US extends Covid public health emergency

A medical worker takes a swab sample from a woman at a COVID-19 testing site in New York, U.S., March 29, 2022.

Wang Yin | Xinhua News Agency | Getty Images

The US has extended the Covid public health emergency until January 11, a clear demonstration that the Biden administration still views Covid as a crisis despite President Joe Biden’s recent claim that the pandemic is over.

The public health emergency, first declared in January 2020 by the Trump administration, has been renewed every 90 days since the start of the pandemic. The powers enabled by the emergency declaration have had a huge impact on the US health care system and social safety net, allowing hospitals to act more nimbly when infections spike and keeping millions covered by public health insurance.

Biden, in a televised interview in September, declared that “the pandemic is over,” although he said that Covid would continue to pose a health challenge. The Centers for Disease Control and Prevention said in August that high levels of immunity in the US, combined with the widespread availability of vaccines and treatments, have greatly reduced the threat that Covid poses to the nation’s health.

But hospitals and pharmacies urged the Department of Health and Human Services to maintain the public health emergency until the U.S. has a sustained period of low transmission of Covid. Hospitals in particular have been overwhelmed with patients every fall and winter since the start of the pandemic, pushing them to breaking point at times.

White House Chief Medical Advisor Dr. Anthony Fauci, in an interview earlier this month, said the president’s comments were “problematic” because some people may let their guard down and not keep up with their vaccines.

“Obviously that can be problematic because people will interpret it as completely over and we’re over for good, which it’s not – no question about that,” said Fauci, who is stepping down in December.

The emergency declaration gives federal agencies broad authority to expand certain programs without congressional approval. The Centers for Medicare and Medicaid, under HHS, dramatically expanded enrollment in Medicaid, the public health insurance for low-income people, to an all-time high of more than 89 million people. HHS has also expanded telehealth services and given hospitals flexibility in how they can deploy staff and beds when patient growth strains capacity.

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HHS Secretary Xavier Becerra told reporters in a call last week that he would give states, health care providers and other stakeholders 60 days notice before lifting the public health emergency. That means HHS must inform them in November if the agency plans to lift the emergency in January.

Whenever the public health emergency finally ends, it will have a dramatic impact on health care in the U.S. HHS estimates that up to 15 million people will lose their Medicaid coverage. Hospitals also risk losing the flexibility they relied on during Covid. Millions of struggling families will also lose extra money through the federal government’s nutrition program.

HHS also greatly expanded the role of pharmacies in the administration of vaccines in the US by temporarily repealing state laws that in some cases limit which vaccines pharmacists can administer to certain age groups. It is not yet clear whether the nationalization of pharmacy vaccine rules will expire when HHS decides to lift the public health emergency.

The Biden administration is relying on pharmacies to administer updated boosters for people age 5 and older that target the dominant omicron BA.5 subvariant. Federal health officials believe the new vaccines will provide better protection against infection and disease than the old ones, which don’t perform as well as they once did because the virus has mutated so much.

Public health officials are worried about another big spike in Covid this winter as people go indoors, where the virus spreads more easily, to escape the colder weather and as families gather during the upcoming holiday season.

Infections, hospitalizations and deaths have declined dramatically since the peak of the massive Omicron surge in January, but more than 300 people continue to die on average each day from Covid and nearly 3,500 patients are hospitalized with the virus daily, according to CDC data.

Dr. Ashish Jha, head of the White House Task Force on Covid, said last week that 70% of those dying from Covid are aged 75 and over. The majority of those who die are either not up-to-date on their vaccines or are not receiving a treatment like Paxlovid when they have breakthrough infections, Jha said.

“This is unacceptable, especially because now we can prevent almost every Covid death in the country with the vaccines and treatments we have,” Jha told reporters on a call. “If you’re up to date with your vaccines and treated when you have a breakthrough infection, your chances of dying are close to zero even in this high-risk population,” he said.

Fauci said earlier this month that the US is moving in the right direction, but Covid deaths are still too high. It’s also possible that a new variant could emerge this winter that could evade immunity even more than the omicron variants the U.S. is currently dealing with, he said.

“While we can feel good that we’re going in the right direction, we can’t let our guard down,” Fauci said.

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