The US COVID public health emergency has ended, leaving behind a battered health system


A signboard outside a hospital advertises COVID-19 testing on November 19, 2021 in New York City.

Spencer Platt | Getty Images

America public health emergency declared in response to COVID-19 Thursday ends more than three years after the pandemic began.

Biden AdministrationThe decision to end the emergency comes as the death toll and the availability of hospitalizations have dropped dramatically VaccinesAntiviral treatment and widespread exposure to the virus.

COVID-19 deaths have fallen to their lowest level since March 2020, when the rapid spread of the virus in the US overwhelmed the health system and led to widespread closures of schools, businesses and public places.

Hospital admissions from the virus also fell to the lowest level since the US began tracking the data in August 2020.

The end of the emergency will mark significant changes in the way the US responds to the virus. If patient admissions increase, hospitals will lose the flexibility to rapidly increase bed capacity, and Centers for Disease Control and Prevention Will reduce your efforts to track down the virus.

After the emergency ends, the CDC will no longer be able to compel labs to report covid Exam Results. The agency does not have the authority to compel US states to report new cases.

CDC Director Dr. Rochelle WalenskyJoe, who will step down at the end of June, warned Congress last week that the agency still has to negotiate data-sharing agreements with individual jurisdictions, a time-consuming process that puts the nation at risk.

“This should concern all of us primarily because of what it says about visibility into the next outbreak,” Walensky told the Senate Health Committee. “When we fight a pathogen we’ll be back in the first place to build surveillance capabilities and have conversations.”

While public health experts acknowledge that the US has many more tools to fight Covid today, they warn that the virus will remain a constant threat to the elderly, the vulnerable and the country’s fractured, battered health care system.

Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, said, “I think we are past the worst, but hospitalizations and deaths will continue for many years to come.” Will be.” ,

the virus is still killing

The US public health emergency has been renewed 13 times since the Trump administration first issued the declaration on January 31, 2020, when there were only six known cases of COVID in the US and no known deaths.

In the three years since then, Covid has killed more than 1.1 million people in the US and hospitalized millions more in the worst public health crisis since the influenza pandemic of 1918 more than a century ago.

virus was the fourth major cause of death In the US in 2022 – two years after Covid first emerged – behind only heart disease, cancer and unintentional injuries.

World Health Organization On Friday announced the end of the global Covid emergency. But WHO chief Tedros Adhanom Ghebreyesus warned national governments against dismantling the systems they built to respond to the virus.

Tedros said, “This virus is here to stay. It is still killing, and it is still changing. There remains a risk of new variants emerging that lead to new surges in cases and deaths.”

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More than 1,000 people a week are still dying from Covid in the US, most of them age 75 or olderBecause the public has largely lost interest in staying up to date about vaccines.

According to CDC data, only 42% of seniors are up to date on their COVID vaccines. Only 17% of the total US population has received the latest booster.

“You need to be up to date to have adequate protection,” said Dr. James Lawler, an infectious disease specialist at the University of Nebraska Medical Center.

“Similar to immunity from vaccination, surviving Covid gives you immunity, but that immunity is not final,” Lawler said.

The Biden administration says the end of the emergency will not affect access to COVID vaccines and antiviral treatments, as there is still a federal stockpile, but many consumers will have to start paying for COVID tests.

Gostin said a misinformation campaign against vaccines, especially in conservative states, as well as a general vaccine fatigue, put the nation’s health at risk.

Meanwhile, millions of people at risk of losing coverage sweep through Medicaid, the public health insurance program for low-income people, as states are now allowed to review eligibility for the first time in years. Congress originally banned people from taking away Medicaid during the pandemic, but those protections expired in April.

“We’re going to be opening up the social and health care safety nets over the next months,” Gostin said. “There will be an increase in unemployment and people will have less access to health care,” he said.

the health system has collapsed

Hospitals have been hit repeatedly by Covid over the past three years, with many health care facilities facing staff shortages as many doctors and nurses suffer burnout.

With the end of emergency, hospitals will lose the flexibility to rapidly add beds in non-traditional settings and tap doctors in training to help with increased patient admissions.

Leading medical associations have warned Biden Administration The last downfall was that emergency departments were forced to wait patients due to insufficient bed capacity and staffing.

And hospitals now face the constant threat of COVID on top of illness caused by the flu and respiratory syncytial virus, which already reduced capacity during the bad respiratory virus season before the pandemic.

“We’ve really lost so much health care capacity in this country from the lack of beds, the lack of health care workers,” said Michael Osterholm, a leading epidemiologist and director of the Center for Infectious Disease Research and Policy in Minnesota.

“We better hope that we’re not going to see any kind of big jump in infectious disease cases over the coming months to years,” Osterholm said.

Lawler, who advised the Bush and Obama administrations on biodefense and pandemic preparedness, said hospitals may need the flexibility provided by a public health emergency if another large-scale Covid outbreak occurs in the future.

“I am not optimistic that once the public health emergency declaration expires, anyone in Washington will be eager to declare another, even if it is warranted,” he said.

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