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COVID-19 pandemic

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Full-Text Articles in COVID-19

Age- And Period-Stratified Associations Between Ambient Fungal Spore Exposure And Asthma Healthcare Utilization In The San Juan Metropolitan Area, Puerto Rico, 2018–2021, Benjamín Bolaños-Rosero, Claudia I. Pereira Moreira, Catalina S. Robles-Rivera, Félix E. Rivera-Mariani Nov 2026

Age- And Period-Stratified Associations Between Ambient Fungal Spore Exposure And Asthma Healthcare Utilization In The San Juan Metropolitan Area, Puerto Rico, 2018–2021, Benjamín Bolaños-Rosero, Claudia I. Pereira Moreira, Catalina S. Robles-Rivera, Félix E. Rivera-Mariani

College of Arts and Sciences Faculty Publications & Presentations

Puerto Ricans experience among the highest asthma morbidity in the United States, and ambient fungal spores are abundant tropical aeroallergens. This ecological time-series study asked whether associations between ambient fungal spores and recorded asthma healthcare utilization in the San Juan Metropolitan Area, Puerto Rico (2018–2021), were stable across two contextual eras (post-Hurricane María recovery, 2018–2019; the COVID-19 pandemic, 2020–2021) and across age groups. Daily Burkard spore counts were linked to 168,578 asthma encounters. Encounter volume (negative binomial rate ratios, RR) and the ED/inpatient encounter fraction (logistic odds ratios, OR) were modeled per 10,000 spores·m−3 using weekly means and 3- and …


The Association Between Prenatal Nicotine Exposure And Postpartum Depression, Reem Ali Sharaf-Alddin Aug 2026

The Association Between Prenatal Nicotine Exposure And Postpartum Depression, Reem Ali Sharaf-Alddin

Health Services Research Dissertations

Postpartum Depression (PPD) is the most common mental health complication of childbirth with 17% of women globally and 13% in the US experience PPD. The pathophysiology of PPD is not yet fully understood, with psycho-social, biological, and environmental factors, interplaying together and predisposing to PPD. One key modifiable risk factor is prenatal exposure to nicotine (PEN) including Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), and Electronic Nicotine Products (ENPs). Several studies investigated the association between prenatal ATS or SHS and PPD, however the findings were inconclusive. There is a lack of studies that assessed the overall PEN, and none of …


Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio May 2026

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …


Lessons Learned In Providing Infant And Early Childhood Mental Health Consultation During The Covid-19 Pandemic, Rashele Wade May 2026

Lessons Learned In Providing Infant And Early Childhood Mental Health Consultation During The Covid-19 Pandemic, Rashele Wade

Journal of Global Awareness

Access to quality childcare is a protective factor from lifelong issues such as school failure, school drop-out, and incarceration. Conversely, preschool suspension and expulsion are significant risk factors. Evidence-based interventions, such as Infant and Early Childhood Mental Health Consultation, aim to reduce and eliminate the incidence of preschool suspensions and expulsions. The COVID-19 pandemic disrupted access to quality childcare for many children across the country and globally. This study utilized a qualitative action research approach and generic qualitative inquiry to examine the research question, “How can we improve Infant and Early Childhood Mental Health Consultation through lessons learned during the …


Practicing Law From Home During The Pandemic: Findings From The University Of Michigan Law School Alumni Survey, David L. Chambers Jan 2026

Practicing Law From Home During The Pandemic: Findings From The University Of Michigan Law School Alumni Survey, David L. Chambers

Bibliography of Research Using UMLS Alumni Survey Data

The University of Michigan Law School, through its Alumni Survey Project, conducts annual surveys of its graduates regarding their current work and their careers as a whole.  In the surveys conducted in 2022, 2023, and 2024, the Project included questions about the impacts of the coronavirus pandemic on various aspects of graduates’ work – their productivity, their co-worker relationships, their client relationships, the balance of their work and family life, and their income – as well as on their work experience overall. 819 graduates who had practiced law fulltime during the pandemic responded to the questions and more than half …


Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson Aug 2025

Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson

Dissertations

This study, conducted several years after the onset of the COVID-19 pandemic, takes a unique approach to investigating the long-term effects of the pandemic-induced disruptions on adolescents during secondary schooling and their academic preparedness in college. The study combined a descriptive qualitative analysis of academic routine data with quantifiable resilience scores, providing a comprehensive understanding of the challenges students faced, their adaptability and resilience, and the overall impact on their education journey into college. This comprehensive descriptive qualitative study utilizes triangulation of quantitative data and qualitative approaches to understand the subject matter thoroughly. The quantitative scores meticulously analyzed resiliency and …


“The Technology We’Ve Been Forced To Use”: Impact Of Online Service Delivery For Kinship Families During The Covid-19 Pandemic, Angela Tobin, Amanda Klein-Cox, Ramona Denby Jul 2025

“The Technology We’Ve Been Forced To Use”: Impact Of Online Service Delivery For Kinship Families During The Covid-19 Pandemic, Angela Tobin, Amanda Klein-Cox, Ramona Denby

Social Work Faculty Research

Purpose: The COVID-19 pandemic rapidly changed the service landscape for both professionals and families. Kinship families, who often navigate multiple systems concurrently with higher service needs, were among the most vulnerable. This study explores kinship caregivers’ and child welfare professionals’ perceptions of changes in service delivery during the pandemic, specifically the sudden shift to virtual platforms.

Materials and Methods: To understand participants’ experiences, focus groups with protocols shaped by initial Delphi Rounds were implemented with 25 kinship caregivers and 34 child welfare professionals from a national sample.

Results: Caregiver and professionals shared themes related to how COVID-19 precautions impacted service …


Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi Jan 2025

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …


Elevated Ambient Temperature Associated With Reduced Infectious Disease Test Positivity Rates: Retrospective Observational Analysis Of Statewide Covid-19 Testing And Weather Across California Counties., Nicholas Wing-Ping Kwok, Joshua Pevnick, Keith Feldman Dec 2024

Elevated Ambient Temperature Associated With Reduced Infectious Disease Test Positivity Rates: Retrospective Observational Analysis Of Statewide Covid-19 Testing And Weather Across California Counties., Nicholas Wing-Ping Kwok, Joshua Pevnick, Keith Feldman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: From medication usage to the time of day, a number of external factors are known to alter human body temperature (BT), even in the absence of underlying pathology. In select cases, clinical guidance already suggests the consideration of clinical and demographic factors when interpreting BT, such as a decreased threshold for fever as age increases. Recent work has indicated factors impacting BT extend to environmental conditions including ambient temperature. However, the effect sizes of these relationships are often small, and it remains unclear if such relationships result in a meaningful impact on real-world health care practices.

OBJECTIVE: Temperature remains …


Employing Expressive Art To Explore Mexican Americans’ Grief Experiences Of Loss Due To Covid-19, Leyla Feize, Varesh Gorabi, Vanessa Garza, Christian Baggett, Cassandra Sarmiento, Margarita Tirado, Angela Maldonado, Melissa Daniels Oct 2024

Employing Expressive Art To Explore Mexican Americans’ Grief Experiences Of Loss Due To Covid-19, Leyla Feize, Varesh Gorabi, Vanessa Garza, Christian Baggett, Cassandra Sarmiento, Margarita Tirado, Angela Maldonado, Melissa Daniels

School of Social Work Faculty Publications

The COVID-19 pandemic changed people’s lives and resulted in tremendous pain, loss and suffering. The Rio Grande Valley (RGV), in the state of Texas in the U.S., was one of the regions with the highest number of infections and deaths during the pandemic. However, individuals’ bereavement in the RGV is rarely addressed. In this qualitative study, a snowball sample of 47 individuals who had lost their loved ones during the years 2020–2021 were interviewed and invited to engage in an art activity. The findings revealed four themes: peculiar funeral, grieving confusion, loved ones’ memories, and connection to self and the …


The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma Aug 2024

The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma

Publications and Research

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries. Methods: Longitudinal study design with 4999 participants (47% male; aged 18–75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US). Measurements: Three web-based surveys at …


Sub-Saharan Africa’S Handling Of Covid-19 Pandemic: Rwanda Versus Tanzania, Luke D. Baumel Apr 2024

Sub-Saharan Africa’S Handling Of Covid-19 Pandemic: Rwanda Versus Tanzania, Luke D. Baumel

