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SARS (severe acute respiratory syndrome) proved an enormous physical and emotional challenge to frontline health care workers throughout the world in late 2002 through to mid 2003. A large percentage of patients (many being health care workers themselves) became critically ill. Unfortunately, clinicians caring for these individuals did not have the advantage of previous experience or research data on which to base treatment decisions. As a result, at least early in the outbreak, a 'best guess approach' and/or anecdotes drove therapy. In many centres systemic steroids, which carry many potential downsides, became a mainstay of therapy. In this issue of Critical Care, two groups that have frontline experience of SARS debate the role of steroids. Let us hope and pray together that we never have the patient population needed to resolve the questions the two sides raise.

critical care

Pro/con clinical debate: steroids are a key component in the treatment of SARS. Con: No, steroids are not a key component of the treatment regimen for SARS.