Primary care perspectives on pandemic politics

Abstract

While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce personto-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity, COVID-19 testing, and contact-tracing. An international survey of primary care experts' perspectives about their country's national responseswas conducted April to early May 2020. This mixed method paper reports on whether they perceived that their country's decision-making and pandemic response was primarily driven by medical facts, economic models, or political ideals; initially intended to develop herd immunity or flatten the curve, and the level of decision-making authority (federal, state, regional). Correlations with country-level death rates and implications of political forces and processes in shaping a country's pandemic response are presented and discussed, informed by our data and by the literature. The intersection of political decision-making, public health/ primary care policies and economic strategies is analysed to explore implications of COVID-19's impact on countries with different levels of social and economic development.

Analysis of the COVID-19 pandemic: lessons towards a more effective response to public health emergencies

“…Countries that have fared the best are the ones with good governance and public support [49]. Countries with an absence of coherent leadership and social trust have worse outcomes than countries with collective action, whether in a democracy or autocracy, and rapid mobilisation of resources [50]. The erosion of trust in the United States government has hurt the country's ability to respond to the COVID-19 crisis [51,52].…”

Editorial: Challenge and resilience: primary care in a COVID-19 world

“…PHC comprises both population-level public health and individual-based primary care, as well as community-based social services (Muldoon et al, 2006). An international study found that in most countries, public health and primary care were insufficiently integrated for an effective epidemic response (Goodyear-Smith et al, 2021). For example, a coordinated approach to COVID-19 swabbing and contact-tracing of positive cases was often lacking.…”

Analysis of the COVID-19 Pandemic: Lessons for a Contextualized and Effective Response to Public Health Emergencies

“…[49] Countries with an absence of coherent leadership and social trust have worse outcomes than countries with collective action, whether in a democracy or autocracy, and rapid mobilisation of resources. [50] The erosion of trust in the United States government has hurt the country's ability to respond to the COVID-19 crisis. [51,52] The editors of the New England Journal of Medicine argued that the COVID-19 crisis has produced a test of leadership;…”

“…[54,55] Countries with health systems and policies that are able to integrate International Health Regulations (IHR) core capacities with primary health care (PHC) services have been effective at mitigating the effects of COVID-19. [50,53] Australia has been able to control its COVID-19 epidemic through a comprehensive primary care response (including protection of vulnerable people, provision of treatment and support services to affected people, continuity of regular healthcare services, protection and support of PHC workers and primary care services, and provision of mental health services to the community and the primary healthcare workforce).…”