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URLhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/
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Meta TitleThe COVID-19 Pandemic Is Over, but the Virus Still Lingers - PMC
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The global health emergency caused by the Coronavirus disease-19 (COVID-19) pandemic officially ended on 11 May 2023. However, COVID-19 is unfortunately still present; its devastating effects have been largely overcome, but they have left an unforgettable impression on us all. The COVID-19 pandemic resulted in human stress with serious and long-term implications for the health, quality of life, and psychological wellness of people worldwide [ 1 ]. On the other side, the COVID-19 pandemic provided an unexpected window of opportunity to see things in a way we had not thought of before. The pandemic has left us with written documents, studies, and evidence of the immense work that doctors, scholars, and all researchers across the globe have carried out to initially understand “what” Severe Acute Respiratory Syndrome Coronavirus-2 was, to define its diagnosis, to find treatments, to discover new vaccines against COVID-19, and finally to provide adequate health systems to meet this global challenge. This was the first global pandemic that the scientific publishing industry had ever faced, and the first of the digital era of communication and internet publishing. During the emergency phase, studies were focused on the field of effectiveness of vaccines and new therapies; subsequently, scholars focused their attention on understanding what the predisposing factors for infections and more serious outcomes are, in addition to previous diseases, in the clinical scenarios of “post-acute sequelae of COVID-19” and/or “long COVID” [ 2 ]. In fact, many important advances have been achieved in the domain of COVID-19, and in particular: (1) the definition of molecular mechanisms that regulate Coronavirus pathogenesis; (2) the use of effective vaccines in real-world settings, especially when the Omicron variant was dominant, with a reduction in mortality; (3) the development of antiviral drugs with additional protection for subjects at higher risk of severe disease; (4) the upgrade of health system organization in several countries; (5) the advances in artificial intelligence, robotics, and automation [ 3 ]. These measures are pivotal in the post-pandemic era, as COVID-19 has now transformed into a persistent but less-deadly presence [ 4 , 5 ]. In conclusion, the COVID-19 pandemic has opened new challenges, but it has also forced humanity to reconsider the impact of health on the quality of life. This particular period of our history has completely changed how we deliver healthcare and the way in which it is possible to conduct research. However, along with the suffering and great challenges, we have the opportunity to make a positive impact on the progress of our society. If we manage to learn from this crisis and from the approach we have used to handle it, many things will change for the better, such as the delivery of high-quality care and the analysis of more accurate data. However, without a global sanitary vision and an adequate scientific policy, both supported by adequate funds, following such a strategy is not possible. Conflicts of Interest The author declares no conflict of interest. Footnotes Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. References 1. DeSalvo K., Hughes B., Bassett M., Benjamin G., Fraser M., Galea S., Gracia J.N. Public Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. NAM Perspect. 2021;2021:1–29. doi: 10.31478/202104c. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 2. Sabitha S., Shobana N., Prakash P., Padmanaban S., Sathiyashree M., Saigeetha S., Chakravarthi S., Uthaman S., Park I.-K., Samrot A.V. A Review of Different Vaccines and Strategies to Combat COVID-19. Vaccines. 2022;10:737. doi: 10.3390/vaccines10050737. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 3. Fang Y., Xing X., Wang S., Walsh S., Yang G. Post-COVID highlights: Challenges and solutions of artificial intelligence techniques for swift identification of COVID-19. Curr. Opin. Struct. Biol. 2024;85:102778. doi: 10.1016/j.sbi.2024.102778. [ DOI ] [ PubMed ] [ Google Scholar ] 4. Mumtaz H., Riaz M.H., Wajid H., Saqib M., Zeeshan M.H., Khan S.E., Chauhan Y.R., Sohail H., Vohra L.I. Current challenges and potential solutions to the use of digital health technologies in evidence generation: A narrative review. Front. Digit. Health. 2023;5:1203945. doi: 10.3389/fdgth.2023.1203945. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 5. Branda F., Abenavoli L., Pierini M., Mazzoli S. Predicting the Spread of SARS-CoV-2 in Italian Regions: The Calabria Case Study, February 2020–March 2022. Diseases. 2022;10:38. doi: 10.3390/diseases10030038. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
