Greater Mortality Research Articles

Epidemiology of COVID-19 in Berlin-Neukölln nursing homes

BackgroundThe COVID-19 pandemic has affected various urban population groups in different ways. Earlier studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disproportionally impacts nursing home residents by increasing morbidity and mortality following viral exposure. However, little is known about the epidemiology of this disease in detail. Therefore, the objective of this study is to analyze the development of the COVID-19 pandemic in 14 nursing homes across Berlin-Neukölln, Germany, during pandemic waves 1 to 5 (Feb 2020 - May 2022). MethodsReporting data to the Neukölln Department of Public Health on COVID-19 cases in connection with nursing homes were extracted from the SORMAS database. The case fatality rates (CFRs) and odds ratios (ORs) of demographic parameters, prevalent variants of concern (VOCs) and vaccine availability were calculated. In addition, the temporal course in waves 1–5 in Neukölln and the relevant government measures were examined. ResultsData collected from nursing homes providing age-dependent physical care revealed that 1.9 % of the total 108,600 cases registered in Berlin-Neukölln during the study period were related one of the 14 facilities. Compared to the general population in Neukölln, nursing homes exhibited a 20-fold increase in the CFR. Notably, nursing homes with higher bed capacities displayed a greater CFR than did smaller nursing homes. Similarly, elderly residents living in nursing homes faced a much greater mortality rate than did their counterparts living outside of medical settings (OR = 3.5). The original wild-type SARS-CoV-2 strain had the most severe direct impact, with a CFR of 16.7 %, compared to the alpha (CFR = 6.9 %), delta (CFR = 10.2 %) and omicron (CFR = 2.8 %) variants in nursing homes. Interestingly, the number of infections increased following vaccination campaigns, but this trend was accompanied by a decrease in the number of deaths from 2.6 to 1.1 per week. As a result, the CFR significantly decreased from 18.4 to 5.5, while still exceeding the mean CFR compared to that of the general population of Neukölln. ConclusionsOur findings reveal the changing patterns of outbreak frequency and severity across the five pandemic waves. They highlight the crucial role of rapid vaccination programs for residents, staff, visitors, and third-party services in safeguarding nursing homes. Additionally, improvements in containment and cluster strategies are essential in prevaccination scenarios to prevent future infection traps for elderly individuals in long-term care facilities. The presented data highlight the importance of tailored protection measures for one of the most vulnerable populations in our society.

Severity, mortality, and incidence of venous thromboembolism in COVID-19 patients

BackgroundCOVID-19 is a global pandemic that negatively affected the world economy and the health care resources. It is associated with great health impact, mortality, and long-term sequelae.MethodsHistory taking computed tomography of the chest and laboratory investigations including complete blood count, liver and kidney function tests, serum ferritin, C-reactive protein, and D-dimer were done.ResultsA total of 246 hospitalized COVID-19 patients were enrolled. Male predominance (67.1% of the total study population) was observed. The mean age was 57.26 ± 14.08 years. Moderate cases comprised 63.8% of the total study population, 22.4% were severe cases, and 13.8% were critical cases. The mortality rate was 8.13% and 6.1% developed venous thromboembolism.ConclusionAge, smoking, and the presence of previous pulmonary disease were among the most important factors affecting COVID-19 severity. The severity of the disease greatly influences the incidence of venous thromboembolism and the outcome of the disease.

Airborne Toxicity in Don DeLillo’s White Noise

Abstract In the wake of the COVID-19 pandemic, people across the world came to realize the significant relationship between air and human health. This pandemic, which changed the course of many lives, demonstrated how air serves as a transmitter of viruses. However, this quality of air is not new, with air acting as a significant tool in transmitting diseases, pollution, and even death. It is crucial to understand that airborne diseases include but are not limited to epidemics or pandemics such as the black death, influenza, or COVID-19. Since the Chernobyl disaster, it is perceived that the previously feared disasters were replaced by new and human-made hazards such as toxicity and radioactivity. Environmental disasters such as the Bhopal disaster, Donora Smog, and the Chernobyl disaster emphasize the impact of toxic chemicals on humans and more-than-human lives. These disasters show that toxic substances that threaten the lives of all living things imperceptibly seep into the soil, water, and air, causing harm to ecosystems, and entering into human and more-than-human bodies. Exposure to toxicity and radioactivity can happen in the blink of an eye, transmitted through the air we breathe. Don DeLillo’s novel White Noise presents a significant example of toxicity through its striking portrayal of an airborne toxic event. This event, the appearance of a cloud of the fictional chemical Nyodene D., presents an environmental crisis through which relationships between air and environments can be explored. Similar to the issues and reflections experienced after the emergence of the COVID-19 pandemic, the characters in White Noise experience chaos, uncertainty, and fear following the abrupt occurrence of an airborne toxic event.

