End of public health emergency comes as some experts warn COVID could make a comeback

May 11, 2023
Blue sign against backdrop of sea grass. The sign says COVID-19 Public Health Emergency. No congregating in groups larger than 10 and please maintain a 6 foot social distance from other parties.
A sign from the early days of the pandemic no longer applies. iStock

Michael Sweat, Ph.D., is ready for the May 11 end of the COVID public health emergency. “I think it is the right decision and for one reason: Emergencies don't mean anything if they're just done too much or never end,” said the leader of the Medical University of South Carolina’s COVID-19 tracking team. 

“And we are in a different place. There's just no question.”

Sweat, a former research scientist with the Centers for Disease Control and Prevention, professor in the MUSC College of Medicine and adjunct professor for the Johns Hopkins Bloomberg School of Public Health, would know. He’s been posting COVID data online, dating back to March 2020. That’s the month the World Health Organization declared there was a pandemic.

“The case numbers are really low. We're at a historic low,” Sweat said. But his team’s work isn’t finished. It will continue tracking available data, such as wastewater testing for the next year, and post updates on its site.

Here’s some of what will change with the end of the public health emergency, according to Sweat. 

“There will be the loss of some funds and servicesThere’s a sort of a political dimension, too, that I think is important,” he said.

Regarding funds and services, here are a couple of examples. Some Medicare and Medicaid waivers and broad flexibilities for health care providers will end. And coverage for COVID testing will change.

Meanwhile, here’s what Sweat means when he refers to the political dimension. “We have democratic processes to mediate civil freedoms. During emergencies, some civil freedoms can be taken away without going through the normal democratic processes. And that happened during COVID. I mean, there were lockdowns; there were mask mandates, vaccine mandates, all kinds of things that circumvented the normal democratic process. That’s ended.”

Data reporting isn’t mandatory anymore. “The legislation through the emergency act that got put into place required states to report data to the CDC, particularly data on COVID cases. So that's already been weakened enormously. States have gone to weekly reporting or no reporting in some cases. But even the CDC, now they don't have to report anything anymore. So that's a deficit,” he said, referring to the Centers for Disease Control and Prevention.

Money set aside for vaccine development may dry up. “That's not necessarily totally linked to the public health emergency, but it has to do with the budget processes that are going forward,” Sweat said of the current political battle in Washington.

The changes are coming against the backdrop of a report by a group of prominent epidemiologists and virologists. “They were weighing in on the chances of another variant similar to Omicron. They projected that there was up to a 40% chance that by 2025, we were going to have another one of those,” Sweat said.

“That's the risk, you know, that we could have another big wave. If we kind of take everything apart, it would be harder to deal with it and track it and put things back together.”

He’s also concerned that the end of the public health emergency will reinforce many people’s impression that COVID is gone, and they’ll quit paying any attention to it. “It's very reminiscent of what happened in the 1918 flu epidemic. Ken Burns did a documentary on that. One of the key things that I remember very vividly was how there was this collective amnesia after the epidemic because it had been so horrible.”

It's not surprising that people wanted – and want – to get back to normal, Sweat said. He just hopes people at higher risk of getting seriously sick from COVID will continue to be vigilant. “If we see spikes, they need to mask up and be cautious.”

But we are, as he said, in a different position. “There's just no question. There's more immunity. People aren't dying like they were. The health system is functioning really fine for the most part. We're really in a way better place, and we need to recognize that.”

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