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The COVID-19 pandemic significantly impacted primary care, but its effect on quality of care is not well understood. We used health administrative data to understand the changes in quality-of-care measures for primary care between October 2018 and April 2022. We examined the following domains: cancer screening, chronic disease (diabetes) management, high-risk prescribing, continuity of care and capacity of primary care services. Colorectal and breast cancer screenings declined after the pandemic and had not returned to baseline by study end. In patients living with diabetes, in-person visits and up-to-date retinopathy screening rates declined after the pandemic declaration and did not return to baseline by study end, while statin prescribing remained stable. High-risk opioid prescribing decreased over time and was not affected by the pandemic. Physician continuity remained stable, though new patient enrollments decreased over the pandemic but returned to baseline by study end. Existing disparities in colorectal cancer screening by income and recent registration widened during the pandemic. In summary, COVID-19 had a variable impact on primary care, with the strongest influence on preventive and chronic disease care that was dependent on in-person visits., (Copyright © 2024 Longwoods Publishing.)

Objective: Bans on evictions were implemented to reduce the spread of COVID-19 and to protect vulnerable populations during a public health crisis. Our objective was to examine how three bans on eviction enforcement impacted eviction filings from March 2020 through January 2022 in Ontario, Canada., Methods: Data were derived from eviction application records kept by the Ontario Landlord and Tenant Board. We used segmented regression analysis to model changes in the average weekly filing rates for evictions due to non-payment of rent (L1 filings) and reasons other than non-payment of rent (L2 filings)., Results: The average number of weekly L1 and L2 applications dropped by 67.5 (95% CI: 55.2, 79.9) and 31.7 (95% CI: 26.7, 36.6) filings per 100,000 rental dwellings, respectively, following the first ban on eviction enforcement (p < 0.0001). Notably, they did not fall to zero. Level changes during the second and third bans were insubstantial and slope changes for L2 applications varied throughout the study period. The L1 filing rate appeared to increase towards the end of the study period (slope change: 1.3; 95% CI: 0.1, 2.6; p = 0.0387)., Conclusion: Our findings suggest that while the first ban on eviction enforcement appeared to substantially reduce filing rates, subsequent bans were less effective and none of them eliminated eviction filings altogether. Enacting upstream policies that tackle the root causes of displacement would better equip jurisdictions during future public health emergencies., (© 2023. The Author(s).)

