POLICIES ON INTENSIVE CARE UNIT (ICU) ADMISSION DURING COVID-19 PANDEMIC

Background: COVID-19 pandemic has tremendously caused significant health impacts leading to high load of ICU critical patients. Multiple Intensive Care Unit (ICU) admission framework and triaging score have been adapted worldwide for admission of COVID-19 patients. The aim of this article is to review the COVID-19 ICU admission policy in five (5) countries, identify challenges and provide recommendations. Materials and Methods: Literature review was carried out through searching available literature from online databases such as EBSCO, PubMed, Research Gate, Google Scholar and Google search engine. The selected information used in this review is taken from any journal, article, report, thesis, national report, news update regarding the topic. Result: The ICU admission policy in 5 countries, namely South Africa, USA, UK, Hong Kong and Malaysia were reviewed. Different countries apply different guidelines to triage, prioritize and admit severe COVID-19 patients to ICU such as Color-coded Priority Scale in South Africa, Critical Care Triage Tool in USA, COVID-19 Critical Care Guideline in UK, COVID-19 Critical Care Triage Tool in Hong Kong and ICU Admission Prioritization Criteria in Malaysia. The ICU admission decision-making is supported with multiple ICU scorings such as Sequential Organ Failure Assessment (SOFA), Clinical Frailty score and National Early Warning score 2 (NEWS2). Conclusion: The COVID-19 ICU admission policies in these countries are well established and have been practised appropriately despite challenges faced by the ICU practitioners. All five selected national guidelines in this paper correspond to the WHO framework on the ICU admission policy. Ethical issues and legal supports on the ICU practitioners in ICU admission decision-making requires great attention form government and relevant policy stakeholders.  Keywords: ICU policy, ICU admission, COVID-19, triage, Malaysia, South Africa, United States of America, United Kingdom, Hong Kong