Editorial Providing end-of-life care in the emergency department: Early experience from Médecins Sans Frontières during the Covid-19 pandemic

While most infections attributable to SARS-CoV-2 (Covid-19) are mild, a considerable percentage of affected people require hospitalisation and critical care. In European and North American centres, the mortality rate amongst individuals that are hospitalised, particularly those requiring mechanical ventilation, is high . Earlier identification of impending severe disease is imperative to reducing mortality from CoVid-19 [4]. Health authorities and others responding to the epidemic should prioritise activities that support this life-saving approach, which includes improving access to health care for persons that are most susceptible to develop critical illness. However, as evidenced in Europe and the USA, maintaining access to health care and prioritising care for the most vulnerable during an epidemic are complex. While resource allocation related to shortages of critical equipment has been heavily emphasized in reports coming from European and North American settings, in African contexts these shortages are more pronounced, and high-complexity care is non-existent in numerous regions. Given underlying issues of access to care in many locations, patients frequently present to African emergency services in an advanced stage of disease suffering from organ failure that cannot be reversed.....