Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
S Afr Med J. 2020 Apr 16;110(5):355-359.
Since the World Health Organization declared coronavirus disease 2019 (COVID-19) a Public Health Emergency of International Concern, COVID-19 infection and the associated mortality have increased exponentially, globally. South Africa (SA) is no exception. Concerns abound over whether SA's healthcare system can withstand a demand for care that is disproportionate to current resources, both in the state and private health sectors. While healthcare professionals in SA have become resilient and adept at making difficult decisions in the face of resource limitations, a surge in COVID-19 cases could place a severe strain on the country's critical care services and necessitate unprecedented rationing decisions. This could occur at two critical points: access to ventilation, and withdrawal of intensive care in non- responsive or deteriorating cases. The ethical dimensions of decision-making at both junctures merit urgent consideration.
自世界卫生组织宣布 2019 年冠状病毒病（COVID-19）为国际关注的突发公共卫生事件以来，COVID-19 感染及其相关死亡率在全球呈指数级增长。南非（SA）也不例外。人们普遍担心南非的医疗保健系统是否能够承受与当前资源不成比例的医疗需求，无论是在国家还是私营医疗部门。虽然南非的医疗保健专业人员已经变得有弹性，并擅长在资源有限的情况下做出艰难的决策，但 COVID-19 病例的激增可能会对该国的重症监护服务造成严重压力，并需要做出前所未有的配给决策。这可能发生在两个关键节点：获得通气和在无反应或恶化的情况下撤出重症监护。这两个节点的决策的伦理维度都值得紧急考虑。
