PurposeWe sought to understand patients’ care-seeking behaviours early in the pandemic, their use and views of different virtual care modalities, and whether these differed by sociodemographic factors.MethodsWe conducted a multisite cross-sectional patient experience survey at 13 academic primary care teaching practices between May and June 2020. An anonymised link to an electronic survey was sent to a subset of patients with a valid email address on file; sampling was based on birth month. For each question, the proportion of respondents who selected each response was calculated, followed by a comparison by sociodemographic characteristics using χ2 tests.ResultsIn total, 7532 participants responded to the survey. Most received care from their primary care clinic during the pandemic (67.7%, 5068/7482), the majority via phone (82.5%, 4195/5086). Among those who received care, 30.53% (1509/4943) stated that they delayed seeking care because of the pandemic. Most participants reported a high degree of comfort with phone (92.4%, 3824/4139), video (95.2%, 238/250) and email or messaging (91.3%, 794/870). However, those reporting difficulty making ends meet, poor or fair health and arriving in Canada in the last 10 years reported lower levels of comfort with virtual care and fewer wanted their practice to continue offering virtual options after the pandemic.ConclusionsOur study suggests that newcomers, people living with a lower income and those reporting poor or fair health have a stronger preference and comfort for in-person primary care. Further research should explore potential barriers to virtual care and how these could be addressed.

Objective During the height of the COVID-19 pandemic, personal support workers (PSWs) were heralded as healthcare ‘heroes’ as many of them cared for high-risk, vulnerable older populations, and worked in long-term care, which experienced a high number of COVID-19 outbreaks and deaths. While essential to the healthcare workforce, there is little understanding of PSW working conditions during the pandemic. The aim of our study was to examine the working conditions (including job security, work policies, and personal experiences) for PSWs in the Greater Toronto Area during the COVID-19 pandemic from the perspectives of PSWs. Methods This study used a mixed-methods design. From June to December 2020, we conducted a survey of 634 PSWs to understand their working conditions during the COVID-19 pandemic. Semi-structured interviews with 31 survey respondents were conducted from February to May 2021 to understand in greater depth how working conditions were impacting the well-being of PSWs. Results We found PSWs faced a range of challenges related to COVID-19, including anxiety about contracting COVID-19, reduced work hours, taking leaves of absences, concerns about job security, and losing childcare. While the COVID-19 pandemic highlighted the PSW workforce and their importance to the healthcare system (especially in the long-term care system), pre-existing poor work conditions of insecure jobs with no paid sick days and benefits exacerbated COVID-19–related challenges. Despite these hardships, PSWs were able to rely on their mental resilience and passion for their profession to cope with challenges. Conclusion Significant changes need to be made to improve PSW working conditions. Better compensation, increased job security, decreased workload burden, and mental health supports are needed. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00643-7.

T he COVID-19 pandemic has had profound effects on health care and society around the world. A major concern has been that health inequities attributed to socioeconomic disparities may be exacerbated, both in terms of the risk of developing COVID-19, 1 as well as poor outcomes among those who become infected. [2][3][4] Supporting health equity has been an important feature of health system and primary care responses to COVID-19. [5][6][7][8] Although physical distancing and closure of nonessential businesses are considered important public health interventions to limit the spread of COVID-19, 9 there are concerns that these public health measures may also lead to worsening social disparities 10 and differential access to health care services, which could lead to poorer health outcomes both during the pandemic and in the future. The existence of socioeconomic disparities in primary care is well established across jurisdictions; 11,12 however, the extent to which the COVID-19 pandemic is worsening these disparities is not well understood.The objective of this study was to assess the impact of the COVID-19 pandemic on access to family physician services across sociodemographic groups. We hypothesized that the effects of COVID-19 would be greatest in patients of lower socioeconomic status.