The COVID-19 Public Health Emergency Is Over — Now, What?

As announced in March, the United States ended the COVID-19 public health emergency on May 11th. The World Health Organization declared its public health emergency of international concern (PHEIC) over on May 5th.
“The end to the PHEIC, to be clear, isn’t a declaration that COVID is over—or even that the pandemic is. Both a PHEIC and a pandemic tend to involve the rapid and international spread of a dangerous disease, and the two typically do go hand in hand. But no set-in-stone rules delineate when either starts or ends.” K. J. Wu, PhD (The Atlantic, May 5.)
In this “new normal,” COVID-19 is still with us, but the intensive public health interventions we had come to know have been scaled back. We are left largely to our own devices. Many—perhaps most—people have immunity from vaccines and previous infections. But how safe are we?
K. Jetelina, PhD (Your Local Epidemiologist, May 25): “We survived the end of the public health emergency. Here’s the state of affairs…SARS-CoV-2 is nosediving across all metrics in all regions of the U.S.: hospitalizations, deaths, emergency room departments, and wastewater. Wastewater is still higher than in 2020 and 2021, though.”
M.F. Cortez (Bloomberg Report, May 24): “After more than three years, the global Covid emergency is officially over. Yet it’s still killing at least one person every four minutes and questions on how to deal with the virus remain unanswered, putting vulnerable people and under-vaccinated countries at risk.

A key question is how to handle a virus that’s become less threatening to most but remains wildly dangerous to a slice of the population. That slice is much bigger than many realize: Covid is still a leading killer, the third-biggest in the US last year behind heart disease and cancer. Unlike with other common causes of death such as smoking and traffic accidents that led to safety laws, though, politicians aren’t pushing for ways to reduce the harm, such as mandated vaccinations or masking in closed spaces.”
E. Anthes (New York Times, May 11): “When the Covid-19 public health emergency expires in the United States…the coronavirus will not disappear. But many of the data streams that have helped Americans monitor the virus will go dark. The Centers for Disease Control and Prevention will stop tabulating community levels of Covid-19 and will no longer require certain case information from hospitals or testing data from laboratories.

And as free testing is curtailed, official case counts, which became less reliable as Americans shifted to at-home testing, may drift even further from reality. But experts who want to keep tabs on the virus will still have one valuable option: sewage. People who are infected with the coronavirus shed the pathogen in their stool, whether or not they take a Covid test or seek medical care, enabling officials to track levels of the virus in communities over time and to watch for the emergence of new variants.”
“At a practical level, that means Americans who want to keep close tabs on the COVID situation will see less frequent data updates and with less granularity — making it harder to assess their personal risk as they try to deal with the virus on an individual basis.” A. Vaziri (San Francisco Chronicle, May 16.)
P. Ofitt, MD (Medpage Today, May 19): “I think that this virus, SARS CoV-2 virus, is about to enter the pantheon of winter respiratory viruses, joining influenza, respiratory syncytial virus [RSV], and others.
  • So, do we need to treat it differently if, like these other viruses, it’s going to be causing hundreds of thousands of hospitalizations and tens of thousands of deaths every year like influenza does or RSV does? I think the answer is yes, to some extent.
  • I think if you are in a high-risk group, meaning people over 75, people who have multiple comorbidities, or people who have immune deficits, and you have upper respiratory tract symptoms — congestion, cough, runny nose, fever, chills — I think you should test yourself for COVID. If you’re positive, you should treat yourself with an antiviral.
  • If you’re not in any of those high-risk groups, if you’re a young, relatively healthy person and you have respiratory symptoms, I think you should assume that you have COVID or influenza or respiratory syncytial virus or one of these other viruses, all of which can cause people to suffer and be hospitalized, and treat that accordingly – meaning stay home until you feel better. If you can’t stay home, wear a mask until you feel better.”
Immune-compromised people worry “that the population-level measures they have depended on, such as widespread masking and social distancing, will also fall by the wayside… [Also,] “‘Long COVID,’ … remains one of the least understood challenges of the post-emergency era. Between 10-20% of COVID-19 patients experience these long-term problems… A majority of long COVID sufferers recover but just how long and widespread a problem post-COVID illness will be has plenty of people concerned.” (G. Spitzer, G. Grayson, NPR, May 26.)

Colleagues for many years at our local health system, Barbara Hemmendinger, MSS, a retired family medicine educator, and Michael Heyd, MLS, a retired medical librarian, now collaborate in Let’s end COVID! working to overcome the COVID-19 pandemic in northcentral PA through education, outreach, and mitigation.
Published: 6/3/23

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