More than three years after the first case of covid-19 was diagnosed in the United States, President Biden announced on Monday that the national emergency to combat the coronavirus will end on May 11.
Few would dispute that covid today is a very different disease than it was in early 2020. At that time, the virus had a much higher fatality rate, and young, previously healthy people were succumbing to a deadly pneumonia. There were no vaccines and very limited treatments.
Declaring a state of emergency then was necessary for three reasons: First, it highlighted the critical urgency of the situation and helped Americans understand the substantial threat that covid posed. Second, it mobilized resources to develop and then deploy vaccines and therapeutics that have dramatically reduced the severity of the coronavirus. Third, it gave flexibility to health departments, hospitals and other entities to overcome bureaucratic hurdles and provide necessary care.
These reasons either no longer apply or have changed so substantially that they no longer justify a state of emergency. Americans have largely moved on from thinking about the coronavirus as a daily threat — and rightfully so, given that vast majority have some immunity because of vaccination, prior infection or both. Continuing to call covid a national emergency is out of step with public opinion, which has a major cost: When there is a true public health emergency in the future, many people might not believe health officials and could defy their guidance.
The emergency declaration succeeded in expediting vaccine development. The Trump administration deserves credit for this, as the Biden administration does for then implementing an extraordinary mass vaccination campaign. More resources would still help, which is why I joined other public health experts in repeatedly calling on Congress to heed the Biden White House’s request for additional covid funding. This hasn’t happened for nearly a year, though, and prolonging the declaration isn’t likely to change things.
In fact, it could make matters worse. This month, House Republicans introduced legislation to force Biden to immediately end the public health emergency. Such a move would cause widespread chaos. Hospitals and insurers need time to adjust to pre-covid regulations while keeping in place positive improvements such as telemedicine access. Plus, as many as 15 million low-income Americans could lose health insurance because the flexibilities around Medicaid coverage will cease when the declaration ends. States need additional assistance to keep eligible people in the program and to ensure that those without insurance can still access vaccines and treatments.
If the president didn’t set a date himself, Congress might have forced his hand. It’s far better for the White House to give advance notice than for there be an abrupt end to the declaration. The administration’s focus until May 11 should be to minimize disruptions to the health-care system.
In the meantime, Biden should continue to be clear that covid remains a crucial concern. The end of the emergency doesn’t mean that covid is over, but rather that it is joining the list of many other serious illnesses that require constant vigilance. This includes harmful infectious diseases such as influenza, HIV and Legionnaires’ disease. But it also includes chronic ailments such as heart disease, cancer, diabetes and obesity, for which far more must be done to prevent, diagnose and treat.
For all of these diseases, resources are concentrated on people who are most at risk of severe outcomes. The same approach should be taken for covid. We’ve long known that older individuals and the immunocompromised are most vulnerable to the coronavirus. Yet only about 40 percent of those 65 and older have received the updated bivalent booster, and only 41 percent of immunocompromised people were considered up-to-date with their vaccines. The antiviral pill Paxlovid is highly effective at preventing hospitalization and death, but even among covid patients aged 80 and above, only about 45 percent have received it.
Public health efforts should aim to get vaccines and treatments to at least 90 percent of these at-risk populations. In addition, there are some immunocompromised patients for whom vaccines don’t work as well and who might be ineligible for existing treatments. Research efforts should concentrate on helping these people, along with those suffering debilitating consequences from long covid.
The blanket emergency declaration has to come to an end. The United States can then shift its focus to the many other pressing health concerns in need of attention — including preparing for the next pandemic.