Background: The COVID-19 pandemic substantially magnified the inequity gaps among vulnerable populations. Both public health (PH) and primary health care (PHC) have been crucial in addressing the challenges posed by the pandemic, especially in the area of vulnerable populations. However, little is known about the intersection between PH and PHC as a strategy to mitigate the inequity gap. This study aims to assess the collaboration between PHC and PH with a focus on addressing the health needs of vulnerable populations during the COVID-19 pandemic across jurisdictions., Methods: We analyzed and compared data from jurisdictional reports of COVID-19 pandemic responses in PHC and PH in Belgium, Canada (Ontario), Germany, Italy, Japan, the Netherlands, Norway, and Spain from 2020 to 2021., Results: Four themes emerge from the analysis: (1) the majority of the countries implemented outreach strategies targeting vulnerable groups as a means to ensure continued access to PHC; (2) digital assessment in PHC was found to be present across all the countries; (3) PHC was insufficiently represented at the decision-making level; (4) there is a lack of clear communication channels between PH and PHC in all the countries., Conclusions: This study identified opportunities for collaboration between PHC and PH to reduce inequity gaps and to improve population health, focusing on vulnerable populations. The COVID-19 response in these eight countries has demonstrated the importance of an integrated PHC system. Consequently, the development of effective strategies for responding to and planning for pandemics should take into account the social determinants of health in order to mitigate the unequal impact of COVID-19. Careful, intentional coordination between PH and PHC should be established in normal times as a basis for effective response during future public health emergencies. The pandemic has provided significant insights on how to strengthen health systems and provide universal access to healthcare by fostering stronger connections between PH and PHC., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The extent to which power, resources, and responsibilities for public health are centralized or decentralized within a jurisdiction and how public health functions are integrated or coordinated with health care services may shape pandemic responses. However, little is known about the impacts of centralization and integration on public health system responses to the COVID-19 pandemic. We examine how public health leaders perceive centralization and integration facilitated and impeded effective COVID-19 responses in three Canadian provinces. We conducted a comparative case study involving semi-structured interviews with 58 public health system leaders in three Canadian provinces with varying degrees of centralization and integration. Greater public health system centralization and integration was seen by public health leaders to facilitate more rapidly initiated and well-coordinated provincial COVID-19 responses. Decentralization may have enabled locally tailored responses in the context of limited provincial leadership. Opacity in provincial decision-making processes, jurisdictional ambiguity impacting Indigenous communities, and ineffectual public health investments were impediments across jurisdictions and thus appear to be less impacted by centralization and integration. Our study generates novel insights about potential structural facilitators and impediments of effective COVID-19 pandemic responses during the second year of the pandemic. Findings highlight key areas for future research to inform system design that support leaders to manage large-scale public health emergencies., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: The COVID-19 pandemic and response has highlighted existing strengths within the system of care for urban underserved populations, but also many fault lines, in particular during care transitions. The objectives of this study were to describe COVID-19 response policies for urban underserved populations in three Canadian cities; examine how these policies impact continuity of care for urban underserved populations; determine whether and how urban underserved community members were engaged in policy processes; and develop policy and operational recommendations for optimizing continuity of care for urban underserved populations during public health crises., Methods: Using Walt & Gilson's Policy Triangle framework as a conceptual guide, 237 policy and media documents were retrieved. Five complementary virtual group interview sessions were held with 22 front-line and lived-experience key informants to capture less well-documented policy responses and experiences. Documents and interview transcripts were analyzed inductively for policy content, context, actors, and processes involved in the pandemic response., Results: Available documents suggest little focus on care continuity for urban underserved populations during the pandemic, despite public health measures having disproportionately negative impacts on their care. Policy responses were largely reactive and temporary, and community members were rarely involved. However, a number of community-based initiatives were developed in response to policy gaps. Promising practices emerged, including examples of new multi-level and multi-sector collaboration., Conclusion: The pandemic response has exposed inequities for urban underserved populations experiencing care transitions; however, it has also exposed system strengths and opportunities for improvement to inform future policy direction., (© 2022. The Author(s).)

Context: The COVID-19 pandemic has impacted health systems worldwide. Studies to date have largely focused on the health care system with less attention to the impact on public health systems and practice., Objective: To describe the early impacts of COVID-19 on public health systems and practice in 3 Canadian provinces from the perspective of public health system leaders and synthesize lessons learned., Design: A qualitative study using semistructured virtual interviews with public health leaders between October 2020 and April 2021. The World Health Organization's essential public health operations framework guided data collection and analysis., Setting: This study involved the Canadian provinces of Alberta, Ontario, and Québec. These provinces were chosen for their large populations, relatively high COVID-19 burden, and variation in public health systems., Participants: Public health leaders from Alberta (n = 21), Ontario (n = 18), and Québec (n = 19) in organizations with a primary mandate of stewardship and/or administration of essential public health operations (total n = 58)., Results: We found that the COVID-19 pandemic led to intensified collaboration in public health systems and a change in workforce capacity to respond to the pandemic. This came with opportunities but also challenges of burnout and disruption of non-COVID-19 services. Information systems and digital technologies were increasingly used and there was greater proximity between public health leaders and other health system leaders. A renewed recognition for public health work was also highlighted., Conclusions: The COVID-19 pandemic impacted several aspects of public health systems in the provinces studied. Our findings can help public health leaders and policy makers identify areas for further investment (eg, intersectoral collaboration, information systems) and develop plans to address challenges (eg, disrupted services, workforce burnout) that have surfaced., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)

