Summary Background There is a lack of knowledge on how people at increased risk of severe illness from Coronavirus disease 2019 (COVID-19) experienced the infection control measures. This study aimed to explore their perspectives and needs during the coronavirus outbreak. Methods A qualitative longitudinal interview study was conducted in Austria during lockdown due to COVID-19 containment and afterwards. People older than 65 years of age and/or affected by a chronic medical condition participated in individual telephone interviews at two time points. Thematic analysis was used to analyze the data and saturation was defined as no new emerging concepts in at least 10 subsequent interviews. Results Thematic saturation was reached when 33 individuals (75.8% female, mean age ± standard deviation [SD] 73.7±10.9 years) were included. A total of 44 lower level concepts were extracted and summarized into 6 higher level concepts. They included (i) a general positive attitude toward COVID-19 measures, (ii) challenges of being isolated from the community, (iii) deterioration of health status, (iv) difficulties with measures due to their health condition, (v) lack of physical contact and (vi) lack of information versus overload. Participants suggested environmental adaptations for strengthening resilience in people at increased risk of severe illness from COVID-19. Conclusion Strategies and interventions are needed to support people at risk under pandemic conditions. Their perceptions and needs should be addressed to reduce the potential deterioration of health conditions and ensure well-being even during prolonged periods of crisis.

Objective: Several comments and recommendations called to embed better the patients' and public voice in healthcare policymaking. Still, no studies captured patients' bottom-up perspectives regarding healthcare at the time of COVID-19 at a micro-level in a range of different countries. We, therefore, explored the perspectives of patient representatives in all six World Health Organisation (WHO) regions and extracted suggestions for care redesign after the pandemic. Methods: We conducted semi-structured interviews with patient representatives until saturation. Thematic analysis followed a modified form of meaning condensation. We established rigour by transcript checking, inter-coder agreement, quote variation and standardised reporting. Results: Disadvantaged people experienced an unprecedented inequity in healthcare from limited access to physical violence. The narratives revealed the extent of this inequity, but also opportunities for health workers to act and improve. Stigmatisation from COVID-19 differed between cultures and countries and ranged from none to feeling "ashamed" and "totally bashed". While experienced as indispensable in the future, patients refused telehealth when they were given "bad news", such as having an eye removed because of melanoma, and in end-of-life care. Patient representatives redefined their role and became indispensable influencers throughout the pandemic and beyond. Conclusion:We reached out to patient representatives with diverse perspectives, including those who represent minorities and marginalised patient populations. Since preferences and personal meanings drive behaviour and could be foundations for targeted interventions, they must be considered in all groups of people to increase society's resilience as a whole. Future healthcare should tackle inequity, address stigmatisation and consider patients' narratives to optimize telemedicine.

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Objective: The COVID-19 pandemic has triggered significant changes in healthcare. As they were mainly driven by professionals and are likely to influence healthcare in the future, it is of utmost importance to consider patients' perspectives equally. We, therefore, explored the lived experiences of patients and patient representatives in all six World Health Organisation (WHO) regions regarding healthcare at the time of COVID-19 and extracted suggestions for care redesign after the pandemic. Methods: We conducted semi-structured interviews until saturation. Thematic analysis followed a modified form of meaning condensation. We established rigour by transcript checking, inter-coder agreement, quote variation and standardised reporting. Results: Disadvantaged people experienced an unprecedented inequity in healthcare due to the pandemic. The main reasons were the reduction in public care services and limited access to information, transportation, technology and income. Stigmatisation from COVID-19 differed between cultural contexts and ranged from none to feeling 'ashamed' and 'totally bashed'. Participants experienced telehealth as indispensable but with limitations. These included giving 'bad news', such as having an eye removed because of melanoma, and the difficulty of providing end-of-life care over the phone. Patient representatives redefined their role and became indispensable influencers throughout the pandemic and beyond. Conclusion: We reached out to individuals with a diversity of perspectives, including minorities and marginalised populations. A systematic exclusion of people with limited technology access increases inequity in healthcare and biases research findings. Since preferences and personal meanings drive behaviour and could be foundations for targeted interventions, they must be considered in all groups of people to increase society's resilience as a whole.