Hepsin as a potential therapeutic target for alleviating acetaminophen-induced hepatotoxicity via gap-junction regulation and oxidative stress modulation

Acetaminophen (APAP) overdose is a leading cause of drug-induced liver damage, highlighting the limitations of current emergency treatments that primarily involve administering the glutathione precursor N-acetylcysteine and supportive therapy. This study highlights the essential protective role of the type II transmembrane serine protease (TTSP), hepsin, in mitigating acetaminophen-induced liver injury, particularly through its regulation of gap junction (GJ) abundance in response to reactive oxygen stress in the liver. We previously reported that reduced levels of activated hepatocyte growth factor and the c-Met receptor tyrosine kinase—both of which are vital for maintaining cellular redox balance—combined with increased expression of GJ proteins in hepsin-deficient mice. Here, we show that hepsin deficiency in mice exacerbates acetaminophen toxicity compared to wild-type mice, leading to more severe liver pathology, elevated oxidative stress, and greater mortality within 6 h after exposure. Administering hepsin had a protective effect in both mouse models, reducing hepatotoxicity by modulating GJ abundance. Additionally, transcriptome analysis and a functional GJ inhibitor have highlighted hepsin's mechanism for managing oxidative stress. Combining hepsin with relatively low doses of N-acetylcysteine had a synergistic effect that was more efficacious than high-dose N-acetylcysteine alone. Our results illustrate the crucial role of hepsin in modulating the abundance of hepatic GJs and reducing oxidative stress, thereby offering early protection against acetaminophen-induced hepatotoxicity and a new, combination approach. Emerging as a promising therapeutic target, hepsin holds potential for combination therapy with N-acetylcysteine, paving the way for novel approaches in managing drug-induced liver injury.Graphical 1. Hepsin−/− mice exhibit exacerbated APAP toxicity, resulting in more severe liver damage, elevated oxidative stress, and higher mortality.2. Hepsin is crucial in protecting against APAP-induced liver injury by regulating gap junctions and reducing oxidative stress.3. Combining hepsin with low doses of N-acetylcysteine provides greater protection against APAP-induced hepatotoxicity than high-dose NAC alone.

Multisystem inflammatory syndrome in adults hospitalizations in the United States; evaluating patient characteristics, COVID-19 associations, and mortality.

Multisystem inflammatory syndrome in adults (MIS-A) is thought to be closely linked with COVID-19 infection. This study aims to elucidate the demographics and clinical characteristics of MIS-A, aiding in timely diagnosis and management. Utilizing the National Inpatient Sample (NIS) database (2021), patients were stratified into MIS-A and non-MIS-A groups. Baseline characteristics and comorbidities, the association with COVID-19, post-COVID-19 syndrome, and personal history of COVID-19, as well as impact on mortality were studied. We identified 2,730 adults with MIS-A. MIS-A was linked with active COVID-19 infection (aOR = 27.436, p < 0.001), post-COVID-19 syndrome (aOR = 32.766, p < 0.001), personal history of COVID-19 (aOR = 2.963, p < 0.001), and an increased mortality (aOR = 3.743, p < 0.001). Using data adjusted for confounding variables, MIS-A was found to be associated with active and past COVID-19, and a greater mortality rate when compared to non-MIS-A patients.

Analysis of ballistic trajectories and its association with clinical outcomes in civilian penetrating brain injury

