In reality, perhaps the question we need to address is the action required when critical care services are overwhelmed. The scalability of triage tools may aid in decision making by objectively altering the threshold for admission to critical care. However, the time may come when we need realistically to evaluate the effectiveness of critical care in influenza. If survival with the benefit of critical care is marginal (for example, <10%) and there is a significant cross-infection risk, perhaps critical care should then close and concentrate its efforts on outreach to other areas, including wards. Direction and support from professional bodies and health departments will be required to support the medical staff with such difficult decisions possibly against a ground swell of media-driven public opinion.