The coronavirus disease 2019 (COVID-19) pandemic will have a large impact in low-resource settings (LRS). 20% of COVID-19 patients become critically ill with hypoxia or respiratory failure. Critical illness, describing any acute life-threatening condition, is receiving increased attention in global health because of its large disease burden and population impact. Before the COVID-19 pandemic, growing evidence suggested that the care of critical illness was overlooked in LRS—hospitals cannot, or do not, prioritise emergency and critical care. Most critically ill patients are cared for in emergency units and general wards and do not have access to advanced care in intensive care units (ICUs). Data from hospital wards in Malawi showed that 89% of hypoxic patients (oxygen saturation <90%) were not receiving oxygen, and 53% of unconscious patients (Glasgow Coma Scale <9) were being nursed supine without a protected airway (unpublished data).

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