key: cord-257076-uh98ilhr authors: Lionis, Christos; Petelos, Elena title: Challenges, priorities and tasks for the generalists at the time of the COVID-19 pandemic date: 2020-07-17 journal: The European journal of general practice DOI: 10.1080/13814788.2020.1791073 sha: doc_id: 257076 cord_uid: uh98ilhr nan A commonly used term, representing an intensely debated concept, is vulnerability. Most reports in the evidence base, including for observational studies conducted for COVID-19, utilise this term in reference to the frequency of co-existing chronic diseases, including diabetes mellitus and cardiovascular disease (CVD). Less attention has been given to the psychosocial factors, and the role they play to increase vulnerability or, conversely, to confer a protective effect, reducing COVID-19 severity and shortening its duration. Research conducted by the University of Crete has attempted to identify such determinants for chronic conditions, including for CVD [2] . Study design should allow correlation of exposures to protective factors, with data being harvested from electronic health records. Such type of evidence generation will contribute to evidencebased practice and shared decision-making. The role of Primary Care and Family Medicine to coordinate and support surveillance, including through community-based monitoring, has been discussed; however, concerted efforts are needed to improve the design and conduct of prevalence studies. The extend of the COVID-19 pandemic has decidedly demonstrated that the only way to monitor the pandemic effectively is to optimise the integration of public health and primary care. That implies sound communication channels and system-level interoperability to develop and execute preparedness plans [3] . There is, also, the definitive need for implementation research on integration, to match the call of the Astana Declaration [4] , and to address the needs of multimorbid patients, including of those in long-term care, through people-centred care approaches. For the four critical-for-quality domains, i.e. access, continuity, comprehensiveness, and coordination [5] , the period of the lockdowns and the quarantine revealed a largely unaddressed need for well-organised home care services. The integration of technology could be a catalyst to build more comprehensive, readily accessible records and registries for the effective allocation of resources to these settings. Individuals and families have been under enormous stress, experiencing fear and anxiety. To respond effectively, generalists have to be adept at using e-health tools and equipped with sound communication skills. Updating existing curricula to enhance the capacity of generalists with motivational interviewing and compassionate care skills should extend to self-compassion and self-protection, for a sustainable health workforce to increase the resilience of healthcare systems and communities alike. We have started sharing our experiences from the University of Crete, as we believe they are encouraging given lessons learned from austerity and the financial crisis [6] . Self-compassion skills are also crucial for informal caregivers to protect themselves; improving the level of literacy, and ensuring they are given timely access to the information and resources they need will further empower them. Considering these challenges for Family Medicine and Primary Care, it is essential to exchange experiences, collaborating across disciplines and co-creating with patients, for evidence-informed policymaking, and for the people and for the society. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Family medicine in times of 'COVID-19': a generalists' voice Impact of religiosity/spirituality on biological and preclinical markers related to cardiovascular disease. results from the SPILI III study Towards evidenceinformed integration of public health and primary health care: experiences from Crete. Public Health Panorama United Nations Children's Fund (UNICEF). A vision for primary health care in the 21st century. Towards universal health coverage and the sustainable development goals. Geneva: World Health Organization and the United Nations Children's Fund The strength of primary care in Europe: an international comparative study Introducing and implementing a compassionate care elective for medical students in Crete This article has been corrected with minor changes. These changes do not impact the academic content of the article.