PurposeCivilian penetrating brain injuries (PBI) caused by firearms are a medical emergency with high rates of morbidity and mortality. The aim of this study was to evaluate the association between trajectory vectors in CT brain angiography and clinical outcomes in patients with civilian gunshots.MethodsThis is a retrospective analytical cross-sectional study that includes patients over 15 years of age with PBI due to firearms, admitted from January 2019 to December 2021 at a University Hospital in Cali, Colombia. A brain CT with angio-CT was performed the first day of admission. An XYZ coordinate system centered on the Turk’s saddle was developed. Trajectories of projectiles were plotted and compared to a patient 0 in a 3D-Slicer software. A bivariate analysis of the clinical and geometric characteristics of the trajectory was performed. Primary outcomes include mortality and disability at 6 months.ResultsTwenty-eight patients with a mean age of 27.39 ± 11.66 years were included. The vectors of non-survivors show a trend, crossing at a specific area. This area was designated as a “potential lethal zone” and inside this area, injuries around 25.3 mm from the circle of Willis, were associated with greater mortality (p < 0.005).ConclusionsIn our study PBI avoiding the ventricular system, brain stem, dorsum sellae and the circle of Willis were associated with more survivability. A “potential lethal zone” was detected and associated with poor outcome after civilian PBI due to firearms. A better evaluation of the performance of this “potential lethal zone” in larger studies will be required.

Characteristics of Patients with Spontaneous Coronary Artery Dissection Presenting with Sudden Cardiac Arrest in the United States and the Potential Role of Implantable Cardioverter Defibrillator Therapy.

Spontaneous coronary artery dissection (SCAD) is a disease entity that often occurs in young, healthy women and can cause life-threatening ventricular arrhythmias and sudden cardiac arrest. However, the characteristics and outcomes of SCAD with cardiac arrest are not well characterized. This study investigated the baseline characteristics of SCAD patients with cardiac arrest using the National Inpatient Sample (NIS) database between 2016 and 2020. In addition, we also sought to determine the potential impact that implantable cardioverter defibrillator (ICD) therapy had on morbidity and mortality in SCAD patients presenting with cardiac arrest. Our findings showed that the SCAD with cardiac arrest population had significantly higher comorbidities, including cardiac arrhythmias, congestive heart failure, pulmonary circulation disorders, liver diseases, solid tumors, coagulopathy, fluid disorders, chronic kidney disease (CKD), anemia secondary to deficiency, psychosis, neurological disorders, carotid artery disease, atrial fibrillation, ventricular arrhythmias (ventricular tachycardia (VT), ventricular fibrillation (VF)), and acute myocardial infarction (AMI), compared to the SCAD without cardiac arrest population. Likewise, for SCAD patients who did not have an ICD in place, we found increasing age, fluid and electrolyte disorders, uncomplicated diabetes, neurological disorders, peripheral vascular disease, pulmonary circulatory disorders, cardiac arrhythmias, and congestive heart failure to be associated with greater mortality. SCAD patients with certain comorbidities (e.g., pulmonary diseases, liver diseases, cancers, coagulopathy, and CKD) who presented with AMI or congestive heart failure should be monitored closely for ventricular arrhythmias as they have a higher chance of progressing to cardiac arrest. ICD therapy can be considered for these patients, but data on the success of this treatment option are limited, and more research needs to be performed to determine whether the benefits of this outweigh the risks.

Shaggy aorta: ideal substrate for disaster. Updated review.

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.

Predictors and outcomes of patients with COVID-19 admitted to intensive care units in Pakistan and the development of nosocomial fungal infections: Findings and implications

ObjectivesPatients with COVID-19 admitted to intensive care units (ICUs) typically have many complications and co-morbidities, including secondary bacterial and fungal infections, which increase morbidity and mortality. The first step to address this is to measure the prevalence rates, predictors of fungal infections, and outcomes of patients with COVID-19 admitted to ICUs in Pakistan. MethodsRetrospective review of medical records of patients admitted with COVID-19 to the ICUs of six tertiary care hospitals in Pakistan between March 2020 and June 2023. ResultsA total of 636 patients were included; 68.9% were aged ≥50 years and 62.6% were male. Diabetes mellitus was the commonest co-morbidity (23.7%). A total of 67.8% of patients had severe COVID-19, with 23% critical cases. Antibiotics and antipyretics (all patients) were the most frequently prescribed medicines, along with corticosteroids (72.5%). A total of 63 nosocomial fungal infections developed in 53 patients, with mechanical ventilation and tracheal intubation being significant predictors of secondary fungal infections among patients with COVID-19. The mortality rate was 4.9%, with secondary fungal infections significantly associated with higher mortality. ConclusionsApproximately 8% of patients with COVID-19 admitted to the ICUs of tertiary developed secondary fungal infections associated with greater mortality. The key factors associated with secondary fungal infections need to be carefully monitored to reduce future mortality in these patients. We will continue to monitor the situation.

