COVID-19 in Venezuela: Costs and challenges of management severe cases at home in a crisis setting

The humanitarian crisis in Venezuela has become an unprecedented regional emergency. Over the past decade, Venezuela's political and economic collapse has eroded the country's healthcare infrastructure and threatened the public health of the population. Shortages of medicines and health supplies, disruptions in basic services, and the emigration of health workers during this humanitarian crisis have affected access to care throughout the country, as well as the capacity of emergency services and outbreak response. During the early waves of the epidemic, COVID-19 collapsed the Venezuelan health system, leaving sentinel centers without inpatient beds and ICU space. Home-based care alternatives quickly emerged, not only for mild to moderate but also for severe and critical COVID-19 cases. Here we discuss the impact of the pandemic on the Venezuelan health system, the emergence of home-based care alternatives for severe and critical COVID-19 cases, as well as their costs and challenges, and finally, their advantages and disadvantages.