Public health emergencies are a test of resilience for health systems, which depend on health workforces that are well managed and cared for. The COVID‐19 pandemic exposed the weakness of many health systems in preparing their health workforces. The crisis also exacerbated the unequal conditions between different professions, an issue that is still understudied in the workforce literature. This paper analyzes the consequences of the COVID‐19 pandemic for different health professionals, considering the ways in which Brazil's the health system does or does not protect them. We also analyse the role of pre‐existing inequalities between different professions and social groups within the workforce in shaping their different experiences of the pandemic. We present data comparing the perceptions of different health professionals facing the pandemic in Brazil: physicians, nurses, and community health workers. Data were collected in an online survey in Brazil with 1630 health care workers between June 15th and July 1st. Findings suggest that none of the professions felt well prepared to work under emergencies. However, differences relating to professional background were exacerbated during the pandemic, creating unequal conditions for different health workers. These inequalities may pose new challenges for the post‐pandemic scenario.

Resumo As fragilidades da Atenção Primária à Saúde podem ser reconhecidas por meio da análise do trabalho das agentes comunitárias de saúde. Uma vez que a situação enfrentada por essas profissionais representa desafios estruturais do sistema de saúde, este artigo tem como objetivo analisar a situação das profissionais em questão no enfrentamento à pandemia de Covid-19 no Brasil. Analisamos seus desafios com base nos dados coletados em um inquérito online e em netnografia. Para a realização da análise dos dados, optamos pela análise de conteúdo, inspirada na grounded-theory. Observamos três dimensões que representam como as agentes comunitárias de saúde experienciam a pandemia: mudanças nas práticas de trabalho, bem como nas interações entre trabalhadores e usuários e a expectativa do futuro no trabalho pós-pandemia. As análises mostram que para resguardar essas profissionais e garantir o funcionamento da Atenção Primária à Saúde é necessário contar com novas estratégias para viabilizar as dinâmicas locais de trabalho.

The COVID-19 pandemic has resulted in calls for an increased integration of community health workers (CHWs) into the health system response. Historically, CHWs can play an important role in ensuring the sustainability of health policy implementation – by addressing social determinants of health and maintaining care for ongoing health problems. Their frontline work, with close contact to populations, places CHWs in a position of increased vulnerability to becoming infected and to being the target of abuse and violence. These vulnerabilities compound underlying problems faced by CHWs, who often come from poor backgrounds, are insufficiently paid and receive inadequate training. Speaking to a scarcity of studies on how CHWs are impacted by the pandemic, this paper conducts a systematic study of CHWs in Brazil. Based on quantitative and qualitative data collected during June and July 2020, it considers perceptions and experiences of CHWs, comparing them with other health professionals. We study the extent to which the pandemic added to existing vulnerabilities and created new problems and imbalances in the work of CHWs. We conclude that COVID-19 led to a deterioration of the working conditions of CHWs, of their relations with other health professionals, and of their ability to carry out their essential work in the public health system.

Resumo Diante da importância do trabalho de Enfermagem no combate a epidemias e dos desafios impostos pela covid-19 ao exercício da profissão, o objetivo deste artigo é analisar as condições de trabalho e as percepções das profissionais de Enfermagem sobre sua atuação no contexto da pandemia de covid-19 no Brasil. Para tanto, realizamos uma pesquisa de caráter exploratório, a partir de um questionário online, aplicado entre 15 de junho e 1º de julho de 2020, respondido por 445 profissionais. Realizamos análise qualitativa, fundamentada na análise de conteúdo proposta por Bardin e Saldaña. No campo das sensações, os relatos das profissionais evidenciam medo, aumento da irritabilidade, sobrecarga de trabalho, tristeza e solidão. A pandemia da covid-19 alterou os processos de trabalho e a organização dos serviços, influenciando no dimensionamento do quantitativo de profissionais, na jornada de trabalho e na modalidade de execução, além de demandar maior vigilância quanto às medidas de prevenção e contágio. As mudanças impactaram no tempo disponibilizado para atendimento, na interação entre profissionais e usuários, e prejudicou a comunicação. A relevância do trabalho de Enfermagem junto às equipes de saúde no enfrentamento à covid-19 no Brasil reforça a necessidade de adoção de medidas eficazes de proteção e preservação da saúde física e mental dessas profissionais.

Dealing with the Covid-19 pandemic requires that the State make hard decisions that involve the action of bureaucrats who interact with the population through the implementation of public policy, the street-level bureaucracy (SLB). In this paper, based on a mixed- method exploratory study, we analyze how the daily performance of street-level bureaucrats in different policy areas- health and social care, access to the justice system, public security and education - has changed during the pandemic. We also explore the repercussions of those changes. Based on the analysis of the perceptions of bureaucrats, changes in their work and in their relationship with the public, we identify three categories that illustrate the dynamics of SLB work during the pandemic: the SLB who faces the crisis on the front lines; the SLB who suffers the effects of the pandemic, but whose work does not require her to face it directly; and the SLB who began to work remotely. We conclude that, during the pandemic, SLB suffered in varying degrees an aggravation of structural problems, such as their removal from decision-making processes - now restricted to the highest government level - and the exacerbation of already existing conflicts and ambiguities.