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[Skip to main content](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#main-content) ![](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/us_flag.svg) An official website of the United States government Here's how you know Here's how you know ![](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/icon-dot-gov.svg) **Official websites use .gov** A **.gov** website belongs to an official government organization in the United States. ![](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/icon-https.svg) **Secure .gov websites use HTTPS** A **lock** ( Locked padlock icon) or **https://** means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. 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Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: [PMC Disclaimer](https://pmc.ncbi.nlm.nih.gov/about/disclaimer/) \| [PMC Copyright Notice](https://pmc.ncbi.nlm.nih.gov/about/copyright/) ![Diseases logo](https://cdn.ncbi.nlm.nih.gov/pmc/banners/logo-diseases.png) editorial Diseases . 2024 Mar 19;12(3):57. doi: [10\.3390/diseases12030057](https://doi.org/10.3390/diseases12030057) - [Search in PMC](https://pmc.ncbi.nlm.nih.gov/search/?term="Diseases"[jour]) - [Search in PubMed](https://pubmed.ncbi.nlm.nih.gov/?term="Diseases"[jour]) - [View in NLM Catalog](https://www.ncbi.nlm.nih.gov/nlmcatalog?term="Diseases"[Title%20Abbreviation]) - [Add to search](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/?term="Diseases"[jour]) # The COVID-19 Pandemic Is Over, but the Virus Still Lingers [Ludovico Abenavoli](https://pubmed.ncbi.nlm.nih.gov/?term="Abenavoli%20L"[Author]) ### Ludovico Abenavoli 1Department of Health Sciences, University “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; l.abenavoli@unicz.it; Tel.: +39-0961-3694387 Find articles by [Ludovico Abenavoli](https://pubmed.ncbi.nlm.nih.gov/?term="Abenavoli%20L"[Author]) 1 - Author information - Article notes - Copyright and License information 1Department of Health Sciences, University “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; l.abenavoli@unicz.it; Tel.: +39-0961-3694387 Received 2024 Mar 5; Revised 2024 Mar 8; Accepted 2024 Mar 8; Collection date 2024 Mar. © 2024 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (<https://creativecommons.org/licenses/by/4.0/>). [PMC Copyright notice](https://pmc.ncbi.nlm.nih.gov/about/copyright/) PMCID: PMC10969173 PMID: [38534981](https://pubmed.ncbi.nlm.nih.gov/38534981/) *** The global health emergency caused by the Coronavirus disease-19 (COVID-19) pandemic officially ended on 11 May 2023. However, COVID-19 is unfortunately still present; its devastating effects have been largely overcome, but they have left an unforgettable impression on us all. The COVID-19 pandemic resulted in human stress with serious and long-term implications for the health, quality of life, and psychological wellness of people worldwide \[[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B1-diseases-12-00057)\]. On the other side, the COVID-19 pandemic provided an unexpected window of opportunity to see things in a way we had not thought of before. The pandemic has left us with written documents, studies, and evidence of the immense work that doctors, scholars, and all researchers across the globe have carried out to initially understand “what” Severe Acute Respiratory Syndrome Coronavirus-2 was, to define its diagnosis, to find treatments, to discover new vaccines against COVID-19, and finally to provide adequate health systems to meet this global challenge. This was the first global pandemic that the scientific publishing industry had ever faced, and the first of the digital era of communication and internet publishing. During the emergency phase, studies were focused on the field of effectiveness of vaccines and new therapies; subsequently, scholars