• The COVID-19 pandemic has challenged the healthcare capacity of many countries. • Strict, horizontal lockdowns have adverse social, economic and health effects that have not been fully considered. • Primary and community care have multiple roles in COVID-19 pandemic mitigation. • Greece is a case example of a country which neglected primary and community care, and in November 2020 implemented a second horizontal lockdown. • Primary and community care, represents the only realistic strategy for successful COVID-19 pandemic mitigation in the long-term.

Emergency departments (EDs) are a vital component of the US health care system, with more than 140 million visits in 2018 incurring a total cost of approximately $75 billion.¹ Emergency department visits are expected to increase even further in the years ahead, by a projected 12% by 2030.^2,3 Although EDs treat patients with acute and unexpected health care conditions, they often serve as a safety net for individuals who are unable to access other health care settings. The use of EDs for nonemergent and preventable medical conditions has been a long-standing challenge in the US health care system. Every year, it is estimated that one-third of all ED visits occur for care that is treatable in primary care settings and preventable.^4-6 At an average cost that is many times higher compared with treatment provided at a physician’s office or an urgent care center, some of these visits suggest inefficient allocation of resources and present a cost-saving opportunity.⁷