Table 1 Some of the aspects we have done well and some we could have done better

Preparation

Using other areas of the hospital to expand ICU capacity

Distributing resources

Increasing resources when still in pre-epidemic period

Providing more psychological support in some centers

Progress

Understanding the pathophysiology

Improving general, especially respiratory, management

Discovering benefit from corticosteroid administration

Increasing international collaboration

Increasing definitive RCTs on therapeutic interventions in critically ill patients

Decreasing enthusiasm for unproven and theoretical treatments

Increasing research on susceptibility and host response factors

Personalization

Rapidly deciphering individual responses and patterns of disease

Individualizing ARDS management

Paying more attention to tissue perfusion

Making greater use of biomarkers to guide therapy

Prioritization

Developing guidelines

Discussing ethical uncertainties and optimizing ICU admissions in some centers

Coordinating resources across centers