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1. Cultivating community-based participatory research (CBPR) to respond to the COVID-19 pandemic: an illustrative example of partnership and topic prioritization in the food services industry

   https://doi.org/10.1186/s12889-023-16787-1  

   Hoerger, Michael; Kim, Seowoo; Mossman, Brenna; Alonzi, Sarah; Xu, Kenneth; Coward, John C; Whalen, Kathleen; Nauman, Elizabeth; Miller, Jonice; De_La_Cerda, Tracey; et al (December 2023, BMC Public Health)

   Abstract BackgroundAs an illustrative example of COVID-19 pandemic community-based participatory research (CBPR), we describe a community-academic partnership to prioritize future research most important to people experiencing high occupational exposure to COVID-19 – food service workers. Food service workers face key challenges surrounding (1) health and safety precautions, (2) stress and mental health, and (3) the long-term pandemic impact. MethodUsing CBPR methodologies, academic scientists partnered with community stakeholders to develop the research aims, methods, and measures, and interpret and disseminate results. We conducted a survey, three focus groups, and a rapid qualitative assessment to understand the three areas of concern and prioritize future research. ResultsThe survey showed that food service employers mainly supported basic droplet protections (soap, hand sanitizer, gloves), rather than comprehensive airborne protections (high-quality masks, air quality monitoring, air cleaning). Food service workers faced challenging decisions surrounding isolation, quarantine, testing, masking, vaccines, and in-home transmission, described anxiety, depression, and substance use as top mental health concerns, and described long-term physical and financial concerns. Focus groups provided qualitative examples of concerns experienced by food service workers and narrowed topic prioritization. The rapid qualitative assessment identified key needs and opportunities, with help reducing in-home COVID-19 transmission identified as a top priority. COVID-19 mitigation scientists offered recommendations for reducing in-home transmission. ConclusionsThe COVID-19 pandemic has forced food service workers to experience complex decisions about health and safety, stress and mental health concerns, and longer-term concerns. Challenging health decisions included attempting to avoid an airborne infectious illness when employers were mainly only concerned with droplet precautions and trying to decide protocols for testing and isolation without clear guidance, free tests, or paid sick leave. Key mental health concerns were anxiety, depression, and substance use. Longer-term challenges included Long COVID, lack of mental healthcare access, and financial instability. Food service workers suggest the need for more research aimed at reducing in-home COVID-19 transmission and supporting long-term mental health, physical health, and financial concerns. This research provides an illustrative example of how to cultivate community-based partnerships to respond to immediate and critical issues affecting populations most burdened by public health crises. 

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2. Global excess tuberculosis mortality during COVID-19: a country-level modeling study of policy and development correlates

   https://doi.org/10.1186/s12889-025-24858-8  

   Karami, Hamed; Mamelund, Svenn-Erik; Smirnova, Alexandra; Chowell, Gerardo (October 2025, BMC Public Health)

   Abstract BackgroundThe COVID-19 pandemic disrupted global tuberculosis (TB) control efforts, leading to a surge in TB-related excess mortality, particularly in low- and middle-income countries. Pandemic mitigation measures, such as lockdowns, reallocation of healthcare resources, and reduced access to diagnosis and treatment, contributed to delayed TB care and disease progression. Quantifying this collateral damage is crucial to bolstering health system resilience. MethodsWe estimated country-level excess TB mortality between 2020 and 2023 using annual TB mortality data reported by the World Health Organization (WHO). Our approach leverages the SubEpiPredict toolbox of the ensemble n-sub-epidemic modeling framework, calibrated to pre-pandemic trends (2010–2019) to forecast expected TB deaths in the absence of COVID-19 disruptions. We selected the best-fitting model based on AICc and compared projected and reported deaths to quantify excess mortality, incorporating both normal and Poisson error structures. We further examined associations between excess TB mortality and country-level indicators, including the COVID-19 Stringency Index, Global Health Security (GHS) Index, and Socio-demographic Index (SDI). It is also noteworthy that for each estimate of excess TB deaths, we provide an associated uncertainty. ResultsOur global estimate of 755,876 excess TB deaths (95%CI: 591,099 to 965,015) aligns closely with the WHO estimate of approximately 700,000 excess deaths. Therefore, it can be estimated a global relative excess mortality of 12.8% (95%CI: 11.6% to 14.2%), compared to the WHO estimate of 14.6% (95% CI: 5.9% to 26.7%). We found substantial geographic heterogeneity, with the highest TB excess mortality rates observed in southern Africa, South Asia, and parts of South America. Countries with high GHS or SDI scores did not necessarily exhibit lower excess TB mortality, suggesting that pandemic-specific disruptions and competing priorities may have overridden structural advantages. Weak-to-moderate correlations were observed between excess mortality and pandemic stringency, peaking in 2021 and waning by 2022, possibly reflecting health system adaptation. ConclusionThis study presents a systematic, model-based analysis of global excess TB mortality during the COVID-19 pandemic, emphasizing disparities in pandemic response impacts across countries. The findings highlight the need for integrated and resilient public health systems capable of maintaining essential services amid global crises. Our methodology can support real-time monitoring of collateral effects of pandemics on endemic diseases and guide strategic investments in TB surveillance and care continuity. 

