The U.S. COVID public health emergency ends this week : Shots
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On January 31, 2020, with six confirmed cases of the new coronavirus in the United States, a group of federal health officials gathered somberly at the lectern in the White House and declared a public health emergency.
“Beginning at 5:00 pm EST on Sunday, February 2, the United States government will implement temporary measures to increase our capabilities to proactively and aggressively detect and contain the coronavirus,” announced at the time the Secretary of Health and Human Services Alex Azar.
More than three years of social disruption, at least 6 million hospitalizations, and 1.1 million deaths in the United States later, that declaration is set to expire this Thursday. Some – including Republicans in Congress who have pushed the Biden administration to end the declaration – say the time has come. Others remain concerned about the virus, and worry that ending the declaration could mean easing measures that would allow the virus to create new disruptions.
“COVID 19 is still a significant problem, but emergencies cannot go on forever,” he observes Dr. Marcus Plescia, chief medical officer of the Association of State and Territory Health Officers. “I think we’re living in a place where we’re treating COVID like the flu.”
Professor Howard Markel, a physician and historian of infectious diseases, is in the still-concerned camp. “History says that all pandemics end,” he says. “But we’ve never had an infectious event like this – ever.”
Concrete changes are coming
In the first months of the pandemic, for a short time, there was remarkable bipartisan unity in the rapid management of federal resources to fight the new virus. This included large investments in vaccine development, new laws that allowed people to remain on public insurance programs without interruption, and free tests and vaccines for all. Those rules allowed for things like drive-through mass vaccination campaigns, where no one asked for your insurance card, and free COVID-19 testing kiosks.
What remains of many of those programs is now being dismantled. Here’s what’s changing and what’s staying the same, for now.
Vaccines and tests are no longer free – now covered by health insurance
The federal government will no longer buy tests or doses of vaccines or treatments to give to the American public for free. The health insurance system will take over – patients will have to go to the doctor, get a prescription, maybe pay a copay for tests and treatments for COVID, just like they do for all other diseases .
It is important to note that vaccines will still be free for virtually everyone. People who are insured are required to get vaccines without cost sharing because of the Affordable Care Act. The White House says people without insurance will still be able to get free COVID-19 vaccines — and treatments like Paxlovid — until 2024.
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The tracking of the COVID data traces back
For people used to relying on data from the Centers for Disease Control and Prevention for guidance on how much virus is circulating in their community, there are big changes ahead. The CDC has announced that it will halt some of its COVID data tracking efforts, including tracking and reporting new infections. It will continue to track COVID-19 hospitalizations and deaths, perform genetic analysis to identify worrisome variants, and monitor the spread through wastewater surveillance.
“We will continue to keep our eye on the ball COVID-19,” Dr. Nirav Shah, the CDC’s deputy chief, told reporters last week. He pointed out recent CDC analysis of the new approach prove that it will be effective.
The changes to how the CDC collects and shares data on COVID-19 “is not surprising at all but is further evidence that these investments have always been temporary and not part of a long-term strategy to be better stewards of -public health data,” Beth Blauer, who helped lead a highly respected COVID data tracker at Johns Hopkins, told NPR.
Access to telemedicine to stay in place
Some popular health care changes brought about by the COVID-19 pandemic will remain in place, at least for a while, including more flexibility with telemedicine, access to controlled substances and hospital-at-home programs. The Drug Enforcement Administration has not said how long it will allow telehealth prescribing of controlled substances, but most of the other measures have been extended at least until the end of next year.
Vaccines, tests and emergency use treatments can continue
Another thing that will not change for now is access to many Vaccines and COVID-19 tests and treatments that have been approved for emergency use by the Food and Drug Administration. That authority comes from different statementwhich is not over yet – the timing of this is in the hands of the Secretary of Health and Human Services Xavier Becerra.
The big Medicaid dissolves
A key provision in one of the first COVID relief laws gave states extra federal funding for Medicaid — the public health insurance program for low-income people — but required states not to exclude no one as long as the public health emergency was in effect.
Liz Adams, a stay-at-home mom in Plant City, Fla., says it was very important for her and her family to know they had Medicaid during the pandemic without having to worry about being certified by the new. “It was there – you knew it was there,” she says. “I didn’t have to worry – I could take my kids to the hospital when they got sick, and I wouldn’t have to stress about it.”
Medicaid has grown to be larger than ever, with estimated 95 million beneficiaries, which is more than 1 in 4 Americans. This provision actually ended shortly before the public health emergency – states can start removing people from April 1.
Although the head of the health agency in charge of Medicaid, Chiquita Brooks-Lasure, has repeatedly said that federal officials are “laser focused” on helping ensure that people who are eligible do not lose the -coverage, recent estimate from the health research group KFF suggested that as many as 24 million people could lose Medicaid, including millions who are still eligible but fall through administrative cracks.
Adams thinks this happened with her children’s Medicaid coverage. Her son, a leukemia survivor, recently had a follow-up biopsy appointment canceled because he was no longer insured. Adams is now working with navigators in the Family Health Care Foundation to help her get coverage back.
The navigators, which help people sign up for free health insurance thanks to federal grants, have extra funds this year to help people who find themselves without Medicaid coverage. (The navigators strongly suggest that Medicaid enrollees make sure their contact information is up to date with their state Medicaid office so they don’t miss a notice about their coverage.)
Will we be prepared for future threats?
The end of America’s public health emergency declaration comes after the World Health Organization made the same determination last week.
In the United States, the bipartisan will to pool resources for the pandemic began to fall apart as the years wore on. The White House and federal health agencies have requested more funding to continue managing COVID-19 and prepare for the next pandemic threat, but congressional Republicans have questioned the need for it.
“One of my biggest worries is that we’re running out of time to prepare for the next pandemic,” Dawn O’Connell, the head of the Strategic Preparedness and Response Administration told senators last week. “It’s the reason why the administration requested $88 billion last year to advance the American pandemic preparedness plan.”
That funding never came, despite the fact that many experts believe the next pandemic could come sooner rather than later.
Pien Huang, Rob Stein, and Yuki Noguchi contributed reporting. Edited by Carmel Wroth.