The United States observed a sharp decline in TB incidence in 2020. Declines were pervasive, observed across almost all states, all age strata, both US- and non-US-born populations, and across all subpopulations disaggregated by race or ethnicity. The COVID-19 pandemic resulted in drastic changes that would be expected to result in short-term declines in TB notifications – but the implications for TB control differ tremendously, providing a unique opportunity to better understand how to control TB in the longer term, irrespective of the pandemic itself. This project will expand a model-based framework (developed in NEEMA/CAMP 1.0) to include mechanisms of change in TB transmission and epidemiology as a result of COVID-19 related disruptions. Using this updated model, the project aims to offer a better understanding of TB transmission and notification patterns following COVID-19 disruptions in CA, FL, NY, and TX, and to project changes in TB trends over the next 20 years in these four target states