focused their attention on understanding what the predisposing factors for infections and more serious outcomes are, in addition to previous diseases, in the clinical scenarios of “post-acute sequelae of COVID-19” and/or “long COVID” \[[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B2-diseases-12-00057)\]. In fact, many important advances have been achieved in the domain of COVID-19, and in particular: (1) the definition of molecular mechanisms that regulate Coronavirus pathogenesis; (2) the use of effective vaccines in real-world settings, especially when the Omicron variant was dominant, with a reduction in mortality; (3) the development of antiviral drugs with additional protection for subjects at higher risk of severe disease; (4) the upgrade of health system organization in several countries; (5) the advances in artificial intelligence, robotics, and automation \[[3](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B3-diseases-12-00057)\]. These measures are pivotal in the post-pandemic era, as COVID-19 has now transformed into a persistent but less-deadly presence \[[4](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B4-diseases-12-00057),[5](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B5-diseases-12-00057)\]. In conclusion, the COVID-19 pandemic has opened new challenges, but it has also forced humanity to reconsider the impact of health on the quality of life. This particular period of our history has completely changed how we deliver healthcare and the way in which it is possible to conduct research. However, along with the suffering and great challenges, we have the opportunity to make a positive impact on the progress of our society. If we manage to learn from this crisis and from the approach we have used to handle it, many things will change for the better, such as the delivery of high-quality care and the analysis of more accurate data. However, without a global sanitary vision and an adequate scientific policy, both supported by adequate funds, following such a strategy is not possible. ## Conflicts of Interest The author declares no conflict of interest. ## Footnotes **Disclaimer/Publisher’s Note:** The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. ## References - 1\. DeSalvo K., Hughes B., Bassett M., Benjamin G., Fraser M., Galea S., Gracia J.N. Public Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. NAM Perspect. 2021;2021:1–29. doi: 10.31478/202104c. \[[DOI](https://doi.org/10.31478/202104c)\] \[[PMC free article](https://pmc.ncbi.nlm.nih.gov/articles/PMC8406505/)\] \[[PubMed](https://pubmed.ncbi.nlm.nih.gov/34532688/)\] \[[Google Scholar](https://scholar.google.com/scholar_lookup?journal=NAM%20Perspect.&title=Public%20Health%20COVID-19%20Impact%20Assessment:%20Lessons%20Learned%20and%20Compelling%20Needs&author=K.%20DeSalvo&author=B.%20Hughes&author=M.%20Bassett&author=G.%20Benjamin&author=M.%20Fraser&volume=2021&publication_year=2021&pages=1-29&pmid=34532688&doi=10.31478/202104c&)\] - 2\. Sabitha S., Shobana N., Prakash P., Padmanaban S., Sathiyashree M., Saigeetha S., Chakravarthi S., Uthaman S., Park I.-K., Samrot A.V. A Review of Different Vaccines and Strategies to Combat COVID-19. Vaccines. 2022;10:737. doi: 10.3390/vaccines10050737. \[[DOI](https://doi.org/10.3390/vaccines10050737)\] \[[PMC free article](https://pmc.ncbi.nlm.nih.gov/articles/PMC9145217/)\] \[[PubMed](https://pubmed.ncbi.nlm.nih.gov/35632493/)\] \[[Google Scholar](https://scholar.google.com/scholar_lookup?journal=Vaccines&title=A%20Review%20of%20Different%20Vaccines%20and%20Strategies%20to%20Combat%20COVID-19&author=S.%20Sabitha&author=N.%20Shobana&author=P.%20Prakash&author=S.%20Padmanaban&author=M.%20Sathiyashree&volume=10&publication_year=2022&pages=737&pmid=35632493&doi=10.3390/vaccines10050737&)\] - 3\. Fang Y., Xing X., Wang S., Walsh S., Yang G. Post-COVID highlights: Challenges and solutions of artificial intelligence techniques for swift identification of COVID-19. Curr. Opin. Struct. Biol. 2024;85:102778. doi: 10.1016/j.sbi.2024.102778. \[[DOI](https://doi.org/10.1016/j.sbi.2024.102778)\] \[[PubMed](https://pubmed.ncbi.nlm.nih.gov/38364679/)\] \[[Google Scholar](https://scholar.google.com/scholar_lookup?journal=Curr.%20Opin.%20Struct.%20Biol&title=Post-COVID%20highlights:%20Challenges%20and%20solutions%20of%20artificial%20intelligence%20techniques%20for%20swift%20identification%20of%20COVID-19&author=Y.