high labour intensity will not serve the broader health needs of these countries in the wake of
the current pandemic or its future iterations
of focus has been paid on developing intensive care services- including mechanical ventilation, as an urgent priority for these countries. While mechanical ventilation and other critical care services are an important part in the management of a small group of very unwell patients, the overall
mortality of such patients remains high even in centres with considerable experience in providing such services. In the wake of a pandemic wave, a much larger proportion of patients admitted to hospitals will require oxygen therapy, and many of these countries are currently ill-equipped to provide this very basic intervention which has the potential to save many more lives. Ensuring
uninterrupted oxygen supply and planning to provide titrated oxygen therapy to multiple patients simultaneously perhaps in large field hospitals must be prioritised in health delivery planning in poor countries in the global south. An over-emphasis on ventilators and advanced organ support that may benefit a significantly smaller cohort of victims by developing ad-hoc intensive care units
with high labour intensity will not serve the broader health needs of these countries in the wake of
the current pandemic or its future iterations
Original language | English |
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Title of host publication | National Science Foundation Sri Lanka |
Subtitle of host publication | COVID 19: Impact, Mitigation, Opportunities and Building Resilience From Adversity to Serendipity |
Editors | Ranjith Senaratne, Dilanthi Amaratunga, Shanthi Mendis, Prema-Chandra Athukorala |
Place of Publication | Colombo Sri Lanka |
Chapter | 1 |
Pages | 64 |
Number of pages | 5 |
Volume | 1 |
Edition | 1 |
Publication status | Published - 30 Jul 2021 |
Keywords
- Covid pnumonitis, Oxygen, Priorities, Low resource, Management, Ventilation, IPPV