On the importance of primary and community healthcare in relation to global health and environmental threats: lessons from the COVID-19 crisis

Abstract

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system’s weaknesses worldwide. In many instances, P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of ‘planetary health’. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that P&CHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic.

Health-seeking and diagnosis delay and its associated factors: a case study on COVID-19 infections in Shaanxi Province, China

“…Longer delay to COVID-19 diagnosis when patients choose community-based service as initial choice of primary care as opposed to larger hospitals may hint at the inefficiency of community services in coping with COVID-19 in Shaanxi. Though community-based healthcare and primary care at large is supposed to play a crucial role to ensure an effective COVID-19 response 58 , community and primary care systems functioned ineffectively in many countries during the height of the pandemic, often because of lack of testing and diagnosis capacities 59 . In addition to insufficient capacities, China’s primary care system faces many other challenges such as undertrained and understaffed workforce, the fragmentation of clinical care and public health service, and the disintegration between primary care institutions and hospitals 60 .…”

Family doctors to connect global concerns due to climate change with local actions: State‐of‐the art and some proposals

“…This illustrates that global strategies addressing CC should be implemented locally. COVID‐19 pandemic showed how important it is (Lauriola et al, 2021).…”

“…The approaches in Germany and South Korea demonstrated the benefits of involving FDs and primary health care services in the public health responses to COVID‐19 at the local and global level (Fischhoff, 2020). Success depends on collaboration between FDs/FPs and local and national public health organizations, allowing primary care services to contribute to the public health response, especially in terms of case identification and contact tracing at the community level (Lauriola et al, 2021). Some important examples illustrating this come from China (Harlan et al, 2020).…”

“…One of the lessons learned from the COVID‐19 emergency has been that professionals, including FDs and FPs, naturally join together in groups to promote understanding and practical initiatives to face impeding hazards (Lauriola et al, 2021). An example is provided in Appendix (Murgia et al, 2020).…”

The role of European health system characteristics in affecting Covid 19 lethality during the early days of the pandemic

“…In many European countries, GPs were at the forefront of tackling the spread of the virus. They are both gatekeepers and health promoter empowering the community to build a firewall against the deadly virus 29 , 30 . Even in hospital-oriented towards the health services, where the family medicine system is not yet fully implemented (as Wuhan), GPs helped in blocking the viral transmission by monitoring people at designated checkpoints in airports, railway stations and highways where they verified personal information and conducted health checks for travelers, reporting suspected cases to hospitals for urgent follow-up 28 .…”