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The pandemic of COVID-19 disease has acted like a stress test on every aspect of life, but particularly exposed weaknesses of health systems design and capacity. There have been similar pandemics in the past, and the threat of more frequent future pandemics in the twenty-first century is real. It is therefore important to learn the right lessons with regard to health systems preparedness and resilience. The five design features that this paper discusses are related to the organization of primary care services, planned surge capacity in s