Critical care is changing. The particular demand for specialised high end care is increasing and will continue to increase in the future. The COVID-19 pandemic has strained the existing critical care resources and encouraged spending to increase the capacity of care beyond that which was possible before.

Respiratory viruses not only target our individual physiological capacity but also exploit the weaknesses of our economic and political institutions. An epidemic of chronic disease and unhealthy living has been exploited by COVID-19 and left some of the most unhealthy nations with the highest death rates.

Our environment crumbles beneath the weight of an increasing world population with rising demand for food and consumer goods. The convenience of plastic products has shaped the modern lifestyle but the toll is being felt by the oceans around us.

We must continue to progress in a changing world, while being mindful of the challenges we face locally and globally.