At the height of the pandemic, Mount Sinai South Nassau hospital in Oceanside, New York, had more than 400 COVID-19 patients, many of whom were very sick. These days, that number is less than five, with no patients in the intensive care unit, according to Dr. Aaron Glatt, the hospital’s epidemiologist.
Those numbers are why Glatt is OK with the federal government’s decision to end the COVID-19 public health emergency. But he also wants the public to understand what that means.
“People have to realize that the benefits that come along with being a public health emergency will go away. And some of the free things that were given out by the government … without concern about financial reimbursement are going to stop. That’s number one,” says Glatt, who also serves as chair of the hospital’s Department of Medicine and chief of infectious diseases.
“Number two is that allowing an emergency situation to occur freed up some of the regulatory restrictions that normally would be present, and those will now go back into play,” he says.
After more than three years, more than 1 million U.S. deaths, and 104.5 million documented infections, the COVID-19 public health emergency comes to an end on May 11.
“I think the biggest implication of it is symbolic,” says Jen Kates, a senior vice president at the Kaiser Family Foundation, a nonprofit that focuses on health care research. “It really is a marker saying, ‘We have this important declaration that has come to an end,’ and it’s symbolizing a move from this emergency state that allowed for a lot of flexibilities to a different place.”
The pandemic reached its peak between July 2020 to July 2021. The highest hospitalization rates were recorded in December 2020 and January 2021.
Americans will feel the end of the COVID-19 emergency in different ways.
“The age of the free COVID test is over,” says Boris Lushniak, a former acting U.S. surgeon general (2013-2014) who now leads the University of Maryland’s School of Public Health. “Things that people will notice, for the most part, is going to be that something that was taken for granted for the last two and a half years in the midst of this pandemic, that we kind of got used to, is now going to become more complicated.”
During the pandemic, the federal government mailed more than 70 million free COVID-19 tests to people’s homes.
Going forward, at-home COVID-19 tests could become more expensive, according to the Kaiser Family Foundation, and people with private insurance and traditional Medicare will no longer be guaranteed to get them for free, athough private insurers might elect to cover the costs of testing.
More than 81% of the U.S. population, almost 268 million people, has had at least one shot of the COVID-19 vaccine.
Vaccines will continue to be free until the stockpiles purchased by the federal government run out, which experts say will probably be by the end of the year. After that, vaccines will continue to be free for most people with public and private insurance. However, the uninsured and the underinsured face losing easy access to COVID-19 vaccines.
“During COVID, we had probably the closest the United States has ever gotten to universal [health] coverage, and we’re going back to where things generally always are — where people who have insurance have access to coverage and services, and people who don’t often are left out,” Kates says.
Medication used to treat COVID-19 also will be free for as long as the federal government supply lasts, which is probably until the fall, according to Kates. Congress has not authorized the funding needed for the federal government to continue to purchase more vaccines and treatments. Private insurance companies were never required to waive costs for COVID-19 treatment.
‘Still need to be vigilant’
The expiring PHE isn’t the only COVID-19-related emergency measure currently in effect. The emergency measures that allow for the use of the COVID-19 vaccines and treatments will continue beyond May 11.
“People need to be reassured that the fact that the public health emergency status is going away is a positive thing, not a negative thing. It doesn’t mean that we’re ignoring this problem, that it’s done with,” Glatt says. “A tremendous amount of public health work will still go on and, in general, the American public is going to be well taken care of going forward regarding COVID.”
Although Lushniak agrees that the PHE should be rescinded, he worries the public will assume that COVID-19 is a thing of the past, even though COVID-19 remained the fourth-leading cause of death in the United States in 2022, behind heart disease, cancer and unintentional injury. Currently, 150 people in the U.S. die from coronavirus disease each day.
“The reality is it’s still not over, and we still need to be vigilant,” Lushniak says. “If you’re not feeling well, stay away from large crowds. This whole idea of disease spread still remains out there. And there are people who are at higher risk around us, so let’s be caring towards others.”
Rules for telemedicine appointments are also changing. During the pandemic emergency, doctors were allowed to prescribe controlled substances during online medical visits. After May 11, people will have to see their doctors in person to get a prescription for those.
The end of the PHE means that states will no longer be required to report COVID-19 infections to federal authorities.
However, the Centers for Disease Control and Prevention usually has individual agreements with each state regarding reporting incidences of infectious diseases, and all hospitals are required to report COVID-19 admissions through April 2024.
Other methods the CDC will use to track future infections include monitoring COVID-19 hospital emergency room visits and by testing wastewater for evidence of the virus that causes COVID-19.
“It’s not like everything is going to go by the wayside,” Lushniak says, “but certainly the data will be less vibrant.”