Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics

Abstract

Background COVID-19 is the fifth and most significant infectious disease epidemic this century. Primary health care providers, which include those working in primary care and public health roles, have critical responsibilities in the management of health emergencies. Objective To synthesize accounts of primary care lessons learnt from past epidemics and their relevance to COVID-19. Methods We conducted a review of lessons learnt from previous infectious disease epidemics for primary care, and their relevance to COVID-19. We searched PubMed/MEDLINE, PROQUEST and Google Scholar, hand-searched reference lists of included studies, and included research identified through professional contacts. Results Of 173 publications identified, 31 publications describing experiences of four epidemics in 11 countries were included. Synthesis of findings identified six key lessons: (i) improve collaboration, communication and integration between public health and primary care; (ii) strengthen the primary health care system; (iii) provide consistent, coordinated and reliable information emanating from a trusted source; (iv) define the role of primary care during pandemics; (v) protect the primary care workforce and the community and (vi) evaluate the effectiveness of interventions. Conclusions Evidence highlights distinct challenges to integrating and supporting primary care in response to infectious disease epidemics that have persisted over time, emerging again during COVID-19. These insights provide an opportunity for strengthening, and improved preparedness, that cannot be ignored in a world where the frequency, virility and global reach of infectious disease outbreaks are increasing. It is not too soon to plan for the next pandemic, which may already be on the horizon.

Transformations in the landscape of primary health care during COVID-19: Themes from the European region

“…Coordination between primary care and other parts of health system at the frontline of an epidemic is essential [23] . Yet in some European countries, primary care collaboration outside of an emergency is not a common feature in their health systems.…”

Factors influencing the willingness of primary care physicians to provide care during the coronavirus disease pandemic: a nationwide survey in Taiwan

“…Strategies such as strengthening the primary healthcare system and providing coordinated with reliable information to the physicians were essential. 18 29 30 The innovative CHCG comprehensive primary healthcare system model was developed in Taiwan after the previous SARS outbreak and the disastrous 921 earthquake. These conditions created an awareness of the need to reinforce primary care under the tremendous public health threats.…”

“…As the unprecedented pandemic threat persists over a broad range of medical care, it is of paramount importance to understand and optimise the primary healthcare workforce, and to maintain sufficient frontline physicians. [15][16][17][18] However, previous reports revealed a high susceptibility to infection among healthcare workers because more than 3000 healthcare workers have been infected in China and 20% of responding healthcare workers were infected early in the COVID-19 pandemic in Italy. 19 20 Moreover, a systematic review by Kisely et al 21 revealed that healthcare workers who had direct contact with patients had higher levels of both acute and posttraumatic stress and psychological distress.…”

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“…A system of primary care performance measurement that meets the information needs of the public, governments and ministries of health, regional health authorities, local communities and primary care practices and organizations for the purposes of public reporting, accountability, planning, and quality improvement. Health IT that effectively supports patients and providers through decision support tools for clinicians and patients, support for patient selfmanagement, performance measurement and reporting capacity and interconnectivity for information exchange across health-care settings [31].…”