Plague and Epidemic Disease in the Northern Parts of the Low Countries, 1349-1450

This article reviews what we know about plague and other epidemic diseases in the northern Low Countries before 1450 – the evidence, its limitations, and its implications. I make three observations. First, sources suggest that the Black Death was severe in central inland areas, although we lack conclusive evidence for its impact in the county of Holland. Second, the recurring epidemics occurring in the northern Low Countries were often severe – in certain localities reaching death rates of 20-25 percent. In this respect, Holland was as afflicted as other areas in the Low Countries. Third, while the outbreak of 1439 was a notable exception, most epidemics in the northern Low Countries rarely occurred during or just after grain price spikes, suggesting that food crises were not major drivers of epidemic disease in the period 1349-1450. I support further attempts to obtain empirical evidence for the mortality effects of epidemics in the medieval Low Countries. Ultimately, this information can be the foundation behind insights into other important long-term narratives in social, demographic, and economic history in the region.

The effect of frailty on mortality and functional outcomes in spontaneous intracerebral haemorrhage

IntroductionLimited data in patients with spontaneous intracerebral haemorrhage (SICH) showed that frailty was associated with mortality; however, there was insufficient data on functional outcomes. This study aimed to investigate the effect of frailty on overall mortality and 90-day functional outcomes in SICH. Materials and methodsWe conducted a retrospective study of 1223 patients diagnosed with SICH from January 2014 to December 2020. Frailty was defined as a clinical frailty scale (CFS) score of 4–9. Binary cut-offs were defined using receiver operating curve analysis. 90-day poor functional outcomes (PFO) were defined as modified Rankin Scale (mRS) ≥3, and utility-weighted mRS (UW-mRS) were based on previous validated studies respectively. Regression analyses were conducted to investigate the association between frailty and outcomes. Confounders adjusted for included demographics, cardiovascular risk factors and haematoma characteristics. Results1091 patients met the inclusion criterion. 167 (15.3 %) had 30-day mortality and 730 (66.9 %) had 90-day PFO. Frailty was significantly associated with lower overall survival (HR: 1.54; 95 % CI: 1.11–2.14, p=0.010), 90-day PFO (OR: 1.90; 95 % CI: 1.32–2.74; p<0.001) and poorer UW-mRS (β: −0.06; 95 % CI: (-0.08 to −0.04); p<0.001) even after adjusting for confounders. ConclusionsFrailty was significantly associated with greater mortality and PFO after incident SICH, even after adjusting for a priori confounders. Frail male individuals may be predisposed to poorer outcomes from higher prevalence of cortical atrophy. The use of CFS in younger individuals may aid management by predicting outcomes after incident SICH. Identifying frail individuals with incident SICH could aid in decision-making and the surgical management of SICH.

Global Health Security: Preparing For Future Pandemics

The interconnectedness of modern societies and global mobility has amplified the risk of infectious disease outbreaks escalating into pandemics. Global health security involves proactive efforts to detect, prevent, and respond to emerging health threats before they become widespread crises. Historical pandemics like the Black Death and the Spanish flu highlight the catastrophic consequences of uncontained outbreaks. Despite advancements in healthcare infrastructure, the COVID-19 pandemic has exposed gaps in preparedness, emphasizing the need for enhanced global surveillance, cross-sectoral collaboration, and technological innovations. This paper explores the historical context of pandemics, key components of pandemic preparedness, and the role of global coordination and technology in mitigating future health threats. It calls for stronger international collaboration and investment in healthcare systems to ensure resilience in the face of future pandemics. Keywords: Global health security, pandemic preparedness, pandemic response, historical pandemics, COVID-19, global surveillance.

The Black Death, Girl Power, and the Emergence of the European Marriage Pattern in England

This article critiques the debate over the extent to which labor shortages caused by the Black Death and subsequent epidemics empowered women economically, and whether this had significant implications for overall demographic behavior and long-term economic performance. Some historians have argued that after ca. 1350 women in the North Sea region were drawn into the land and labor markets to a far greater extent than women in other parts of Europe, and in particular into employment as single live-in servants, which led to a rise in the average age of women at first marriage and the proportion of women never marrying. This in turn led to the formation of the European Marriage Pattern (EMP), which is associated with fertility restriction and higher levels of household income. The evidence and arguments underpinning this viewpoint are critically evaluated for England, where by 1600 the EMP was certainly established. The extant sources do not enable us to measure the extent of women's financial gains after the Black Death, or to assess changes in their marital choices. There is no convincing evidence for any rise in the proportion of single female servants in the century after the Black Death or for the existence of the EMP before 1550. Young women did not increase their participation in the land market in order to construct a marriage fund. The article concludes by assessing the possible chronologies of England's transition to the EMP, and by suggesting new lines of enquiry about structural changes in women's work during the sixteenth century.

