The COVID-19 pandemic highlighted both the importance of primary care and the fragility of its current infrastructure in the United States (US). Within its first 2 months, stark reminders of racial injustice, unaddressed health disparities, and grossly inequitable access to healthcare further underscored the current lack and future importance of universal access to high-performing primary care. At the start of the pandemic, fewer than 1 in 5 Americans could identify a personal usual source of healthcare. In this time of uncertainty, many patients went without timely care due to a myriad of difficulties. Perhaps chief among these was the lack of an accessible, trusted personal clinician capable of and committed to delivering personalized advice and comprehensive care at a time of unprecedented medical and public health uncertainty. In response to this crisis, changes in actual and virtual visit accessibility to primary care were further complicated by the limited office hours or practice closures imposed by crises in provider organizational finances.

In our previous study, we revealed a disconnect in the early phases of the pandemic between primary care strength at a national level and early mortality rates from COVID-19, but also widespread and shared perceptions of limited investment in, coordination with, and engagement of primary care in pandemic response. This follow up one year into pandemic confirms nearly 80% of respondents felt that primary care providers are insufficiently remunerated to provide remote access services, with even higher proportions in the AMRO region.

In general, countries where primary care has been integrally involved in vaccine delivery appear to have better vaccination rates, but this is also influenced by the availability of vaccine. Having a coordinated response between public health and primary care also appears to be an effective strategy.

The vast majority of respondents affirmed the need for greater integration of and coordination between public health and primary care. And on a personal level, 85% reported experiencing some degree of personal mental health difficulty over the preceding year.

More positively, respondents felt that the primary care sector had learned from the pandemic, and would be in a better position to respond to the next one. Specifically, they noted that primary care providers have acquired an increased capacity for using technology in delivering primary care services as a result of COVID-19.