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What happens at the end of the Covid-19 public health emergency?


The World Health Organization ended the global public health emergency on May 5. The US public health emergency ends on May 11, and Dr. Rochelle Walensky is stepping down as director of the Centers for Disease Control and Prevention.

Hospitalizations and deaths from Covid-19 are now relatively low, thanks in part to vaccines, tests and treatments that have strengthened our defenses. However, the virus is not going away. The country continues to report hundreds of Covid-19-related deaths per day. Many others are still dealing with lingering health consequences.

“While next week marks the end of the public health emergency, it is not the end of Covid-19,” said Nirav Shah, deputy director at the CDC. “We will continue to monitor the Covid-19 ball.”

Here’s what you need to know about the current state of the pandemic and what will happen when the global and US emergencies end:

What does the end of the global public health emergency mean?

The end of the international public health emergency is largely symbolic, as the WHO statement does not change government funding or services.

It is a milestone in the fight against Covid-19 and WHO officials said declining mortality, reduced pressure on health systems and rising population immunity mean countries can now emerge from crisis mode.

“This news means it is time for countries to move from a state of emergency to managing Covid-19 alongside other infectious diseases,” said WHO Director-General Tedros Adhanom Ghebreyesus.

Is the Covid-19 pandemic over?

The global health emergency is over, but that doesn’t mean Covid-19 is no longer a threat to health, Dr Tedros said. Covid-19 has not entered a pattern predictable enough for the pandemic to be over, some public health experts said.

“There won’t be a moment when the WHO comes along and says the pandemic is over,” said Dr. Michael Ryan, Executive Director of the WHO Health Emergencies Program. “The good news is that the global health emergency is over.”

There are no official rules or mechanisms for when a pandemic starts or ends. The term has been applied to only a few diseases throughout history.

“In practice, it is generally said that pandemics have ended when they reach a state of stability, when they are no longer a dominant concern for the public and for policymakers,” said Dr. Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco. “That’s all very fuzzy; it’s kind of a full judgement.”

What is an Endemic Disease? Will Covid-19 become endemic?

A disease is endemic when it exists at a baseline, predictable level and is a constant presence in a population, according to the Centers for Disease Control and Prevention.

The Covid-19 pandemic will eventually fall into a predictable, more stable pattern and become endemic over time, most infectious disease epidemiologists agree. Determining exactly when a pandemic will end is often done in hindsight, public health experts say.

“We’re in the transition to endemic, but not quite there yet,” said Dr. Mark Levine, health commissioner for the Vermont Department of Health. “I would like to go through a summer without a Covid spike.”

What the spread of Covid-19 could look like in the long run also depends on the level of disease that governments and societies are willing to tolerate and the actions they are willing to take, public health experts have said . The end of a pandemic is social and political as well as epidemiological.

What will change when the US public health emergency ends?

As of May 11, the CDC no longer has the authority to require states to report certain Covid-19 data, and data sharing is likely to get worse, public health experts said. In many cases, insurers no longer have to provide full coverage for Covid-19 tests.

“It’s not clear whether health plans will cover home testing,” said Dr. Jennifer Kates, director of global health and HIV policy at the Kaiser Family Foundation. “Even for tests that aren’t home tests, like PCR, people can have cost sharing.”

People are also being unenrolled from Medicaid, after a provision related to the public health emergency that kept people enrolled continuously was cut. Up to 15 million Americans, including seven million children, are at risk of losing coverage as a result, said Dr. Michelle Taylor, director of the Shelby County Health Department in Tennessee.

Is there anywhere else I can get Covid-19 tests, vaccines and treatments for free?

Yes, Covid-19 vaccines and some treatments are still free until government supplies run out. After that, insurance will cover at least some of those costs, and the Biden administration has set up a safety net for those without insurance to access pharmacies and health centers.

The federal government is still sending some vaccines and home test kits to some health departments, according to Chrissie Juliano, executive director of Big Cities Health Coalition, an advocacy group for city health department officials.

Some local health departments also have their own programs, and people can still order free home tests from the federal government if they haven’t already reached the family limit.

What happens to Covid-19 data at the end of the public health emergency?

As of May 11, the federal government no longer has the authority to require states to submit certain Covid-19 data. The CDC is working on voluntary data use agreements with individual states.

Because of these regulatory changes, the CDC said it would stop posting aggregated case data and the calculated Covid-19 community levels. Covid-19 death data on its website will now come from preliminary death certificate records, rather than from state and local health departments.

The CDC will continue to rely on data from hospitals, genomic sequencing, some labs and wastewater testing to detect the virus, said Dr. Shah of the CDC. Covid-19 data will still be better than what is available for other respiratory pathogens, including flu and RSV, he said.

“We will still be able to see it snowing even though we are no longer counting every snowflake,” said Dr. Shah.

What is the average number of US cases and deaths now?

The U.S. reported about 77,000 cases in the week ending May 3, with about 1,110 Covid-19-related deaths that week, according to data from the CDC.

Covid-19 hospitalizations and deaths are approaching new lows after a winter with a milder spread compared to previous winter highs.

The current number of cases is also a major undercount, in part because of the widespread use of rapid at-home Covid-19 tests that often cannot be tracked by public health officials. Data reporting is also more patchy, as some states have scaled back reporting.

—Denise Roland contributed to this article.

Joanna Swanson

Joanna Swanson is Europe correspondent at the Thomson Reuters Foundation based in Brussels covering politics, culture, business, climate change, society, economies and inclusive tech. With specific focus in breaking news, she has covered some of the world's most significant stories.