The US COVID-19 public health emergency is coming to an end. What does it mean?


In January 2020, the US government declared COVID-19 a public health emergency. Now, with the drop in coronavirus cases and deaths, that announcement is quickly approaching a predetermined end date.

Set to expire on May 11, the purpose of the public health emergency was to contain the spread of the coronavirus. In the early days of the pandemic, the announcement took temporary measures such as quarantine for people exposed to the virus (Sn: 1/31/20, It later allowed federal officials to make tests, drugs and vaccines authorized by the US Food and Drug Administration freely available to the public.

“Ending the public health emergency signals that we think we have turned a corner in a very dark time in America,” says Leighton Koo, a health policy researcher at the Center for Health Policy Research at George Washington University in Washington, DC. are the heads of. (This is not the first pandemic-related proclamation to expire. On April 10, President Joe Biden signed into law ending national emergencywhich was released in March 2020 waive certain requirements for federal health insurance programs, such as allowing coverage of telehealth visits,

Even as the public health emergency becomes another relic of a painful period, COVID-19 is not going away. more than 1,000 people in the United States Died from COVID-19 from April 20 to April 26According to the US Center for Disease Control and Prevention. And the coronavirus continues to evolve. Although Not all new variants are worrisome, some may be ,Sn: 10/17/22, So it remains to be seen whether now is the time to lower our guard, Ku says.

Testing, drugs and vaccines will continue to be important tools to control the spread of the virus, and researchers hope to improve our arsenal. Here’s what the end of the public health emergency means for these efforts.

Millions may lose access to free testing

The COVID tests — at home and lab versions — that were authorized by the FDA over the past three years will remain available. these tests were allowed emergency use authorization, or EUAs, which allow public access to tests that are not formally approved by the FDA. Instead of ending with a public health emergency, the FDA can decide when it wants to end individual EUAs, and it can still issue EUAs for any new tests that may be developed.

What could change is who pays for the tests and diagnostics. It all comes down to insurance.

For those with private insurance, the cost will depend on the individual insurers. Starting in January 2022, the Biden administration Required insurers to pay for eight at-home tests per person per month. The ending of the public health emergency means that at-home and laboratory tests, even if ordered by a physician, are no longer guaranteed to be fully covered.

The shift also affects people enrolled in federal health insurance programs — Medicare for people age 65 and older and Medicaid for those below a certain income level.

Like those with private insurance, Medicare Part B users will also lose access to their eight free home-tests per month. However, the program will continue to cover laboratory tests when ordered by a health professional, although test seekers may be required to pay for the relevant doctor’s visit. Those covered by Medicaid will still receive free at-home and lab tests until September 2024. After that, the cost may vary by state.

Currently, uninsured people in most states pay full cost for rapid at-home tests, roughly $10 each, and laboratory tests, about $150 per standard PCR test. And that pool of people is going to grow.

States can now begin disenrolling people from Medicaid and its equivalent Children’s Health Insurance Program for children, which covered about 95 million individuals, by January 2023. If they were no longer eligible. That provision expired in March and could result in 17 million people are losing insurance by May 2024According to an April 26 analysis by KFF, a health policy research organization based in San Francisco.

Uninsured individuals may still have access to testing at free clinics and a limited supply of home tests already stockpiled by the government. Based on resource availability, CDC expanding community access to testing program Will continue to offer testing to people without insurance.

Regardless, millions more will soon join a group of individuals who, for the most part, probably can’t afford testing. SARS-CoV-2 can run on a large scale In communities when people don’t test themselves for the virus and unknowingly spread it (Sn: 7/7/22, “In general history shows us that the disadvantaged, minority, poor populations suffer the most,” says Koo. “So it’s likely to happen.”

Availability of COVID vaccines and treatments will not change (for now)

The end of the national emergency did not affect people’s ability to access vaccines and antiviral treatments. Nor will the end of the public health emergency.

Vaccines and treatments “generally will not affect,” says the US Department of Health and Human Services, or HHS. The FDA can continue to issue EUAs for any new vaccines or treatments that may be developed to fight future variants.