%20Fang&author=X.%20Xing&author=S.%20Wang&author=S.%20Walsh&author=G.%20Yang&volume=85&publication_year=2024&pages=102778&pmid=38364679&doi=10.1016/j.sbi.2024.102778&)\] - 4\. Mumtaz H., Riaz M.H., Wajid H., Saqib M., Zeeshan M.H., Khan S.E., Chauhan Y.R., Sohail H., Vohra L.I. Current challenges and potential solutions to the use of digital health technologies in evidence generation: A narrative review. Front. Digit. Health. 2023;5:1203945. doi: 10.3389/fdgth.2023.1203945. \[[DOI](https://doi.org/10.3389/fdgth.2023.1203945)\] \[[PMC free article](https://pmc.ncbi.nlm.nih.gov/articles/PMC10568450/)\] \[[PubMed](https://pubmed.ncbi.nlm.nih.gov/37840685/)\] \[[Google Scholar](https://scholar.google.com/scholar_lookup?journal=Front.%20Digit.%20Health&title=Current%20challenges%20and%20potential%20solutions%20to%20the%20use%20of%20digital%20health%20technologies%20in%20evidence%20generation:%20A%20narrative%20review&author=H.%20Mumtaz&author=M.H.%20Riaz&author=H.%20Wajid&author=M.%20Saqib&author=M.H.%20Zeeshan&volume=5&publication_year=2023&pages=1203945&pmid=37840685&doi=10.3389/fdgth.2023.1203945&)\] - 5\. Branda F., Abenavoli L., Pierini M., Mazzoli S. Predicting the Spread of SARS-CoV-2 in Italian Regions: The Calabria Case Study, February 2020–March 2022. Diseases. 2022;10:38. doi: 10.3390/diseases10030038. \[[DOI](https://doi.org/10.3390/diseases10030038)\] \[[PMC free article](https://pmc.ncbi.nlm.nih.gov/articles/PMC9326619/)\] \[[PubMed](https://pubmed.ncbi.nlm.nih.gov/35892732/)\] \[[Google Scholar](https://scholar.google.com/scholar_lookup?journal=Diseases&title=Predicting%20the%20Spread%20of%20SARS-CoV-2%20in%20Italian%20Regions:%20The%20Calabria%20Case%20Study,%20February%202020%E2%80%93March%202022&author=F.%20Branda&author=L.%20Abenavoli&author=M.%20Pierini&author=S.%20Mazzoli&volume=10&publication_year=2022&pages=38&pmid=35892732&doi=10.3390/diseases10030038&)\] *** Articles from Diseases are provided here courtesy of **Multidisciplinary Digital Publishing Institute (MDPI)** ![Close](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/usa-icons/close.svg) ## ACTIONS - [![View on publisher site icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/launch.svg) View on publisher site](https://doi.org/10.3390/diseases12030057) - [![Download PDF icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/file_download.svg) PDF (142.7 KB)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/pdf/diseases-12-00057.pdf) - ![Cite icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/format_quote.svg) Cite - ![Collections icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/action-bookmark-full.svg) ![Collections icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/action-bookmark-empty.svg) Collections - ![Permalink icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/share.svg) Permalink ## PERMALINK ![Copy icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/content_copy.svg) Copy ## RESOURCES ### Similar articles ### Cited by other articles ### Links to NCBI Databases ## Cite ![Close icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/close.svg) - ![Copy icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/content_copy.svg) Copy - [![Download icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/file_download.svg) Download .nbib .nbib](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/ "Download a file for external citation management software") - Format: ## Add to Collections Follow NCBI [NCBI on X (formerly known as Twitter)](https://twitter.com/ncbi) [NCBI on Facebook](https://www.facebook.com/ncbi.nlm) [NCBI on LinkedIn](https://www.linkedin.com/company/ncbinlm) [NCBI on GitHub](https://github.com/ncbi) [NCBI RSS feed](https://ncbiinsights.ncbi.nlm.nih.gov/) Connect with NLM [NLM on X (formerly known as Twitter)](https://twitter.com/nlm_nih) [NLM on Facebook](https://www.facebook.com/nationallibraryofmedicine) [NLM on YouTube](https://www.youtube.com/user/NLMNIH) [National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894](https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/%4038.9959508,%0A%20%20%20%20%20%20%20%20%20%20%20%20-77.101021,17z/data%3D!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb%3A0x19156f88b27635b8!8m2!3d38.9959508!%0A%20%20%20%20%20%20%20%20%20%20%20%204d-77.0988323) - [Web Policies](https://www.nlm.nih.gov/web_policies.html) - [FOIA](https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office) - [HHS Vulnerability Disclosure](https://www.hhs.gov/vulnerability-disclosure-policy/index.html) - [Help](https://support.nlm.nih.gov/) - [Accessibility](https://www.nlm.nih.gov/accessibility.html) - [Careers](https://www.nlm.nih.gov/careers/careers.html) - [NLM](https://www.nlm.nih.gov/) - [NIH](https://www.nih.gov/) - [HHS](https://www.hhs.gov/) - [USA.gov](https://www.usa.gov/) Back to Top ![back to top icon](https://cdn.ncbi.nlm.nih.gov/pmc/pd-medc-pmc-cloudpmc-viewer/production/8a2a0396/var/data/static/img/arrow_upward.svg)
