What Happens at the End of the Covid-19 Public-Health Emergency?
The World Health Organization on May 5 declared an end to the global public-health emergency. The public-health emergency in the U.S. is set to expire on May 11, and Dr. Rochelle Walensky is stepping down as director of the Centers for Disease Control and Prevention.
Covid-19 hospitalizations and deaths now are relatively muted, thanks in part to vaccines, tests and treatments that have helped boost our defenses. The virus, however, isn’t going away. The country is still reporting hundreds of Covid-19-related deaths a day. Many others still face lingering health consequences.
“Although next week marks the end of the public-health emergency, it is not the end of Covid-19,” said Nirav Shah, principal deputy director at the CDC. “We will continue to keep our eye on the Covid-19 ball.”
Here’s what to know about the current state of the pandemic and what will happen as the global and U.S. emergencies end:
What does the end of the global public-health emergency mean?
The end to the public-health emergency of international concern is largely symbolic, since the WHO declaration doesn’t change government funding or services.
It does mark a milestone in the fight against Covid-19 and WHO officials said that decreasing mortality, easing pressure on health systems and increasing population immunity mean that countries can now transition out of crisis mode.
“What this news means is that it’s time for countries to transition from emergency mode 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 health threat, Dr. Tedros said. Covid-19 hasn’t fallen into a pattern predictable enough for the pandemic to be over, some public-health experts said.
“There will not be a point where WHO comes along and says the pandemic is over,” said Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme. “The good news is 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“In practicality, pandemics are generally said to have ended when they reach a state of stability, when they no longer represent a dominant concern for the public and for policy makers,” said Dr. Bob Wachter, chair of the Department of Medicine of the University of California, San Francisco. “All of that is very fuzzy; it’s sort of completely a judgment call.”
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 end up falling into a predictable, more stable pattern and become endemic over time, most infectious disease epidemiologists agree. Determining when exactly a pandemic hits its end often happens in hindsight, public-health experts said.
“We are in the transition to endemic but not quite there.” 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 Covid-19 spread might look like in the long term 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 changes when the public-health emergency ends in the U.S.?
Starting on May 11, the CDC will no longer have the authority to require states to report some Covid-19 data, and data sharing will likely get worse, public-health experts said. Insurers will no longer need to provide full coverage for Covid-19 tests in many cases.
“It’s not clear if health plans are going to cover home tests,” 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 might have cost sharing.”
People are also starting to get disenrolled from Medicaid, after a provision tied to the public-health emergency that kept people continuously enrolled was dropped. Up to 15 million Americans, including seven million children, risk losing coverage as a result, said Dr. Michelle Taylor, director of the Shelby County Health Department in Tennessee.
Is there anywhere I can still get Covid-19 tests, vaccines and treatments for free?
Yes, Covid-19 vaccines and some treatments are still free until the government stockpile runs out. After that, insurance will cover at least some of those costs, and the Biden administration has set up a safety net for people without insurance to get access at pharmacies and health centers.
The federal government is still sending some vaccines and at-home test kits to some health departments, according to Chrissie Juliano, executive director of Big Cities Health Coalition, an advocacy group for officials in city health departments.
Some local health departments also have their own programs, and people can also still order free home tests from the federal government, if they haven’t already hit the household limit.
What will happen to Covid-19 data at the end of the public-health emergency?
Starting on May 11, the federal government will no longer have the authority to require states to submit some 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 aggregate case data and its calculated Covid-19 community levels. Covid-19 death data on its website will now come from provisional death certificate data, rather than from state and local health departments.
The CDC will continue to rely on data from hospitals, genomic sequencing, some laboratories and wastewater testing to track the virus, CDC’s Dr. Shah said. 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 tell that it’s snowing even though we’re no longer counting every snowflake,” Dr. Shah said.
What is the average number of U.S. cases and deaths now?
The U S. reported some 77,000 cases the week ended May 3, according to data from the CDC, with roughly 1,110 Covid-19-related deaths reported that week.
Covid-19 hospitalizations and deaths are hovering near new lows following a winter of milder spread compared with the prior winter surges.
The current case counts are also a large undercount, in part because of the widespread use of rapid, at-home Covid-19 tests that often aren’t trackable by public-health officials. Data reporting is also patchier, as some states have scaled back on reporting.
