Methodology for a COVID-19 Recovery Surveillance Study Conducted Through an Academic-State Partnership

Public Health Rep. 2025 Jul 10:333549251323859. doi: 10.1177/00333549251323859. Online ahead of print.

Abstract

Objective: We describe the methodologic approach to rapidly launching a population-based surveillance study in spring 2020 to examine the lasting physical, mental, and economic effect of COVID-19 among adults in Michigan.

Materials and methods: We established a partnership between the University of Michigan School of Public Health and the Michigan Department of Health and Human Services to conduct this study. Using a sequential stratified sampling strategy, we randomly selected adults with polymerase chain reaction-confirmed SARS-CoV-2 infection in the Michigan Disease Surveillance System. From 2020 through 2022, respondents completed detailed surveys on the lasting effect of their COVID-19 illness online in English or by telephone in English, Spanish, or Arabic, reflecting the diverse population in Michigan. We created and used sampling weights to reduce survey nonresponse bias and tested the performance of the weights with a nonresponse bias analysis.

Results: Of all sampled people (n = 17 584), 5521 completed our baseline survey a median of 4.5 months after their COVID-19 onset, for a response rate of 32.1%. Most respondents completed the survey online in every region except Detroit, where 67.1% completed the survey by telephone, highlighting the importance of multimode surveys to increase accessibility and generalizability. Our findings suggest minimal nonresponse bias in the weighted baseline sample.

Practice implications: This unique academic-state partnership resulted in timely and actionable findings related to the lasting effect of COVID-19 that were unavailable elsewhere. While this effort was successful, it was built out of necessity given the limited resources available to local and state health departments to conduct surveillance during the COVID-19 pandemic.

Keywords: communicable diseases; epidemiology; public health; research methods; surveillance.