As COVID-19 emergency ends, US response shifts to ‘peacetime’ mode
WASHINGTON — On Thursday, three years and 100 days after the Trump administration declared the coronavirus a public health emergency, the Biden administration will allow the emergency declaration to expire, ushering in a new era when the government will treat COVID-19 like any other respiratory ailment.
If the coronavirus pandemic was a war, the United States is about to officially enter peacetime.
But interviews with senior federal and state health officials — including the secretary of health and human services and the commissioner of the Food and Drug Administration — make clear that while the United States has greatly improved its capacity to fight COVID-19, it is not fully prepared for a radically different future variant or a new pandemic.
State health officials, tasked with tracking the coronavirus, are burned out, their departments understaffed. President Joe Biden’s coronavirus response team will soon disband. The White House has yet to fulfill Congress’ directive to set up a new pandemic preparedness office, and key officials, including Dr. Ashish K. Jha, the coronavirus response coordinator, and Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, are stepping down or intend to do so.
Jha and other federal health officials have spent months laying the groundwork for the end of the public health emergency, and the Biden administration has set up programs to keep vaccines free for the uninsured and to support medical research into new vaccines and therapies. But the officials say they are operating on a tight budget; Congress has refused to give the administration any new money for the pandemic response.
When asked if the country was prepared for a new pandemic, Dr. Francis Collins, the former director of the National Institutes of Health, simply replied, “No.” Biden’s secretary of health and human services, Xavier Becerra, paused for several seconds before answering the same question.
“It depends on the degree,” Becerra finally said, adding: “We’ve learned a lot from COVID. We’re prepared to deal with COVID — even some of the variants as they come. If it’s something totally different, avian flu, I become a little bit more concerned. If it becomes some kind of biological weapon, you know, that’s another issue altogether.”
The emergency declaration, Jha said, has given the government and the nation’s health care system the flexibility to take extraordinary measures during the crisis, like setting up hospital beds in a parking lot. Jha, who has told colleagues he intends to return to his job as dean of the Brown University School of Public Health, said those kinds of steps were no longer necessary.
But he cautioned that the virus was not going away. More than 1,000 people are still dying of COVID-19 in the United States each week, according to the CDC.
“COVID is going to be with us, but we know how to live with it in a way that need not cause disruption, need not put people in the hospital — or worse,” Jha said. “And we know how to monitor this virus and manage it so that if it takes a turn, if it does something different, we’re ready for that.”
In the immediate term, the end of the emergency declaration will not cause dramatic changes for Americans, though some people could face new costs for coronavirus testing. After Thursday, private insurers will no longer be required to cover up to eight at-home tests per month. Those with Medicare or private insurance may have copays for lab tests.
For now, vaccines will continue to be free because the government has a stockpile of them. When they move to the commercial market later this year, they will remain free for most people with insurance. For the uninsured, the Biden administration plans to spend more than $1 billion on a new program to offer free shots, though questions remain about how the initiative will work.
It is unclear when Paxlovid, the leading antiviral medication for COVID-19, will move to the commercial market. For now, it will also remain free because of the government’s stockpile, though patients may have to pick up part of the cost once the supply is depleted.
Some experts fear that policymakers and elected officials, who have already put COVID-19 in the rearview mirror, will forget about it entirely once the emergency declaration is gone.
“It’s going to be interpreted, I fear, as a ‘mission accomplished’ moment,” said Gary Edson, the president of the COVID Collaborative, a group of experts that has worked to inform the federal response, adding, “As soon as we take that view, we’ve given up all hope, all mobilization for defensive preparedness.”
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