However, at the end of this year another big change has come to the fore. During the pandemic, the US government stockpiled vaccines and treatments to fight COVID-19 and provided them to the public for free. Congress has decided not to continue funding these efforts. There are stockpiles for COVID-19 vaccines and treatments expected to be finished this summer or fallWhite House COVID-19 response coordinator Ashish Jha said earlier this year in an interview with the University of California, San Francisco.

On the vaccine front, the government had earlier procured the vaccines Discounted cost of approximately $21 per shot According to KFF data, from pharmaceutical companies. When supplies run out, health care providers will have to buy them directly from the companies. pfizer And modernaBoth of those who manufacture the widely used mRNA shots estimate the commercial cost to be between $110 and $130 per shot.

How will those costs affect patients? Again, it depends on the type of insurance you have.

Medicaid will continue to cover the shots through September 30, 2024. Vaccines will remain covered for patients enrolled in Medicare Part B. CDC’s Vaccines for Children Program Will also continue to provide COVID-19 vaccines to uninsured children.

Otherwise, the cost will vary depending on the state you live in and your insurance company. HHS claims that because the COVID-19 vaccination is recommended By the CDC’s Advisory Committee on Immunization Practices, it is counted as preventive health care, which will be covered without a co-pay by most private insurers. HHS on April 18 also announced A new program to continue access to vaccines and treatments for the uninsured through partnerships with pharmacies, with funding through December 2024.

On the treatment front, antivirals procured by the government will be free till government stocks last. Pharmacies then have to buy them directly from the companies. Medicaid will continue to cover the treatment until September 2024, but costs may vary by state after that. Medicare Part D, the prescription drug arm of the insurance program for seniors, only covers drugs with full FDA approval, which may affect treatments available through the EUA.

Paxlovid, a popular antiviral drug that curbs the symptoms of COVID-19 and Long reduces the risk of covid ,Sn: 3/31/23), was originally purchased by the government at a cost of $530 per dose. pfizer It hasn’t disclosed how much it plans to charge. On the commercial market, KFF Health News reports. The company has also applied to receive formal endorsement from the FDA, and an advisory committee voted in March. Recommend approval of Paxlovid,

Research on new COVID vaccines and treatments will continue

The bulk of funding for coronavirus research was not directly linked to the public health emergency, so ongoing and future studies will not stop. How some data is reported to the CDC will change.

While most CDC data tracking is not directly affected by the end of the public health emergency, daily reports of COVID-related hospitalizations may come less frequently, according to the agency. Laboratories will no longer be required to report COVID-19 lab test results, making it harder to track what percent of tests are positive — a metric useful for monitoring new surges of infections. There may be a slight delay in reporting rising cases and hospitalizations for places that do not regularly release information to the CDC, potentially making it more difficult for people to know when cases begin to rise in their community And it’s time to start wearing masks again.

As immune protection fades – especially in older people or those who are immune-compromised – or the virus evolves in ways that could make vaccines less effective at protecting people from severe disease, researchers may look for variant-proof Looking for vaccines and treatments. The Biden administration is earmarking more than $5 billion for “Project Next Gen” to accelerate research.

The aim of the program is to develop mucosal vaccines which can protect the nose and throat from infection and reduce the likelihood that a sick person will pass the virus to others (Sn: 6/10/22,

Another aim is to develop longer-lasting, lab-engineered antibodies that can be used to treat infected people. Such monoclonal antibodies proved effective in preventing severe disease in newly infected people in clinical trials, but no longer work Because the virus has changed a lot (Sn: 1/13/23, Now, the plan is to develop new ones that attack parts of the virus that don’t change often as the virus evolves.

Also wishlist to craft universal coronavirus vaccines Which protects people not only from newly emerging variants but also from other types of coronavirus (SN: 9/29/22, The virus that causes COVID-19 isn’t going anywhere, and there are plenty of other coronaviruses circulating among animals like bats that could pose a threat to people as well.

Having a vaccine to protect against a broad group of related viruses could help prevent coronaviruses from provoking another round of future health emergencies. Time will tell if that goal becomes a reality.

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