—Denise Roland contributed to this article.
The World Health Organization on May 5 declared an end to the global public-health emergency. The public-health emergency in the U.S. is set to expire on May 11, and Dr. Rochelle Walensky is stepping down as director of the Centers for Disease Control and Prevention.
Covid-19 hospitalizations and deaths now are relatively muted, thanks in part to vaccines, tests and treatments that have helped boost our defenses. The virus, however, isn’t going away. The country is still reporting hundreds of Covid-19-related deaths a day. Many others still face lingering health consequences.
“Although next week marks the end of the public-health emergency, it is not the end of Covid-19,” said Nirav Shah, principal deputy director at the CDC. “We will continue to keep our eye on the Covid-19 ball.”
Here’s what to know about the current state of the pandemic and what will happen as the global and U.S. emergencies end:
What does the end of the global public-health emergency mean?
The end to the public-health emergency of international concern is largely symbolic, since the WHO declaration doesn’t change government funding or services.
It does mark a milestone in the fight against Covid-19 and WHO officials said that decreasing mortality, easing pressure on health systems and increasing population immunity mean that countries can now transition out of crisis mode.
“What this news means is that it’s time for countries to transition from emergency mode 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 health threat, Dr. Tedros said. Covid-19 hasn’t fallen into a pattern predictable enough for the pandemic to be over, some public-health experts said.
“There will not be a point where WHO comes along and says the pandemic is over,” said Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme. “The good news is 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 practicality, pandemics are generally said to have ended when they reach a state of stability, when they no longer represent a dominant concern for the public and for policy makers,” said Dr. Bob Wachter, chair of the Department of Medicine of the University of California, San Francisco. “All of that is very fuzzy; it’s sort of completely a judgment call.”
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 end up falling into a predictable, more stable pattern and become endemic over time, most infectious disease epidemiologists agree. Determining when exactly a pandemic hits its end often happens in hindsight, public-health experts said.
“We are in the transition to endemic but not quite there.” 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 Covid-19 spread might look like in the long term 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 changes when the public-health emergency ends in the U.S.?
Starting on May 11, the CDC will no longer have the authority to require states to report some Covid-19 data, and data sharing will likely get worse, public-health experts said. Insurers will no longer need to provide full coverage for Covid-19 tests in many cases.
“It’s not clear if health plans are going to cover home tests,” 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 might have cost sharing.”
People are also starting to get disenrolled from Medicaid, after a provision tied to the public-health emergency that kept people continuously enrolled was dropped. Up to 15 million Americans, including seven million children, risk losing coverage as a result, said Dr. Michelle Taylor, director of the Shelby County Health Department in Tennessee.
Is there anywhere I can still get Covid-19 tests, vaccines and treatments for free?
Yes, Covid-19 vaccines and some treatments are still free until the government stockpile runs out. After that, insurance will cover at least some of those costs, and the Biden administration has set up a safety net for people without insurance to get access at pharmacies and health centers.
The federal government is still sending some vaccines and at-home test kits to some health departments, according to Chrissie Juliano, executive director of Big Cities Health Coalition, an advocacy group for officials in city health departments.
Some local health departments also have their own programs, and people can also still order free home tests from the federal government, if they haven’t already hit the household limit.
What will happen to Covid-19 data at the end of the public-health emergency?
Starting on May 11, the federal government will no longer have the authority to require states to submit some 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 aggregate case data and its calculated Covid-19 community levels. Covid-19 death data on its website will now come from provisional death certificate data, rather than from state and local health departments.
The CDC will continue to rely on data from hospitals, genomic sequencing, some laboratories and wastewater testing to track the virus, CDC’s Dr. Shah said. 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 tell that it’s snowing even though we’re no longer counting every snowflake,” Dr. Shah said.
What is the average number of U.S. cases and deaths now?
The U S. reported some 77,000 cases the week ended May 3, according to data from the CDC, with roughly 1,110 Covid-19-related deaths reported that week.
Covid-19 hospitalizations and deaths are hovering near new lows following a winter of milder spread compared with the prior winter surges.
The current case counts are also a large undercount, in part because of the widespread use of rapid, at-home Covid-19 tests that often aren’t trackable by public-health officials. Data reporting is also patchier, as some states have scaled back on reporting.
—Denise Roland contributed to this article.
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