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Understanding the end of the COVID public health emergency

Steven Marshall, DNP, RN
Conditions
April 22, 2023
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The COVID-19 pandemic has been an unprecedented event for worldwide health care. The call to action for organizations included setting up mass testing sites to serve their communities. I helped set up multiple locations across several counties using a mobile model. We tested hundreds of patients each day in various places. Once the vaccine was approved, we began our vaccination efforts using our mobile model and mass vaccine sites, including large event centers. Our treatment arsenal expanded once the first monoclonal antibody therapy for COVID-19 was approved, and we quickly opened an infusion center serving hundreds of people per week. Our care delivery methods are forever changed three years later due to our pandemic response. With the end of the declared public health emergency on the horizon, it is essential to understand what is and isn’t changing.

Vaccines, testing, and authorized COVID-19 therapies were available at no cost to the public throughout the pandemic response. COVID-19 testing and vaccination data are shared with the CDC and compiled for publication on the organizations’ COVID Data Tracker web page. Funding for health care organizations to support their pandemic response was available through the Federal Emergency Management Agency (FEMA). Funding for this program concluded in December 2022. The government closely monitored personal protective equipment (PPE) supplies to prevent critical shortages.

Ending the COVID-19 public health emergency

The COVID-19 public health emergency (PHE) will end on May 11, 2023. While the PHE is ending, we must understand that we still face infections with the virus. The total cases, deaths, and hospitalizations continue to decline; however, there are still thousands of Americans hospitalized (14,118 as of 3/31/23). Over 270 million Americans have received at least one COVID-19 vaccine, with only 16.5 percent having received the latest booster dose. This data supports the need to remain vigilant in our fight against the virus and its spread.

What will remain the same

The government is committed to continued support in the battle against COVID-19. Home testing will continue to be available through the government, depending on available supplies. Ending the PHE will not affect access to vaccination and antiviral treatments. Vaccination and antiviral therapies will become part of our standard of care. Currently, no intravenous monoclonal antibody (MAB) therapies are available for COVID-19. The last MAB to achieve Emergency Use Authorization (EUA) was Bebtelovimab. The EUA for this MAB was stopped on November 30, 2022, due to its lack of effectiveness against the Omicron variant. EUAs for other existing therapies will not be affected by the end of the PHE, and newer treatments may continue to be studied and approved. The pandemic brought significant improvements in access to care through telehealth, and these services will not be affected by the PHE ending. Access to buprenorphine through telehealth will also continue to be available.

What will be changing

The requirement for insurers to cover COVID-19 testing at no cost will end. Medicare Part B will continue to cover testing, Medicaid coverage will continue until September 2024, and private insurance coverage will vary and not be guaranteed after the PHE ends. The U.S. Department of Health and Human Services (HHS) will no longer require testing and immunization data reporting. Organizations that do not continue this reporting could negatively impact estimates of COVID-19 rates across the country. Manufacturers’ requirements to report levels of PPE will no longer be required resulting in the decentralization of supply data. This data is necessary to detect potential shortages of these critical supplies early. Additional requirements will be developed for the continued prescribing of controlled substances via telemedicine.

Conclusion

The COVID-19 pandemic has changed the landscape of health care. Many of these changes are critical in our continued response to the virus. Ending the PHE should not lead to diminished treatment and resources for those who continue to be affected by the further spread of COVID-19.

Steven Marshall is a medical writer.

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