Honors Undergraduate Conference

How has the Covid-19 outbreak in early 2020 and the pandemic that followed been handled in Sub-Saharan Africa? What was done well and what was done poorly and why? What are the implications of the way it was handled? These questions and more are answered throughout this paper, using Rwanda as an example of a Sub-Saharan African country who handled it relatively well and neighboring Tanzania as an example of a Sub-Saharan African country that mishandled the outbreak and pandemic. In early 2021, most Sub-Saharan African countries had been afflicted by Covid-19 at a relatively lower rate than many Western …


Changes In Unhealthy Food Consumption Among Vulnerable Elementary-Aged Children In The United States During The Covid-19 Pandemic: A Serial Cross-Sectional Analysis, Nivedhitha Parthasarathy, Nalini Ranjit, Ru-Jye Chuang, Christine Markham, Mike Pomeroy, Jacqueline Noyola, Deepali K Ernest, Shreela V Sharma Jan 2024

Changes In Unhealthy Food Consumption Among Vulnerable Elementary-Aged Children In The United States During The Covid-19 Pandemic: A Serial Cross-Sectional Analysis, Nivedhitha Parthasarathy, Nalini Ranjit, Ru-Jye Chuang, Christine Markham, Mike Pomeroy, Jacqueline Noyola, Deepali K Ernest, Shreela V Sharma

Faculty, Staff and Student Publications

Objective: Several studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic.

Methods: This study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete …


Latinx Social Work Students’ Well-Being Prior To And During The Covid-19 Pandemic, Leyla Feize Nov 2023

Latinx Social Work Students’ Well-Being Prior To And During The Covid-19 Pandemic, Leyla Feize

School of Social Work Faculty Publications

This is a reflection on social work students’ well-being before and during the COVID-19 pandemic. This narrative was indirectly written by the students, as it is their interpretations of their feelings, thoughts, and behaviors derived from drawing their own mandalas daily for one month. It is a comparison of two stories of struggle, hope, and change during two different periods which were close in time, but far in reality.


Parent-Reported Provider Recommendation Of Hpv Vaccination Among Minority Adolescents Before And During The Covid-19 Pandemic: Findings From The National Immunization Survey-Teen, 2019-2021, Chinenye Lynette Ejezie, Paula Cuccaro, Casey Durand, Lara Savas, Ross Shegog Oct 2023

Parent-Reported Provider Recommendation Of Hpv Vaccination Among Minority Adolescents Before And During The Covid-19 Pandemic: Findings From The National Immunization Survey-Teen, 2019-2021, Chinenye Lynette Ejezie, Paula Cuccaro, Casey Durand, Lara Savas, Ross Shegog

Faculty, Staff and Student Publications

Provider recommendation of human papillomavirus (HPV) vaccination among adolescents has steadily improved over the years, however, limited research has been conducted to examine if the COVID-19 pandemic disrupted this positive trend in parent-reported provider recommendation among minority adolescents. Therefore, we conducted the present study to determine if there is an association between the pandemic and parent-reported provider recommendation of HPV vaccine among non-Hispanic black and Hispanic adolescents. We also examined whether any changes in parent-reported provider recommendation in the years 2019, 2020, and 2021 differed by race or ethnicity. Using a cross-sectional design to examine data from the National Immunization …


How Has The Covid-19 Pandemic Transformed The Relevance Of The Traditional College Experience?, Zachary Schueller May 2023

How Has The Covid-19 Pandemic Transformed The Relevance Of The Traditional College Experience?, Zachary Schueller

Political Science Theses and Capstones

Over the past three years, the Covid-19 pandemic has fundamentally altered students’ college experience through its location format and delivery. Research and early interviews suggest that students are now less likely to pursue a four-year traditional college experience than they were before the start of the pandemic. Instead, students are increasingly choosing to pursue other options such as not going to college or learning remotely. Even before the start of the pandemic data shows that college enrollment was already declining. While this data shows the short-term effects of Covid-19 on students there are a number of questions about the long-term …


Differences In American Adolescent Sport Participation During The Covid-19 Pandemic By Learning Mode: A National Survey, Ashleigh M Johnson, Gregory Knell, Timothy J Walker, Emily Kroshus Apr 2023

