A experiência da reorganização da Atenção Primária à Saúde – APS e trabalho dos agentes comunitários de saúde frente à COVID-19 em um município no interior do Amazonas

The COVID-19 hit the Amazon, expanding the vulnerabilities that already existed, especially in the cities of the interior. Considering the important role that Primary Health Care – PHC has in the current pandemic, besides the fact that most health services in the municipalities of the interior of the state are offered by PHC, we sought to describe the experience of the reorganization of PHC, with emphasis on the actions of Community Health Workers (CHW) of a municipality in the interior of Amazonas. Coari is located in the mesoregion Centro Amazonense, whose access is by river and air, 363 kilometers from the capital, Manaus. Until September 12, 2020, the municipality occupied the second position in the state with the highest number of cases (n=6,990); and third in number of deaths (n=105). It has 223 CHW, integrating 22 family health strategy teams and three expanded Centers of Family Health and Primary Care. In the pandemic, 35 CHW were removed because they were in the risk groups. It’s noteworthy that the CHW of the urban and rural area (including riverside communities) incorporated into their list of activities actions to monitor confirmed and suspected cases, through home visits or remotely (by mobile phone). We highlight the challenges arising from geographical barriers and telephone signal, characteristics of housing (high home density), high prevalence of other common diseases in the region, and deficiency of higher education professionals in rural/riverside units. However, even with the challenges, the CHW have been strategic actors to cope with the pandemic in Coari, acting in the organization of the service and in the continuity of care. Strategies that strengthen PHC, placing it at the center of discussions, prioritizing resources for its financing and recognizing the role of CHW, are essential for the success of coping with COVID-19 in the country, especially in the municipalities of the interior.