Primary healthcare in times of COVID-19: what to do?

Abstract

The COVID-19 pandemic poses an unprecedented challenge for science and society, demanding rapid and diverse responses by health systems that need to be reorganized in all their components. In Brazil and in various countries elsewhere in the world, the health response has centered on hospital services, expanding the number of beds, especially in intensive care units, and mechanical ventilators. Without denying the importance of adequate structuring of specialized care for more serious cases of COVID-19, much can and must be done in the sphere of primary healthcare (PHC). In the absence of vaccines and specific drugs and due to the infection’s high transmissibility, the only effective interventions to control the pandemic are public health measures such as isolation, social distancing, and case surveillance in order to reduce transmission, thereby avoiding suffering and death by slowing the pandemic’s pace. It is also necessary to supply the system with resources to provide adequate and timely care 1. Thus, the reorganization of PHC services to simultaneously fight the epidemic and maintain the regular supply of its activities is crucial. Documents and reports in Brazil have emphasized necessary leadership role and readjustment of PHC in this context 2,3. Even acknowledging various weaknesses in the action by Family Health Strategy (FHS) teams, PHC is the most adequate model, given its attributes of territorial responsibility and community orientation, to support populations in social isolation; more than ever, it is necessary to maintain the contacts and bonds with the professionals caring for the population’s health. This article analyzes the possibilities for action by PHC services in the Brazilian Unified National Health System’s (SUS) network who contribute to controlling the epidemic and simultaneously play their essential role of guaranteeing daily and capillary care.