Differences In American Adolescent Sport Participation During The Covid-19 Pandemic By Learning Mode: A National Survey, Ashleigh M Johnson, Gregory Knell, Timothy J Walker, Emily Kroshus

Faculty, Staff and Student Publications

This study aimed to examine the relation between learning mode with sport participation and compare participation prevalence in different settings by learning mode among United States adolescents during the COVID-19 pandemic. A cross-sectional, national survey was conducted by a market research company (December 2021-January 2022) among parents whose child participated in sports pre-pandemic. Parents were asked about their child's learning mode (in-person, online, hybrid); sports participation (yes/no) during the pandemic; and participation setting (school, community, club/elite). Weighted logistic regression models examined the relation between learning mode with sport participation. Weighted prevalence estimates of participation setting were compared by learning mode. …


Conspiracy Theories Are Not Religions: Scrutinizing Religious Exemptions To The Covid-19 Vaccine, Shirley B. Luk Jan 2023

Conspiracy Theories Are Not Religions: Scrutinizing Religious Exemptions To The Covid-19 Vaccine, Shirley B. Luk

University of San Francisco Law Review

No abstract provided.


California Constitutional Law: The Emergency Police Power, Daniel H. Bromberg Jan 2023

California Constitutional Law: The Emergency Police Power, Daniel H. Bromberg

University of San Francisco Law Review

No abstract provided.


A Pandemic Of Division: Finding Justice At Work In Challenging Times, Catherine L. Fisk Jan 2023

A Pandemic Of Division: Finding Justice At Work In Challenging Times, Catherine L. Fisk

University of San Francisco Law Review

No abstract provided.


Assessing Pandemic Preparedness, Response, And Lessons Learned From The Covid-19 Pandemic In Four South American Countries: Agenda For The Future, Andrea Ramírez Varela, Michael Touchton, J Jaime Miranda, Juliana Mejía Grueso, Rachid Laajaj, Gabriel Carrasquilla, Martha Vives Florez, Ana María Vesga Gaviria, Ana María Ortiz Hoyos, Esteban Orlando Vanegas Duarte, Alejandra Velásquez Morales, Nubia Velasco, Silvia Restrepo Restrepo Jan 2023

Assessing Pandemic Preparedness, Response, And Lessons Learned From The Covid-19 Pandemic In Four South American Countries: Agenda For The Future, Andrea Ramírez Varela, Michael Touchton, J Jaime Miranda, Juliana Mejía Grueso, Rachid Laajaj, Gabriel Carrasquilla, Martha Vives Florez, Ana María Vesga Gaviria, Ana María Ortiz Hoyos, Esteban Orlando Vanegas Duarte, Alejandra Velásquez Morales, Nubia Velasco, Silvia Restrepo Restrepo

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world's hardest hit by the pandemic, accounting for 10.1% of total cases and 20.1% of global deaths.

METHODS: This study explores how pandemic PPR were affected by political, socioeconomic, and health system contexts as well as how PPR may have shaped pandemic outcomes in Argentina, Brazil, Colombia, and Peru. We then identify lessons learned and advance an agenda for improving PPR capacity at regional and national levels. We do this through a …


Containment Measures During The Covid Pandemic: The Role Of Non-Pharmaceutical Health Policies, Michael Funke, Tai-Kuang Ho, Andrew Tsang Jan 2023

Containment Measures During The Covid Pandemic: The Role Of Non-Pharmaceutical Health Policies, Michael Funke, Tai-Kuang Ho, Andrew Tsang

Faculty, Staff and Student Publications

Many countries have imposed a set of non-pharmaceutical health policy interventions in an effort to slow the spread of the COVID-19 pandemic. The objective of this paper is to examine the effects of the interventions, drawing on evidence from the OECD countries. A special feature here is the mechanism that underlies the impact of the containment policies. To this end, a causal mediation analysis decomposing the total effect into a direct and an indirect effect is conducted. The key finding is a dual cause-effect channel. On the one hand, there is a direct effect of the non-pharmaceutical interventions on the …


Workplace Aggression Against Healthcare Workers In A Spanish Healthcare Institution Between 2019 And 2021: The Impact Of The Covid-19 Pandemic, Aitor Díaz, Mireia Utzet, Joan Mirabent, Pilar Diaz, Jose Maria Ramada, Consol Serra, Fernando G Benavides Jan 2023