Background: The COVID-19 pandemic has highlighted the role of personal support workers (PSWs) in health care, as well as their work conditions. Our study aimed to understand the characteristics of the PSW workforce, their work conditions and their job security, as well as to explore the health of PSWs and the impact of precarious employment on their health., Methods: Our community-based participatory action research focused on PSWs in the Greater Toronto Area. We administered an online, cross-sectional survey between June and December 2020 using respondent-driven sampling. Data on sociodemographics, employment precarity, worker empowerment and health status were collected. We assessed the association between precarious employment and health using multivariable logistic regression models., Results: We contacted 739 PSWs, and 664 consented to participate. Overall, 658 (99.1%) completed at least part of the survey. Using data adjusted for our sampling approach, the participants were predominantly Black (76.5%, 95% confidence interval [CI] 68.2%-84.9%), women (90.1%, 95% CI 85.1%-95.1%) and born outside of Canada (97.4%, 95% CI 94.9%-99.9%). Most worked in home care (43.9%, 95% CI 35.2%-52.5%) or long-term care (34.5%, 95% CI 27.4%-42.0%). Although most participants had at least some postsecondary education (unadjusted proportion = 83.4%, n = 529), more than half were considered low income (55.1%, 95% CI 46.3%-63.9%). Most participants were precariously employed (86.5%, 95% CI 80.7%-92.4%) and lacked paid sick days (89.5%, 95% CI 85.8%-93.3%) or extended health benefits (74.1%, 95% CI 66.8%-81.4%). Nearly half of the participants described their health as less than very good (46.7%, 95% CI 37.9%-55.5%). Employment precarity was significantly associated with higher risk of depression (odds ratio 1.02, 95% CI 1.01-1.03)., Interpretation: Despite being key members of health care teams, most PSWs were precariously employed with low wages that keep them in poverty; the poor work conditions they faced could be detrimental to their physical and mental health. Equitable strategies are needed to provide decent work conditions for PSWs and to improve their health., Competing Interests: Competing interests: Andrew D. Pinto reports funding from the Canadian Institutes for Health Research (CIHR), the Government of Ontario, PSI Foundation, Maytree Foundation, Atkinson Foundation, St. Michael’s Hospital Foundation, Ontario SPOR Support Unit, the Canadian Institute for Health Information and the Public Health Agency of Canada. He also reports honoraria for presentations at the University of Toronto, McMaster University, University of Ghent, the North American Primary Care Research Group and Toronto Metropolitan University. He serves on the scientific advisory board of the Alliance for Healthier Communities, the Pan-Canadian Advisory Panel on a Framework for a Prescription Drug List organized by Canadian Agency for Drugs and Technologies in Health and the CIHR Institute Advisory Board for the Institute of Population and Public Health. He receives salary support from St. Michael’s Hospital and the University of Toronto, is the CIHR Applied Public Health Chair and is a scientific advisor to Mutuo Health Solutions. Ayu Hapsari reports an honorarium from Toronto Metropolitan University. No other competing interests were declared., (© 2022 CMA Impact Inc. or its licensors.)

Background: Being responsive and adaptive to local population needs is a key principle of integrated care, and traditional top-down approaches to health system governance are considered to be ineffective. There is need for more guidance on taking flexible, complexity-aware approaches to governance that foster integration and adaptability in the health system. Over the past two decades, paramedics in Ontario, Canada have been filling gaps in health and social services beyond their traditional mandate of emergency transport. Studying these grassroots, local programs can provide insight into how health systems can be more integrated, adaptive and responsive., Methods: Semi-structured interviews were conducted with people involved in new, integrated models of paramedic care in Ontario. Audio recordings of interviews were transcribed and coded inductively for participants' experiences, including drivers, enablers and barriers to implementation. Thematic analysis was done to ascertain key concepts from across the dataset., Results: Twenty-six participants from across Ontario's five administrative health regions participated in the study. Participants described a range of programs that included acute, urgent and preventative care driven by local relationship networks of paramedics, hospitals, primary care, social services and home care. Three themes were developed that represent participants' experiences implementing these programs in the Ontario context. The first theme, adapting and being nimble in tension with system structures, related to distributed versus central control of programs, a desire to be nimble and skepticism towards prohibitive legal and regulatory systems. The second theme, evolving and flexible professional role identity, highlighted the value and challenges of a functionally flexible workforce and interest in new roles amongst the paramedic profession. The third theme, unpredictable influences on program implementation, identified events such as the COVID-19 pandemic and changing government priorities as accelerating, redirecting or inhibiting local program development., Conclusions: The findings of this study add to the discourse on governing health systems towards being more integrated, adaptive and responsive to population needs. Governance strategies include: supporting networks of local organizational relationships; considering the role of a functionally flexible health workforce; promoting a shared vision and framework for collaboration; and enabling distributed, local control and experimentation., (© 2022. The Author(s).)

