Ethics approval and consent to participate.In Belgium and France, there were no specific ethics approval requiredfor the present study. However, the Belgian sentinel network wasapproved as a whole by the Ethical Committees of the Scientific Societyof Flemish GPs and the Catholic University of Louvain (UCL). In France,the sentinel protocol was approved by the French Data ProtectionAgency (CNIL#471393) and the French ethical research committee.In Spain, the protocol was approved by the Health Sentinel NetworkCommittee, according to the Order SAN/620/2016, that regulates theorganization and functioning of the Health Sentinel Network of Castileand León (BOCYL nº 132, 11 July 2016). Consent was obtained from allindividual participants included in the study. An email was sent to thephysicians of the sentinel networks, with information and a link to acceptor decline their participation. ; International audience ; BackgroundThe knowledge of risk perceptions in primary care could help health authorities to manage epidemics.MethodsA European multi-center cross-sectional study was conducted in France, Belgium and Spain to describe the perceptions, the level of anxiety and the feeling of preparedness of primary healthcare physicians towards the COVID-19 infection at the beginning of the pandemic. The factors associated with the feeling of preparedness were studied using multivariate logistic regressions.ResultsA total of 511 physicians participated to the study (response rate: 35.2%). Among them, only 16.3% (n=82) were highly anxious about the pandemic, 50.6% (n=254) had the feeling to have a high level of information, 80.5% (n=409) found the measures taken by the health authorities suitable to limit the spread of COVID-19, and 45.2% (n=229) felt prepared to face the epidemic. Factors associated with feeling prepared were: being a Spanish practitioner (adjusted OR=4.34; 95%CI [2.47; 7.80]), being a man (aOR=2.57, 95%CI [1.69; 3.96]), finding the measures taken by authorities appropriate (aOR=1.72, 95%CI [1.01; 3.00]) and ...