The White House announced Monday that COVID-19 emergency declarations would end in May, a little more than three years after their approval by the Trump administration in March 2020.
The COVID-19 national and public health emergencies have allowed government funding to cover the costs of public health resources like tests, lab supplies and vaccinations. The declarations, which have been extended numerous times to supplement these costs, will be re-upped once more before ending May 11.
The ceasing of the declarations means COVID-related costs would transfer more of the burden onto private insurance and government health plans. Because local health departments get their funding from the state, and thus from the Centers for Disease Control and Prevention, they will not be able to supplement lost funding when the declarations end.
It’s not yet clear exactly what will change in terms of the availability of resources such as COVID-19 tests and vaccinations. Graham Snyder, the medical director of infection prevention and hospital epidemiology at UPMC and a professor of infectious diseases at Pitt, said there’s still a lot to be determined, but worries this will increase issues with accessing care.
“The concern is that people without insurance will have to pay for testing and vaccination and will not be able to pay,” he said. “This will be potentially harmful to their health.”
It’s possible that private insurance companies will step up and cover the cost, he said, but it’s still too soon to tell.
Dr. Maureen Lichtveld, the dean of the University of Pittsburgh School of Public Health, said this represents a larger issue of a lack of funding for public health infrastructure. Dr. Lichtveld worked at the CDC for two decades managing hurricane disaster response and noticed holes in the coordinated response to the pandemic, where funding for preparedness was deficient.
To compensate, she said the government ensured the vaccine was available to those who needed it most by funding preparedness measures later with the emergency declarations.
“I am afraid that if there’s no longer an emergency declaration, which would imply the funds for preparedness go away, we will see a flare-up [in cases] and need another emergency declaration,” she said. “That funding needs to be secured.”
“It’s important to understand that COVID is still around,” Dr. Snyder said. “The declaration doesn’t change the trajectory of the virus.”
According to the Allegheny County Health Department’s COVID dashboard, infections reported to the Health Department have been declining since Christmas, but an average of about 40 people are still dying each month from the virus.
Alternative ways to acquire public health funding include President Joe Biden signing an executive order that bypasses Congress, Dr. Lichtveld noted, or by adding an amendment to the Public Readiness and Emergency Preparedness (PREP) Act, which could secure that additional funding through the Department of Health and Human Services.
Messaging around the pandemic may also change as a result of the emergency declaration stoppage, if local health departments do not have the funding to maintain it or to offer services like tests or vaccines.
And this is particularly concerning, said Dr. Lichtveld, due to the wide array of misinformation surrounding the coronavirus and the COVID-19 vaccines. She said that misinformation was “a wild card we had not seen before” in previous pandemics.
“If you have not yet gotten the vaccine or have put off getting the bivalent booster, this may provide a bit of motivation to get it now,” Dr. Snyder said. “It’s safe and shown to be effective against severe illness.”
Dr. Lichtveld echoed these sentiments.
She also called for “sustained funding of public health infrastructure throughout the world” to prevent and prepare for catastrophes, like future pandemics. “Unless we fund that system, we won’t be prepared for the next pandemic.”
First Published: January 31, 2023, 10:24 p.m.
Updated: February 1, 2023, 1:01 p.m.
