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60, P 0.001). There was no difference in waitlist inactivations between the pre-COVID era and the second COVID-19 era (P = 0.1. Weekly volume was not associated with trends in COVID-19 cases across any era, but was negatively associated with waitlist inactivations due to COVID-19 precautions entering the first COVID-19 era (r = -0.73, P = 0.04) and second COVID-19 era (r = -0.89, P = 0.003). Due to the COVID-19 pandemic, the United States experienced a decrease in lung transplant volume. While overall volume has returned to norm