The expansion of ICU facilities during the SARS epidemic in Hong Kong and Singapore was recently described [25] . Infection control is recognised as an overriding priority for the delivery of critical care, including the ability, in the early stages, to cohort cases. This should ideally include the use of separate entrances and exits, isolation rooms with negative pressure ventilation and dedicated separate healthcare staff. The Toronto experience identified 21 secondary cases of nosocomial transmission of SARS in ICU from an initial index case before infection control measures were introduced. Even following the introduction of extensive protective equipment, nine healthcare workers developed SARS as a result of being present in the room during the intubation of a single patient. In terms of personal protection, planning and practice in the donning of protective equipment (PPE) and prior fit testing is essential [26] . The practicalities of being able to manage patients when fully attired must be understood and consideration given to the fact that any procedure or task will take longer. This will impact on care efficiency and the staff to patient ratio.