Readable Markdown
*** The global health emergency caused by the Coronavirus disease-19 (COVID-19) pandemic officially ended on 11 May 2023. However, COVID-19 is unfortunately still present; its devastating effects have been largely overcome, but they have left an unforgettable impression on us all. The COVID-19 pandemic resulted in human stress with serious and long-term implications for the health, quality of life, and psychological wellness of people worldwide \[[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B1-diseases-12-00057)\]. On the other side, the COVID-19 pandemic provided an unexpected window of opportunity to see things in a way we had not thought of before. The pandemic has left us with written documents, studies, and evidence of the immense work that doctors, scholars, and all researchers across the globe have carried out to initially understand “what” Severe Acute Respiratory Syndrome Coronavirus-2 was, to define its diagnosis, to find treatments, to discover new vaccines against COVID-19, and finally to provide adequate health systems to meet this global challenge. This was the first global pandemic that the scientific publishing industry had ever faced, and the first of the digital era of communication and internet publishing. During the emergency phase, studies were focused on the field of effectiveness of vaccines and new therapies; subsequently, scholars focused their attention on understanding what the predisposing factors for infections and more serious outcomes are, in addition to previous diseases, in the clinical scenarios of “post-acute sequelae of COVID-19” and/or “long COVID” \[[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B2-diseases-12-00057)\]. In fact, many important advances have been achieved in the domain of COVID-19, and in particular: (1) the definition of molecular mechanisms that regulate Coronavirus pathogenesis; (2) the use of effective vaccines in real-world settings, especially when the Omicron variant was dominant, with a reduction in mortality; (3) the development of antiviral drugs with additional protection for subjects at higher risk of severe disease; (4) the upgrade of health system organization in several countries; (5) the advances in artificial intelligence, robotics, and automation \[[3](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B3-diseases-12-00057)\]. These measures are pivotal in the post-pandemic era, as COVID-19 has now transformed into a persistent but less-deadly presence \[[4](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B4-diseases-12-00057),[5](https://pmc.ncbi.nlm.nih.gov/articles/PMC10969173/#B5-diseases-12-00057)\]. In conclusion, the COVID-19 pandemic has opened new challenges, but it has also forced humanity to reconsider the impact of health on the quality of life. This particular period of our history has completely changed how we deliver healthcare and the way in which it is possible to conduct research. However, along with the suffering and great challenges, we have the opportunity to make a positive impact on the progress of our society. If we manage to learn from this crisis and from the approach we have used to handle it, many things will change for the better, such as the delivery of high-quality care and the analysis of more accurate data. However, without a global sanitary vision and an adequate scientific policy, both supported by adequate funds, following such a strategy is not possible. ## Conflicts of Interest The author declares no conflict of interest. ## Footnotes **Disclaimer/Publisher’s Note:** The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. ## References - 1\. DeSalvo K., Hughes B., Bassett M., Benjamin G., Fraser M., Galea S., Gracia J.N. Public Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. 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