Purpose: The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global public health crisis. Mass vaccination is the safest and fastest pandemic exit strategy. Mass vaccination clinics are a particularly important tool in quickly achieving herd immunity. Primary care physicians have played a crucial role in organizing and running vaccination clinics. In this special report, we synthesize existing guidelines and peer-reviewed studies to provide physicians with practical guidance on planning and implementing COVID-19 mass vaccination clinics., Methods: PubMed, Ovid MEDLINE and Embase were used to search for relevant literature using search terms that included COVID-19, mass vaccination, and best practice. We also identified and analyzed national and international guidelines., Results: Forty-six relevant articles, reports, and guidelines were identified and synthesized. Articles included mass vaccination clinic guidelines and studies before and during the COVID-19 pandemic. Key considerations for COVID-19 mass vaccination clinics include leadership and role designation, site selection, clinic layout and workflow, day-to-day operations, infection prevention, and communication strategies., Conclusions: Planning and implementing a successful COVID-19 mass vaccination clinic requires several key considerations. Primary care plays an important role in organizing clinics and ensuring populations made vulnerable by social and economic policies are being reached. Ongoing data collection is required to evaluate and continuously improve COVID-19 mass vaccination efforts. As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine rollout occurs in various countries, research will be required to identify the main factors for success to inform future pandemic responses. VISUAL ABSTRACT ., (© 2022 Annals of Family Medicine, Inc.)

Objectives: The COVID-19 pandemic has disproportionately impacted 2SLGBTQ+ youth experiencing homelessness. Little is known about vaccine attitudes and uptake among this population. To address this, the objectives of this study were to explore this group's COVID-19 vaccine attitudes, and facilitators and barriers impacting vaccine uptake., Methods: 2SLGBTQ+ youth experiencing homelessness in the Greater Toronto Area were recruited to participate in online surveys assessing demographic characteristics, mental health, health service use, and COVID-19 vaccine attitudes. Descriptive statistics and statistical tests were used to analyze survey data to explore variables associated with vaccine confidence. Additionally, a select group of youth and frontline workers from youth serving organizations were invited to participate in online one-on-one interviews. An iterative thematic content approach was used to analyze interview data. Quantitative and qualitative data were merged for interpretation by use of a convergent parallel analytical design., Results: Ninety-two youth completed surveys and 32 youth and 15 key informants participated in one-on-one interviews. Quantitative and qualitative data showed that the majority of 2SLGBTQ+ youth experiencing homelessness were confident in the COVID-19 vaccine; however, numerous youth were non-vaccine confident due to mistrust in the healthcare system, lack of targeted vaccine-related public health information, concerns about safety and side effects, and accessibility issues. Solutions to increase vaccine confidence were provided, including fostering trust, targeted public health messaging, and addressing accessibility needs., Conclusion: Our study highlights the need for the vaccine strategy and rollouts to prioritize 2SLGBTQ+ youth experiencing homelessness and to address the pervasive health disparities that have been exacerbated by the pandemic., (© 2022. The Author(s).)

