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Research ArticleReports of Committees

Primary care in the COVID-19 pandemic and beyond

Lessons from Ontario

Danielle Martin, Fahad Razak, Imaan Bayoumi, Azza Eissa, Michael E. Green, Richard H. Glazier, Allan K. Grill, Noah M. Ivers, Derelie Mangin, Elizabeth Muggah, Sarah Newbery, Onyenyechukwu Nnorom, Dominik Alex Nowak, Kamila Premji, Andrew D. Pinto, Jennifer Rayner, Janet Smylie and Tara Kiran
Canadian Family Physician January 2025; 71 (1) 31-40; DOI: https://doi.org/10.46747/cfp.710131
Danielle Martin
Family physician and Chair in the Department of Family and Community Medicine (DFCM) at the University of Toronto (U of T).
MD CCFP FCFP MPubPol
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  • For correspondence: danielle.martin@wchospital.ca
Fahad Razak
Internist at St Michael’s Hospital in Toronto, Ont, and Canada Research Chair in Healthcare Data and Analytics at U of T.
MD MSc FRCPC
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Imaan Bayoumi
Associate Professor in the Department of Family Medicine at Queen’s University in Kingston, Ont.
MD MSc CCFP FCFP
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Azza Eissa
Clinician Scholar in the DFCM at U of T.
MD PhD
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Michael E. Green
President, Vice-Chancellor, Dean, and Chief Executive Officer of the NOSM University.
MD MPH CCFP FCFP
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Richard H. Glazier
Senior Core Scientist at ICES, Scientist in the MAP Centre for Urban Health Solutions at St Michael’s Hospital, and Professor in the DFCM, the Dalla Lana School of Public Health, and the Institute of Health Policy, Management and Evaluation at U of T.
MD MPH CCFP FCFP
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Allan K. Grill
Chief of Family Medicine at Oak Valley Health’s Markham Stouffville Hospital in Ontario.
MD CCFP(COE) MPH FCFP
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Noah M. Ivers
Family physician at Women’s College Hospital, Scientist at the Women’s College Research Institute and Associate Professor in the DFCM at U of T.
MD PhD CCFP
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Derelie Mangin
Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont.
MBChB DPH FRNZCGP MCFP
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Elizabeth Muggah
Senior Clinical Advisor of Primary Care at Ontario Health in Toronto and Associate Professor in the Department of Family Medicine at the University of Ottawa in Ontario.
MD MPH CCFP FCFP
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Sarah Newbery
Associate Professor and Associate Dean of Physician Workforce Strategy at NOSM University.
MD CCFP FCFP
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Onyenyechukwu Nnorom
Family doctor, a public health specialist, and Associate Program Director of the Public Health and Preventive Medicine Residency Program at U of T.
MD CCFP MPH FRCPC
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Dominik Alex Nowak
President of the Ontario Medical Association in Toronto and Assistant Professor in the DFCM at U of T.
MD MHSc CCFP
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Kamila Premji
Family physician, Assistant Professor at the University of Ottawa, Clinician Researcher at the Institut du Savoir Montfort in Ottawa, and a doctoral candidate at Western University in London, Ont.
MD CCFP
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Andrew D. Pinto
Director of the Upstream Lab, a public health and preventive medicine specialist and family physician at St Michael’s Hospital, and Associate Professor at U of T.
MD MSc
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Jennifer Rayner
Director of Research and Policy at the Alliance for Healthier Communities in Toronto and Associate Professor in the DFCM at U of T.
PhD
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Janet Smylie
Family physician and Research Scientist at Unity Health Toronto, Professor in the Dalla Lana School of Public Health and DFCM at U of T, and Tier 1 Canada Research Chair in Advancing Generative Health Services for Indigenous Populations in Canada.
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Tara Kiran
Vice-Chair of Quality and Innovation in the DFCM at U of T; Associate Professor in the Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at U of T; Scientist in the MAP Centre for Urban Health Solutions at St Michael’s Hospital; and a staff physician in the DFCM at St Michael’s Hospital, Unity Health Toronto.
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    Figure 1.

    Spending on primary health services as share of current expenditure on health, 2018

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    Figure 2.

    Ecology of health care in Ontario: Average number of health services accessed each day (Ontario 2019-2020). Values rounded to the nearest thousand with the exception of hip and knee replacements, which were rounded to the nearest 10.

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    Figure 3.

    Weekly primary care visits by type from January 2019 to March 2022 in Ontario

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    Figure 4.

    COVID-19 vaccinations in Ontario by delivery channel stratified by public health unit: Data received via personal communication with Dr Daniel Warshafsky on August 11, 2022; and from INSPIRE–Primary Health Care (unpublished data).

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    Figure 5.

    Preventive care during the pandemic: A) Changes in the proportion of eligible Ontario residents who are up to date with cervical, breast, and colorectal cancer screening. Unpublished analysis of ICES data from INSPIRE-PHC. B) Changes in percentage of Ontario patients with diabetes or hypertension who had at least 1 in-person visit to a physician within their group in the past 12 months from October 2018 to April 2022. Unpublished analysis of ICES data from INSPIRE-PHC.

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    Figure 6.

    Percentage of patients not attached to family health teams by region

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Canadian Family Physician: 71 (1)
Canadian Family Physician
Vol. 71, Issue 1
1 Jan 2025
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Primary care in the COVID-19 pandemic and beyond
Danielle Martin, Fahad Razak, Imaan Bayoumi, Azza Eissa, Michael E. Green, Richard H. Glazier, Allan K. Grill, Noah M. Ivers, Derelie Mangin, Elizabeth Muggah, Sarah Newbery, Onyenyechukwu Nnorom, Dominik Alex Nowak, Kamila Premji, Andrew D. Pinto, Jennifer Rayner, Janet Smylie, Tara Kiran
Canadian Family Physician Jan 2025, 71 (1) 31-40; DOI: 10.46747/cfp.710131

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Primary care in the COVID-19 pandemic and beyond
Danielle Martin, Fahad Razak, Imaan Bayoumi, Azza Eissa, Michael E. Green, Richard H. Glazier, Allan K. Grill, Noah M. Ivers, Derelie Mangin, Elizabeth Muggah, Sarah Newbery, Onyenyechukwu Nnorom, Dominik Alex Nowak, Kamila Premji, Andrew D. Pinto, Jennifer Rayner, Janet Smylie, Tara Kiran
Canadian Family Physician Jan 2025, 71 (1) 31-40; DOI: 10.46747/cfp.710131
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