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3. Mental health during the COVID-19 pandemic: Impacts of disease, social isolation, and financial stressors

   https://doi.org/10.1371/journal.pone.0277562  

   Kraut, Robert E.; Li, Han; Zhu, Haiyi (November 2022, PLOS ONE)

   Nabi, Mohammad Hayatun (Ed.)

   BackgroundAlthough research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens. AimsThe current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress. MethodsWe combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents’ behavior and fears. ResultsCounty-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people’s concerns about their household’s finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation. ConclusionThis research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress. 

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4. Influence of Lived Experiences on Public Responses to Future Diseases via (De)Sensitization of Concern

   https://doi.org/10.1017/dmp.2022.240  

   Pritchard, Alexander J; Silk, Matthew J; Fefferman, Nina H (January 2023, Disaster Medicine and Public Health Preparedness)

   Abstract Objectives:Public responses to a future novel disease might be influenced by a subset of individuals who are either sensitized or desensitized to concern-generating processes through their lived experiences during the coronavirus disease 2019 (COVID-19) pandemic. Such influences may be critical for shaping public health messaging during the next emerging threat. Methods:This study explored the potential outcomes of the influence of lived experiences by using a dynamic multiplex network model to simulate a COVID-19 outbreak in a population of 2000 individuals, connected by means of disease and communication layers. Then a new disease was introduced, and a subset of individuals (50% or 100% of hospitalized during the COVID-19 outbreak) was assumed to be either sensitized or desensitized to concern-generating processes relative to the general population, which alters their adoption of non-pharmaceutical interventions (social distancing). Results:Altered perceptions and behaviors from lived experiences with COVID-19 did not necessarily result in a strong mitigating effect for the novel outbreak. When public disease response is already strong or sensitization is assumed to be a robust effect, then a sensitized subset may enhance public mitigation of an outbreak through social distancing. Conclusions:In preparing for future outbreaks, assuming an experienced and disease-aware public may compromise effective design of effective public health messaging and mitigative action. 

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5. SARS-CoV-2 Is Not Special, but the Pandemic Is: The Ecology, Evolution, Policy, and Future of the Deadliest Pandemic in Living Memory

   https://doi.org/10.1146/annurev-anthro-041420-100047  

   Brinkworth, Jessica F.; Rusen, Rachel M. (October 2022, Annual Review of Anthropology)

   The COVID-19 pandemic is extraordinary, but many ordinary events have contributed to its becoming and persistence. Here, we argue that the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, which has radically altered day-to-day life for people across the globe, was an inevitability of contemporary human ecology, presaged by spillovers past. We show the ways in which the emergence of this virus reiterates other infectious disease crises, from its origin via habitat encroachment and animal use by humans to its evolution of troublesome features, and we spotlight a long-running crisis of inequitable infectious disease incidence and death. We conclude by describing aspects of SARS-CoV-2 and the COVID-19 pandemic that present opportunities for disease control: spaces for intervention in infection and recovery that reduce transmission and impact. There are no more “before times”; therefore, we encourage embracing a future using old mitigation tactics and government support for ongoing disease control. 

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