Competing Interests: Intérêts concurrents: Nav Persaud signale être membre du Groupe d’étude canadien sur les soins de santé préventifs, avoir reçu un remboursement de ses frais de déplacement de la part de l’Agence de la santé publique du Canada [ASPC]) et être consultant bénévole auprès du Groupe consultatif pancanadien sur un cadre en vue d’une liste de médicaments. Le Dr Persaud déclare aussi avoir reçu des subventions des Instituts de recherche en santé du Canada (IRSC), du Programme des chaires de recherche du Canada et de l’Ontario Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit. James Dunn signale avoir reçu des honoraires personnels de la Ville de Toronto (Santé publique de Toronto) pour une recherche sur les options en matière de politiques pour des logements salubres. Stephen Hwang signale faire partie à titre bénévole (sans rémunération) du conseil d’administration de Good Shepherd Ministries, être président du comité de surveillance de la sécurité des données pour l’étude Inspire Quitting (financée par le National Cancer Institute, les National Institutes of Health [à titre bénévole, sans rémunération]) et être membre bénévole du Comité de la recherche pour le National Health Care for the Homeless Council (sans rémunération). Le Dr Hwang déclare aussi avoir reçu des honoraires à titre d’investigateur principal (IP) du Programme de subvention Fondation des IRSC pour la recherche sur des interventions concernant, l’itinérance, le logement et la santé et en tant qu’IP d’une étude de cohorte sur la COVID-19 et l’itinérance à Toronto soutenue par une subvention de fonctionnement des IRSC. Le Dr Hwang a reçu des honoraires à titre de professionnel de la santé de la part d’Inner City Health Associates (subventionné par le ministère de la Santé et des soins de longue durée de l’Ontario). Le Dr Jonathon Maguire signale avoir reçu des subventions des Instituts de recherche en santé du Canada (IRSC) et de l’Ontario Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit. Andrew Pinto signale avoir fait partie du comité consultatif de l’Alliance pour des communautés en santé, et avoir été consultant bénévole auprès de Muto Health Solutions. Le Dr Pinto signale aussi avoir reçu des subventions des IRSC, du gouvernement de l’Ontario, notamment du ministère de la Santé et des Soins de longue durée, de la PSIM Foundation, de la Maytree Foundation, de l’Atkinson Foundation; de la Metcalf Foundation, de la Fondation de l’Hôpital St. Michael et de l’Ontario SPOR SUPPORT Unit. Le Dr Pinto a reçu des honoraires pour des présentations au Joint Centre for Bioethics de l’Université de Toronto (2019), de l’Université McMaster (2020) et de l’Université de Gand (2020). Le Dr Pinto déclare avoir reçu un salaire du Département de médecine familiale et communautaire de l’Hôpital St. Michael, du Département de médecine familiale et communautaire de la Faculté de médecine de l’Université de Toronto et de l’Institut du savoir Li Ka Shing de l’Hôpital St. Michael. Le Dr Pinto a été lauréat de la bourse PSI Graham Farquharson Knowledge Translation Fellowhip en 2019. Patricia O’Campo signale faire partie du conseil d’administration de Centraide du Grand Toronto, qui subventionne des agences qui desservent les femmes victimes de violence conjugale. Mme O’Campo signale aussi avoir reçu deux subventions des IRSC comme détentrice de la Chaire de recherche du Canada sur les approches interventionnelles dans le domaine de la santé des populations et du Conseil de recherches en sciences humaines pour des projets sur la violence conjugale. Sean Rourke signale avoir reçu des honoraires de consultation en tant qu’expert de la mise en œuvre stratégique pour la Fondation canadienne de recherche sur le sida. M. Rourke déclare également des subventions des IRSC et de l’ASPC, versées à l’Hôpital St. Michael, et une subvention de l’Annual Foundation, versée à la Fondation canadienne de recherche sur le sida (et non à M. Rourke). Daniel Werb signale avoir reçu une bourse salariale de nouveau chercheur des IRSC et une subvention de la Fondation de l’Hôpital St. Michael. M. Werb est aussi en attente d’un brevet pour un dispositif de vérification des médicaments. Aucun autre intérêt concurrent n’a été déclaré. Déclaration d’intérêts: Nav Persaud est corédacteur pour le CMAJ, mais n’a pas participé au processus ayant mené au choix de cet article.

