# Systems Thinking, Causal Loop Diagram, and Systems Dynamic in Public Health Challenges: Navigating Long COVID Syndrome and Sense of Smell in LGBTQIA+ Communities

## TL;DR

This paper introduces a systems thinking framework to better understand and address long COVID and its impact on LGBTQIA+ communities, especially regarding sense of smell and mental health.

## Contribution

The paper introduces a novel public health framework called model-based systems thinking (MBST) to address long-term effects of COVID-19 in marginalized communities.

## Key findings

- Long COVID symptoms like anosmia and cognitive deficits overlap with mental health issues in vulnerable populations.
- Systems thinking models can help untangle the complex interactions between socioeconomic factors and health outcomes in LGBTQIA+ communities.
- The paper emphasizes the need for multidisciplinary research and support for marginalized groups affected by long-term COVID-19.

## Abstract

The coronavirus pandemic has profoundly affected global health, economic stability, and environmental sustainability. Despite these challenges, significant gaps in data remain, particularly in effectively assessing and engaging diverse communities such as color, LGBTQIA+ individuals, and low‐income groups. This shortage of comprehensive research limits our capacity to undertake sensitive studies, specifically in dealing with the complexities of long COVID, which some individuals continue to suffer from after their initial recovery.

This review delves into the ongoing repercussions of long‐term COVID‐19, a postinfectious syndrome marked by neurological symptoms such as cognitive deficits and sensory impairments, which may last well beyond the acute phase of the illness. These symptoms frequently overlap with mental health issues (e.g., anxiety and depression), which can aggravate the socioeconomic challenges faced by vulnerable populations, especially within the LGBTQA+ communities.

To tackle these complex interactions, we have introduced a novel public health framework: model‐based systems thinking (MBST), which incorporates System Dynamics and causal loop diagrams (CLD).

The articles were selected on the basis of their discussion of COVID‐19‐associated anosmia, exploration of olfactory dysfunction alongside neurocognitive disorders, and the challenges experienced in LGBQA+ communities. This approach offers a robust framework for dissecting the intricate ties between socioeconomic factors, health outcomes, and the extended recovery trajectories associated with long‐term COVID‐19, with a particular focus on olfactory dysfunction. We also explore strategies to make our models more accessible to healthcare providers and the LGBTQA+ communities, encouraging its broader adoption.

Long COVID's impact on public health and marginalized communities highlights the urgent need for adopting systems thinking models. Additionally, this article calls for a concerted effort from all experts to foster multidisciplinary, team‐based research and implement effective support measures for COVID‐19 survivors across all communities, mainly focusing on the scientific, social, and behavioral challenges LGBTQIA+ and low‐income individuals face.

This graphical abstract illustrates the multifaceted approach to understanding and addressing long COVID‐19, highlighting the integration of natural remedies, diverse medical personnel, and the impacts on public health and LGBTQ+ communities, reflecting the interconnectedness of biological, social, and healthcare dimensions.