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This has included, for example, implementing infection prevention measures or making <br />ventilation improvements. <br />In particular, state, local, and Tribal governments have mounted significant efforts to <br />safely reopen schools. A key factor in school reopening is the ability to implement COVID-19 <br />mitigation strategies such as providing masks and other hygiene resources, improving air -quality <br />and ventilation, increasing outdoor learning and eating spaces, testing and contact tracing <br />protocols, and a number of other measures.45 For example, one recipient described plans to use <br />SLFRF funds to further invest in school health resources that were critical components of school <br />reopening and reducing the spread of COVID-19 in schools. Those investments include the <br />increasing school nurses and social workers, improved ventilation systems, and other health and <br />safety measures. <br />The need for public health measures to respond to COVID-19 will continue moving <br />forward. This includes the continuation of vaccination campaigns for the general public, booster <br />doses, and children. This also includes monitoring the spread of COVID-19 variants, <br />understanding the impact of these variants, developing approaches to respond, and monitoring <br />global COVID-19 trends. Finally, the long-term health impacts of COVID-19 will continue to <br />require a public health response, including medical services for individuals with "long COVID," <br />and research to understand how COVID-19 impacts future health needs and raises risks for the <br />tens of millions of Americans who have been infected. <br />The COVID-19 pandemic also negatively impacted other areas of public health, <br />particularly mental health and substance use. In January 2021, over 40 percent of American <br />45 This includes implementing mitigation strategies consistent with the Centers for Disease Control and Prevention's <br />(CDC) Guidance for COVID-19 Prevention in K-12 Schools (November 5, 2021), available at <br />https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html. <br />49 <br />