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The QR code encodes the actual secret data for the TOTP, so backing up the QR code is sufficient.

Screenshot -> Print is one backup method.

Screenshot -> Encrypt -> Save to secure location is another method.

Does that mean you need to take a new screenshot every time you add a new account?

Yes, but for my threat model I avoid 2fa for accounts that don’t really need it so in practice I’m not adding accounts regularly.