Ready or Not–Here It Comes: COVID-19 Public Health Emergency Declaration Expires Early in 2023
President Biden’s COVID-19 public health emergency (PHE) declaration is ending soon and is not being renewed. The exact deadline is unclear—it may be as early as January or as late as April, but regardless the end of special pandemic accommodations is soon to be evaluated. The implications of the end of this declaration are enormous.
There will be instances where new policies and procedures will remain in effect; however, there will be many instances where policies and procedures revert to the way they were before the pandemic.
PHE declarations began in January 2020 and were eligible to be renewed every 90 days later. With the number of deaths per day holding steady at about 300—while still high, the Biden administration felt it was time to shift from a state of pandemic emergency and start to return to “normal.”
However, while Biden is cautiously optimistic about COVID-19’s grip loosening, he still believes there needs to be targeted support to remain prepared and nimble if there is another outbreak of COVID-19 or one of its variants. As such, he has sent a $9.25 billion proposal to Congress for COVID-19 support.
Below are some highlights of what’s included in the bill:
- $2.5 million "to ensure continued access to vaccines and therapeutics (including for the uninsured) as transition to commercialization of vaccines and therapeutics continues and for Strategic National Stockpile maintenance costs"
- $5 billion for "development of next-generation vaccines and therapeutics"
- $750 million for Long Covid research and treatment
- $1 billion in funding for the State Department to "provide support to prevent, detect, and respond to COVID-19 and other infectious diseases, including through vaccines, tests, and treatments, and through efforts to close gaps in routine immunizations”
Let’s explore the impact the end of this PHE will have in the short and long term.
For example, once the public health emergency ends, the federal government will stop paying for vaccines, tests, and treatments, shifting the costs to the commercial sector.
Impact on Healthcare System and Workers When PHE Expires
During the pandemic, we witnessed a massive exodus of healthcare personnel as COVID-19 pressed on; now is the time to address the shortage, but it is not an easy task and will not be rebuilt overnight.
Also, how patients interface with the healthcare system is likely to be very different. For example, a patient feels like he may be coming down with the flu but is worried that it may be COVID-19, so he goes to the doctor, and the doctor needs to do two tests for both the flu and COVID-19. In addition, two tests for lab work, more supplies, and more labor. All of this translates into increased costs.
However, there is a positive outcome from the pandemic that will impact healthcare delivery in the long term, and that is telehealth. Now providers can deliver across state lines and prescribe medication without requiring inpatient visits.
Easing up on the non-stop demands on our healthcare workers will make them better prepared to treat ongoing COVID-19 patients and better treat those coming to the hospital for non-COVID-19 reasons.
Impact on Medicaid, Children’s Health Insurance Program (CHIP), and Supplemental Assistance Program
Due to the declarations, the Biden administration was in a position to temporarily expand public health insurance dramatically. For example, enrollment in these programs increased 26% during the pandemic to a record of more than 89 million people as of June.
HHS now estimates that as many as 15 million people could lose Medicaid or CHIP once the programs return to pre-pandemic operations.
Food insecurity is expected to rise as millions of Americans will lose access to the federal Supplemental Nutrition Assistance Program (food stamps) that they had received temporarily during the pandemic.
Future Role of FDA involvement
The FDA’s ability to fast-track authorization of COVID-19 drugs, vaccines, tests, and protective equipment relies mostly on the legal foundations of a national emergency. Ending the public health emergency may effectively prohibit FDA’s emergency use authorities and prevent liability protections for manufacturers, distributors, and retailers of these life-saving medical countermeasures. The FDA is currently assessing how to unravel dozens of emergency powers.
Public Health Surveillance to Suffer
Public health surveillance activities to monitor COVID-19 cases, already grossly underfunded, would be badly impacted. CDC has used emergency powers to ask states to report COVID-19 infections, hospitalizations, and deaths. That could go away. Absent effective, real-time data, the risks of continued COVID-19 variants spreading nationally increase exponentially.
Closing
There are tremendous implications for the end of PHE declarations, and the clock is ticking. Time will tell how well we have prepared for post-pandemic living.
Research and materials for this article were compiled, written, and distributed on behalf of the National Public Health Information Coalition. The views and opinions expressed in this blog are those of the various authors and do not necessarily reflect the official policy or position of the National Public Health Information Coalition or its members.
References:
https://amp.cnn.com/cnn/2022/11/15/politics/supplemental-funding-white-house/index.html