Ontario’s plan to contain second wave needs a dose of primary care engagement
The first wave of COVID-19 focused Ontario’s collective attention on hospitals, critical care beds and ventilators. With case counts rising and Ontario now in its second wave, pandemic leaders within government must broaden that focus to face a double challenge: How to respond to rising case rates while also continuing other important care for Ontarians.
Regardless of what happens with COVID-19, other illnesses continue their relentless march. Ask anyone and many will share stories of late diagnosis, delayed treatment, avoidable outcomes and suffering faced by people, families and caregivers.
The hospital-centric approach in the first wave made sense. The second wave, however, needs a more thoughtful approach. The majority of care happens in the community. Family doctors alone provide two-thirds of all healthcare visits, not to mention the care done by other community-based physicians including specialists, those providing diagnostic services and other health professionals.
For our next wave and beyond, Ontario’s leaders need to immediately engage primary care physicians. Research shows that people with a family doctor benefit from timely cancer screening, fewer hospitalizations and emergency visits and live longer. Primary care is the heart of a high-functioning healthcare system and family doctors have continued to tirelessly care for Ontarians throughout the pandemic.
Consider a typical morning at your family doctor’s office. A 91-year-old living alone, with a history of lung disease, heart failure, atrial fibrillation, advanced kidney disease, calls in with worsening shortness of breath and fatigue. New parents call in worried about their newborn’s poor feeding. A 17-year-old student with severe social anxiety asks for help. And that’s just the first half-hour.
When decision-makers prioritize primary care, they are supporting safe, high-quality, holistic and compassionate care for Ontarians.
A few family doctors have helped shape Ontario’s pandemic strategy. However, front-line family physicians want to see a more meaningful partnership. We need to ensure that any plan that can move us forward – whether around a vaccine strategy, pandemic communication or support for non-COVID care – works effectively in the real world of your doctor’s office.
With this in mind, our prescription for Ontario’s pandemic leaders is simple: engage us, invest in us and lean on us.
First, engage family physicians in planning and rollout. Consider flu vaccination in Ontario. Family practices can identify priority groups for immunization including children, older adults and people with complex health conditions. In a year when widespread vaccination is critical, imagine the success story from meaningfully engaging family doctors to vaccinate everyone through coordinated primary care hubs. The flu vaccine may be important today but our plan for the COVID-19 vaccine will be critical in the months ahead.
Second, invest in us. In the first wave, community practices had to fend for themselves; clinics were left to source their own life-saving personal protective equipment. Even before the pandemic, Ontario’s health policy neglected much of primary care –the majority of Ontarians are excluded from interprofessional primary care teams. Approximately 1 million Ontarians do not have a family doctor or primary care professional. Imagine if every Ontarian had a team of experts to manage and coordinate his or her care, to promote health throughout and beyond COVID-19.
Third, lean on us. Primary care professionals hold trusted relationships with the people, families and caregivers in our communities. The pandemic is an opportunity to lean on the province’s 9,000 comprehensive family physicians to help socialize physical distancing, universal masking and other public health measures. Ontario’s family doctors are ready to support a provincial communications strategy that relies on key local primary care experts and influencers to convey a unified, science-based and compassionate message at a time when misinformation is deadly.
The second wave is a critical juncture. It is an opportunity for creative and courageous decisions in how we care for Ontarians. Most care happens in the community and primary care is central to an efficient, effective and equitable health system as well as its COVID-19 response.
Ontario’s doctors urge our pandemic leaders within government to engage with, invest in and lean on the province’s primary care professionals. Through the coming waves of the pandemic, the health of Ontarians depends on it.