The ERC Ethics writing group identified a clear need for ethical guidance. We are very much aware that important changes to resuscitation guidelines might have a significant and potentially long-lasting impact on subsequent outcomes. Any ‘temporary’ adaptations of the existing guidelines should always be interpreted within the context of each healthcare system and take into account factors such as the prevalence of COVID-19 within a region, and the overall impact on available resources. Given the limited evidence available, most of the following statements are the result of expert consensus. They are based on the very recent ILCOR systematic review on the risk of transmission of COVID-19 to rescuers during resuscitation, on existing guidelines from other societies and councils and recent, mostly observational, clinical studies. Indirect evidence from non-clinical papers, such as those on pathophysiology, also informed our final ‘insights’.