Workplace Aggression Against Healthcare Workers In A Spanish Healthcare Institution Between 2019 And 2021: The Impact Of The Covid-19 Pandemic, Aitor Díaz, Mireia Utzet, Joan Mirabent, Pilar Diaz, Jose Maria Ramada, Consol Serra, Fernando G Benavides

Faculty, Staff and Student Publications

OBJECTIVES: Describe the incidence of first aggressions among healthcare workers (HCWs) before and during the COVID-19 pandemic in a Spanish healthcare institution, according to workers' socio-occupational characteristics and analyze the impact of the pandemic on it.

METHODS: A cohort involving HCWs who worked in the institution for at least 1 week each year from 1 January 2019 to 31 December 2021. Adjusted relative risks (aRR) were estimated using generalized estimating equations and negative binomial models to calculate the differences in WPA between the different time periods. All analyses were stratified by gender.

RESULTS: Among women, the incidence was 6.8% (6.0; …


Factors Associated With Meeting Physical Activity Guidelines During The Covid-19 Pandemic, Natalia I Heredia, Michael Machiorlatti, Belinda M Reininger, Candace Robledo Nov 2022

Factors Associated With Meeting Physical Activity Guidelines During The Covid-19 Pandemic, Natalia I Heredia, Michael Machiorlatti, Belinda M Reininger, Candace Robledo

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics.

METHODS: Data included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin …


Firpta Repeal: The United States’ Post-Pandemic Economic Solution To Infrastructure Reform, Adam Mazin Jan 2022

Firpta Repeal: The United States’ Post-Pandemic Economic Solution To Infrastructure Reform, Adam Mazin

University of San Francisco Law Review

No abstract provided.


The Economic Sustainability Of Culture In Hawai’I: Tourists’ Willingness To Pay For Hawaiian Cultural Experiences, Gabriella Andrade, Holly Itoga, Catherine Linnes, Jerome Agrusa, Joseph Lema Sep 2021

The Economic Sustainability Of Culture In Hawai’I: Tourists’ Willingness To Pay For Hawaiian Cultural Experiences, Gabriella Andrade, Holly Itoga, Catherine Linnes, Jerome Agrusa, Joseph Lema

Hospitality Faculty Research

Given the current travel restrictions with the COVID-19 pandemic, there is an unprecedented opportunity for Hawai’i to reexamine its current tourism offerings and establish a new approach to support a more authentic, cultural, and sustainable tourism for the U.S. domestic tourist market. As tourists from the continental U.S. are the largest source market for visitors to Hawai’i, the purpose of this study is to examine the trend towards an “authentic cultural” tourism experience and evaluate whether U.S. visitors will be willing to pay for a deeper integration and representation of Hawaiian culture in tourism offerings. The contingent valuation method (CVM) …


“Doing What I Can, But I Got No Magic Wand:” A Snapshot Of Early Childhood Educator Experiences And Efforts To Ensure Quality During The Covid-19 Pandemic, April Crawford, Kelly A Vaughn, Cathy L Guttentag, Cheryl Varghese, Yoonkyung Oh, Tricia A Zucker Jan 2021

“Doing What I Can, But I Got No Magic Wand:” A Snapshot Of Early Childhood Educator Experiences And Efforts To Ensure Quality During The Covid-19 Pandemic, April Crawford, Kelly A Vaughn, Cathy L Guttentag, Cheryl Varghese, Yoonkyung Oh, Tricia A Zucker

Faculty, Staff and Student Publications

The COVID-19 pandemic impacted early childhood programs serving infants, toddlers, and preschoolers in dramatic ways. After temporarily closing, many educators quickly adapted their procedures to ensure children's safety as they reopened to provide childcare for essential workers and then the community at large. This manuscript reports on statewide efforts to continue quality improvement initiatives for early childhood programs amidst the COVID-19 pandemic. We first describe the impacts of the COVID-19 pandemic for over 2000 educators-teachers, administrators, and specialists-who completed surveys in the Spring and Fall of 2020. These survey data come from a statewide system called the Texas Early Childhood …