Objective: To describe the impact of social determinants on the experience of the coronavirus disease 2019 (COVID-19) pandemic within the pediatric population, how this impact may influence the long-term health and security of children, and what measures can be taken to ameliorate this impact moving forward., Data Sources: Nonsystematic review of relevant literature and news sources., Study Selections: Relevant literature and news sources., Results: There have been increases in housing insecurity and food insecurity during the pandemic, including global increases in poverty. Public policies such as school closures have had a disproportionate impact on those facing adverse social determinants. There has been a dramatic increase in reports of abuse-related injuries and other injuries indicative of child abuse during the pandemic. In addition, there are disproportionate impacts of COVID-19 based on race and ethnicity within the United States. It is clear that children are facing more adverse determinants as a result of this pandemic and that there are both short-term and long-term implications associated. For those living in poverty or with other adverse social determinants of health, the pandemic has made a bad situation worse. Ongoing studies are required to measure the impact of COVID-19 on those with adverse social determinants, in particular among children., Conclusion: Social determinants of health must be part of pandemic research priorities, public health and vaccination goals, and economic policy implementation. The impact of the COVID-19 pandemic has further served to shed a light on the broad disparities that exist within our society and their direct and indirect impacts on health outcomes., (Copyright © 2021 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Early reports indicate that the social determinants of health are implicated in COVID-19 incidence and outcomes. To inform the ongoing response to the pandemic, we conducted a rapid review of peer-reviewed studies to examine the social determinants of COVID-19. We searched Ovid MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials from December 1, 2019 to April 27, 2020. We also searched the bibliographies of included studies, COVID-19 evidence repositories and living evidence maps, and consulted with expert colleagues internationally. We included studies identified through these supplementary sources up to June 25, 2020. We included English-language peer-reviewed quantitative studies that used primary data to describe the social determinants of COVID-19 incidence, clinical presentation, health service use and outcomes in adults with a confirmed or presumptive diagnosis of COVID-19. Two reviewers extracted data and conducted quality assessment, confirmed by a third reviewer. Forty-two studies met inclusion criteria. The strongest evidence was from three large observational studies that found associations between race or ethnicity and socioeconomic deprivation and increased likelihood of COVID-19 incidence and subsequent hospitalization. Limited evidence was available on other key determinants, including occupation, educational attainment, housing status and food security. Assessing associations between sociodemographic factors and COVID-19 was limited by small samples, descriptive study designs, and the timeframe of our search. Systematic reviews of literature published subsequently are required to fully understand the magnitude of any effects and predictive utility of sociodemographic factors related to COVID-19 incidence and outcomes. PROSPERO: CRD4202017813., Competing Interests: The authors have declared that no competing interests exist.

Background: Persistent income inequality, the increase in precarious employment, the inadequacy of many welfare systems, and economic impact of the COVID-19 pandemic have increased interest in Basic Income (BI) interventions. Ensuring that social interventions, such as BI, are evaluated appropriately is key to ensuring their overall effectiveness. This systematic review therefore aims to report on available methods and domains of assessment, which have been used to evaluate BI interventions. These findings will assist in informing future program and research development and implementation. Methods: Studies were identified through systematic searches of the indexed and grey literature (Databases included: Scopus, Embase, Medline, CINAHL, Web of Science, ProQuest databases, EBSCOhost Research Databases, and PsycINFO), hand-searching reference lists of included studies, and recommendations from experts. Citations were independently reviewed by two study team members. We included studies that reported on methods used to evaluate the impact of BI, incorporated primary data from an observational or experimental study, or were a protocol for a future BI study. We extracted information on the BI intervention, context and evaluation method. Results: 86 eligible articles reported on 10 distinct BI interventions from the last six decades. Workforce participation was the most common outcome of interest among BI evaluations in the 1960–1980 era. During the 2000s, studies of BI expanded to include outcomes related to health, educational attainment, housing and other key facets of life impacted by individuals' income. Many BI interventions were tested in randomized controlled trials with data collected through surveys at multiple time points. Conclusions: Over the last two decades, the assessment of the impact of BI interventions has evolved to include a wide array of outcomes. This shift in evaluation outcomes reflects the current hypothesis that investing in BI can result in lower spending on health and social care. Methods of evaluation ranged but emphasized the use of randomization, surveys, and existing data sources (i.e., administrative data). Our findings can inform future BI intervention studies and interventions by providing an overview of how previous BI interventions have been evaluated and commenting on the effectiveness of these methods. Registration: This systematic review was registered with PROSPERO (CRD 42016051218). [ABSTRACT FROM AUTHOR]

The world is facing unprecedented challenges with the COVID-19 pandemic. Existing biomedical conceptualizations of pain often construct pain in dualistic and reductionist ways, and thereby problematize people living with pain. 4 Eccleston C, Blyth F, Dear B, Fisher E, Keefe F, Lynch M, Palermo T, Reid M, Williams A. Managing patients with chronic pain during the Covid-19 outbreak: considerations for the rapid introduction of remotely supported (e-health) pain management services. [Extracted from the article]