Demographic History and English Culture

In England, the period from the late Middle Ages through early modernity was bookended by demographic change. On one edge, there was the Black Death and subsequent plague pandemics, which halved the population, reshaping English society in their wake. On the other, there was the demographic transition of the mid-eighteenth century, which reduced death rates and led to modern family structures. Between these two epochal events, demographic trends shaped English customs and values, and were in turn shaped by them. The articles in this special issue draw on cutting-edge demographic research to offer new interpretations of the effects of plague, patterns of marriage, evolving forms of labor, and the morality of crime and charity, among other subjects. Together, they illustrate how quantitative studies in historical demography can shed light on key transformations in culture and society—and vice versa.

Climate, Disease, and Upheaval in the Turkic World in the 14th-15th Centuries

This paper examines the role of climate and disease as a major factor resulting in disruption and upheaval in the Turkic world in the 14th-15th centuries. The first issue the paper addresses is the beginning of the climatic downturn in circa 1280, which will ultimately culminate in the Little Ice Age of the late 15th-18th centuries. The paper cites recent work on the role of climate in the history of Iran. While the author has explored this issue in detail for the history of the Golden Horde, the impact of climate change on Iran in the 14th-15th centuries is a topic which has yet to be investigated adequately by historians. More importantly, climate change is associated with the spread of the Black Death, both in the original point of its spread and especially in the lower Volga River delta. The paper addresses the role of the Black Death (1346- ) as a disruptive factor in the history of the Golden Horde and the Chağatay Khanate. Citing recent research, it also considers legacy of the Black Death in the political, socio-economic, and cultural history of the Il-Khanate and what it meant for the rise of the Aqqoyunlu state. In the Golden Horde, Central Asia, and the Ottoman Empire, the Black Death led to a decline or disappearance in the earlier Islamic Turkic literary language. The earlier archair literary language was replaced by a newer literary language closer to the vernacular or spoken language of the people. There is also evidence of cultural responses to plague written in the new language.

Title

During the fourteenth century, the bubonic plague or Black Death killed more than one third of Europe or 25 million people. Those afflicted died quickly and horribly from an unseen menace, spiking high fevers with suppurative buboes (swellings). Its causative agent is Yersinia pestis, creating recurrent plague cycles from the Bronze Age into modern-day California and Mongolia. Plague remains endemic in Madagascar, Congo, and Peru. This history of medicine review highlights plague events across the centuries. Transmission is by fleas carried on rats, although new theories include via human body lice and infected grain. We discuss symptomatology and treatment options. Pneumonic plague can be weaponized for bioterrorism, highlighting the importance of understanding its clinical syndromes. Carriers of recessive familial Mediterranean fever (FMF) mutations have natural immunity against Y. pestis. During the Black Death, Jews were blamed for the bubonic plague, perhaps because Jews carried FMF mutations and died at lower plague rates than Christians. Blaming minorities for epidemics echoes across history into our current coronavirus pandemic and provides insightful lessons for managing and improving its outcomes

Addressing new aspects of surveillance in late mediaeval England, 1350-1550

The paper addresses new aspects of surveillance in late medieval England. New approaches to the study of the phenomenon are introduced, while a limited study puts some of the author’s suggestions to the test. The study addresses the modus operandi of political and labour surveillance focusing on late medieval English towns. Surveillance was intensified after the Black Death. Institutional and noninstitutional surveillance were part of everyday life, but they were also used by the ruling elites to consolidate their power. Surveillance was endured by the lower social ranks. Nevertheless, evidence suggests that sometimes popular classes resisted surveillance or even used it to their own advantage.

