Brief on Primary Care Part 1: The Roles of Primary Care Clinicians and Practices in the First Two Years of the COVID-19 Pandemic in Ontario

Abstract

About Us: The Ontario COVID-19 Science Advisory Table is a group of scientific experts and health system leaders who evaluate and report on emerging evidence relevant to the COVID-19 pandemic, to inform Ontario's response. The Science Advisory Table's mandate is to provide summaries of relevant scientific evidence to public health and health care professionals, as well as the general public, by integrating information from existing scientific tables, Ontario's universities and agencies, and the best global evidence. The Science Advisory Table is hosted by Public Health Ontario (PHO). Aligned with PHO's mandate, the Science Advisory Table provides credible and independent scientific and technical advice to inform government and the broader public about COVID-19 and to help prepare for and respond to future public health emergencies.

Brief on Primary Care Part 3: Lessons Learned for Strengthened Primary Care in the Next Phase of the COVID-19 Pandemic

“…It builds on the analyses completed for the preceding parts, entitled "The roles of primary care clinicians and practices in the first two years of the COVID-19 pandemic in Ontario" and "Factors Affecting Primary Care Capacity for Response and Recovery". 2,3 The evidence from parts 1 and 2 was supplemented by additional literature reviews and an environmental scan to identify best practices that might be transferable to the Ontario context. The authors of parts 1 and 2 collaborated to develop the key lessons learned and relevant recommendations.…”

“…For example, on social media, family physician-led initiatives such as PandemicPregnancyGuide (40, reflecting the high levels of trust that people place in their PCC, especially in the context of long-standing relationships. 2 The potential influence of PCCs on population health may be amplified if partnerships are deepened with trusted community-based service providers to reach populations where higher levels of mistrust in the health care system exist due to a range of factors, including historic, contemporary, and systemic discrimination.…”

“…Primary care clinicians (PCCs) played integral (but variable) roles in the pandemic response in Ontario; a reduction in some important primary care services also occurred during this time. 2 A backlog of deferred and delayed care in hospitals, diagnostics, and specialty care due to the pandemic adds to current pressures on the primary care sector. Here we consolidate lessons learned building upon the evidence summarized in parts 1 and 2 of this 3-part Science Brief and offer a series of immediate-and longer-term recommendations to support the primary care sector and the patients it serves as the health system continues to respond and recover from the COVID-19 pandemic.…”

Brief on Primary Care Part 2: Factors Affecting Primary Care Capacity in Ontario for Pandemic Response and Recovery

“…56 The benefits associated with team-based care have been prominent throughout the pandemic. As described in detail in part 1 of this Ontario Science Table Brief, 57 throughout COVID-19, teams have inherently had the flexibility and interprofessional resources to meet their patients' and communities' needs to a greater extent than have non-team-based primary care practices. This has included the redeployment of staff to perform outreach services to people with greater needs, such as those experiencing mental illness and homelessness, and the redesign of health promotion and social support programs to ensure their ongoing availability to the community at large.…”

“…75 Further detailed data on virtual care is provided in part 1 of this Ontario Science Table Brief. 57 As discussed in that section of the Brief, the ideal proportion of virtual care in primary care is unknown. Family physicians who provided a higher proportion of virtual care did not have higher ED visit rates among their patients compared to those who provided less virtual care overall.…”