Managerial challenges and solutions for COVID-19 outbreak: New insights for global primary healthcare system.

The world is now witnessing an outbreak of a contagious disease. High mortality and morbidity and inability of countries to control it, have indicated that COVID-19 management requires comprehensive efforts in all areas of health, technological, economic, social, political, cultural and environmental [1].

In the field of health, countries rapidly increased their healthcare capacity. So that, some hospitals were considered in each city for COVID-19. The action that China did in this regard was to build a hospital specifically for COVID-19 patients. The difference between the disease deployment in China than many other countries was that in China the disease was limited to the Wuhan province, so by building a large hospital and focusing financial, human and equipment resources, the disease becomes manageable. However, in other countries, the disease has expanded throughout them, and the construction of one or more large hospitals at one or more points cannot bring a high effect on the disease control. Therefore, it is reasonable to concentrate the efforts on promoting public health behaviors.

Primary Health Care (PHC) system has a huge capacity and can play a unique role in this regard [2]. This system has spread throughout the world and has close contact with people. Iran is a good example of a country that has utilized the system extensively. As an example of COVID-19, Iran PHC system screened all of the population and those with 3 main symptoms of cough, fever and dyspnea were taken under surveillance. It should not be forgotten that it was the PHC services that led to eradication of many infectious diseases. Ignoring PHC, and reduce the necessary investments in terms of manpower, equipment and buildings, and eventually weak health education and people's adherence to PHC principles will cause an increase in COVID-19 morbidity and mortality. Nevertheless, despite the lack of specific treatment for COVID-19, unfortunately, hospital staff are considered as the COVID-19 front line globally and the role that PHC providers can play is forgotten.

A very important point regarding planning for the provision of the COVID-19 equipment is considering that the disease is expanding all around the world for an unknown period of time. This means that countries should themselves launch the production lines of the necessary equipment such as coronavirus test kits, surgical gowns, face and body protectors, N95 face and 3 layer masks, ventilator, etc. In other words, due to the needs of all countries to them, requesting and buying the equipment from other countries are encountered with difficulties and restrictions.

Social media at the time of the outbreaks, especially COVID-19, acts as a double-edged sword. On the one hand, its role is very valuable for promoting knowledge, attitude and practice (KAP) and providing useful information in a short time. It reflects the public opinions to the authorities, creates responsiveness and provide the ground for changes in policies. On the other hand, it is exposed to disseminating incorrect information and destroy the efforts of health service providers and government officials. To attract public confidence, it is necessary to supervise social media, introducing credible ones to the public and providing correct information.

The COVID-19 outbreak leaves an undeniable effect on the GDP growth of countries [3]. It causes decrease in production, recession in jobs, decrease in economic exchanges between countries, and decrease in income. However, this crisis can be looked from another point of view. In crises, all social groups, from the government to the people, fight for a common goal. They put aside political problems and grudges, think about the excellence of society and comprehensive interaction for the public benefits increases. The COVID-19 crisis has promoted the emergence and promoting some businesses. Increase in internet-based service providence in banks, electronic sales of goods, virtual and webinar-based meetings and classrooms, electronic presentations of services in the time of emergencies and disasters provide great savings in transportation, air pollution, paper consumption and durable and consumable equipment. All of these measures accelerate development of smart cities.

Hypothetically, when the affected population exceeds 10% of the population, it is not the case how much hospital beds and ICUs are devoted to COVID-19, the available facilities will not be accountable. The health systems require more experts in the fields of PHC including epidemiologists, environmental health, nutrition, occupational health, and PHC managers, rather than specialists that can focus on individual cases.

Disclosure of interest

The authors declare that they have no competing interest.