Sex Disparities in Mortality After Endovascular Therapy in Large Core Infarcts

Background In recent large core endovascular therapy (EVT) trials of large vessel occlusion acute ischemic stroke (AIS), treatment was associated with reduced rates of mortality. Because post‐AIS mortality can be influenced by societal and biological factors that differ between women and men, we investigate sex‐based differences in mortality outcomes following EVT in large core AIS. Methods From our prospectively collected multicenter registry across 4 comprehensive stroke centers in the Greater Houston area, we identified patients from 2017 to 2022 with large vessel occlusion AIS and large infarct core. Large infarct core was defined by computed tomography perfusion exceeding 70 mL (by regional cerebral blood flow measurements using automated postprocessing) or computed tomography Alberta Stroke Program Early CT [Computed Tomography] Score&lt;6. The primary outcome of this study was the likelihood of mortality at 90 days, determined through multivariable logistic regression adjusted for EVT, sex, and EVT/sex interaction term. Secondary outcomes included 90‐day disability outcomes and intracerebral hemorrhage. Results Among 190 patients who met inclusion criteria, 50% were female and 45.3% received EVT. Demographic differences between the sexes were largely balanced apart from the older age of presentation for women compared with men (75 versus 67, women versus men; P &lt;0.01). In univariable analysis, women who did not receive EVT had greater mortality (27.4% difference; P &lt;0.001) compared with men, with comparable rates in EVT‐treated cohorts. In multivariable analysis, non‐EVT management was strongly associated with mortality in women compared with men at discharge (odds ratio [OR] 5.81, 95% CI [1.96–17.23]) and 90‐days (OR 6.77, 95% CI [2.09–21.94]). In the secondary analysis, which additionally adjusted the model for age and National Institutes of Health Stroke Scale score, these findings were unchanged. The sex/EVT interaction term showed significant interaction for mortality both at discharge and 90 days ( P &lt;0.01). Conclusion EVT in large core AIS populations may disparately reduce mortality in women compared to men.

Towards a Comprehensive Definition of Pandemics and Strategies for Prevention: A Historical Review and Future Perspectives.

The lack of a universally accepted definition of a pandemic hinders a comprehensive understanding of and effective response to these global health crises. Current definitions often lack quantitative criteria, rendering them vague and limiting their utility. Here, we propose a refined definition that considers the likelihood of susceptible individuals contracting an infectious disease that culminates in widespread global transmission, increased morbidity and mortality, and profound societal, economic, and political consequences. Applying this definition retrospectively, we identify 22 pandemics that occurred between 165 and 2024 AD and were caused by a variety of diseases, including smallpox (Antonine and American), plague (Justinian, Black Death, and Third Plague), cholera (seven pandemics), influenza (two Russian, Spanish, Asian, Hong Kong, and swine), AIDS, and coronaviruses (SARS, MERS, and COVID-19). This work presents a comprehensive analysis of past pandemics caused by both emerging and re-emerging pathogens, along with their epidemiological characteristics, societal impact, and evolution of public health responses. We also highlight the need for proactive measures to reduce the risk of future pandemics. These strategies include prioritizing surveillance of emerging zoonotic pathogens, conserving biodiversity to counter wildlife trafficking, and minimizing the potential for zoonotic spillover events. In addition, interventions such as promoting alternative protein sources, enforcing the closure of live animal markets in biodiversity-rich regions, and fostering global collaboration among diverse stakeholders are critical to preventing future pandemics. Crucially, improving wildlife surveillance systems will require the concerted efforts of local, national and international entities, including laboratories, field researchers, wildlife conservationists, government agencies and other stakeholders. By fostering collaborative networks and establishing robust biorepositories, we can strengthen our collective capacity to detect, monitor, and mitigate the emergence and transmission of zoonotic pathogens.

From Susceptibility to Immunity: The Pandemic of Homicide Grief

Grief from homicide is a global phenomenon. A pattern of structural racism and systemic inequities have shaped Black homicide deaths and have increased the prevalence, susceptibility, spread, and impact of homicide grief for Black communities throughout the global diaspora. A complex interplay of structural vulnerabilities has constituted a worldwide pandemic of homicide grief for Black communities. In this paper, homicide grief is conceptualized as a pandemic. Historical and structural factors that create vulnerability to homicide loss, enhance susceptibility, and facilitate the spread of homicide grief for Black communities is described. A public health framework incorporating prevention, protection, and mitigation strategies is critical to addressing pandemics. A public health framework that incorporates anti-Black racism and other sociopolitical factors that render Black communities disproportionately vulnerable to homicide grief is proposed. Recommendations for reducing the prevalence and interrupting the inequitable spread of homicide grief within Black communities is discussed, including improved access to culturally responsive grief and bereavement services, influencing policy structures, and increasing culturally attuned research efforts.