The End of the "Emergency"

Some thoughts as the public health emergency comes to a close

The day has finally come. After more than three years, the public health emergency for Covid-19 is finally coming to an end tonight at midnight Eastern time. A separate national emergency ended last month, but this is the more important of the two emergency declarations. This brings to an end many elements of the pandemic mitigations in this country, including most (but not all) federal Covid vaccine mandates, 20% add-on payments to hospitals for Covid patients on Medicare, and many of the CDC’s reporting capabilities. However, other aspects like emergency use authorization (EUA) for Covid vaccines and treatments, many elements of liability protection through the PREP Act, and provisions for telehealth access, will continue.

There are several fact sheets from the federal government that attempt to spell out the changes and what won’t change with the end of the PHE that I’ve linked to below for reference:

• HHS Fact Sheet: End of the COVID-19 Public Health Emergency

• CDC: End of the Federal COVID-19 Public Health Emergency (PHE) Declaration

• HHS Fact Sheet: Announces Intent to Amend the Declaration Under the PREP Act for Medical Countermeasures Against COVID-19 (Full text of PREP Act Amendment available here.)

While not an official aspect of the public health emergency ending, the end of the national emergency and public health emergency have provided an impetus for many colleges, private businesses, and others move on from pandemic restrictions, giving them a reason to lift long-standing vaccine mandates (and even a few remaining mask mandates in places like Baltimore City Hall and this New Jersey school district).

Fortunately, most experts seem to be in agreement that it is time to end the public health emergency. Notably, the World Health Organization (WHO) also announced an end to their Public Health Emergency of International Concern (PHEIC) last week. And in fact, the vast majority of Americans (and people worldwide) have moved on from the Covid emergency a long time ago, as evidenced by the packed concerts, sporting events, restaurants, airports, and other locations.

However, some people are still not mentally prepared for the end of the pandemic. Laurie Garrett, a once highly respected and award-winning science writer, wrote a bizarre piece about our “never-ending nightmare,” in which she compares Covid to AIDS and claims both vaccine and natural immunity provide only short-lived protection against severe disease. And many other Zero Covid advocates are melting down all over Twitter, certain that the end is near.

A now-deleted sentence from a recent New York Times article seemed to indicate that even CDC Director Rochelle Walensky may have been surprised by the Biden administration’s late January announcement that the public health emergency would be ending in May: “The director was upset by the agency’s relations with the White House and did not expect the announcement of the end of the public health emergency, the person said.” New York Times reporter Apoorva Mandavilli didn’t answer questions about the accuracy of this statement, simply saying it was removed as part of the “editing and updating” process as it was a “developing story.”

A Politico article about the departure of the CDC Director states, “Walensky had earlier this year notified top White House aides, including Chief of Staff Jeff Zients, that she planned to leave….” Earlier this year, as in shortly after Biden announced the public health emergency would be ending in May? Did she decide to quit because she wasn’t consulted about the end of the public health emergency? Or was she pushed out because she wouldn’t get on board? I wonder if any interviews after she leaves the agency will shed light on this.

This also raises the question about what Walensky’s actual role was at the CDC. There have been a lot of accusations during Covid about White House meddling with CDC guidance, during both administrations. Many people have wondered if some of Walensky’s statements as CDC Director were her own, or if they were simply positions she was instructed to take by the White House. In June 2022, just a few months after Dr. Ashish Jha began his role as the White House Covid Czar, Biden said, “He’s the guy that’s running the CDC for me these days.” I can’t imagine Walensky was happy to hear that.

So far, there has been no announcement about who will replace Walensky, but I wonder if Jha will assume that position. Back in March, Washington Post reported that the White House Covid Response Team headed by Dr. Jha would be ending along with the end of the public health emergency. That article said Jha is “likely to leave the administration once his team is disbanded.” And yesterday, a New York Times article reported that colleagues of Dr. Jha say “he intends to return to his job as dean of the Brown University School of Public Health.” But at a recent press conference, Jha deflected questions about his future plans and other staffing changes, stating, “when I have more to announce about my future I will be happy to get that answered.”

As for the ending of public health emergency — with a reduction in Covid data reporting from CDC, many mandates ending around the country, and several other elements of our Covid response winding down, hopefully most of the remaining signs of the pandemic will fade away. I suspect that over time Covid fears will become less front and center for many people, and slowly even the most anxious will start to see that the world has moved on, and the apocalyptic ending that they’ve feared never materialized.

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On a personal note, I have been winding down much of my Covid data analysis at covid-georgia.com over the past year. I’m currently deciding which of my data visualizations to keep updating, if any. I’m also looking forward to putting more energy into writing for my Substack, and starting to cover some health/science topics not directly related to Covid. Most of my articles so far have been longer articles about once a week or two, but I’ve considered writing shorter, more frequent articles going forward that would allow me to respond to news in a more timely manner. (I’d still do some deep-dives when I think the topic needs more discussion.) Please vote in the poll and let me know what you think - it’s open to all subscribers. (Paid subscribers can leave additional thoughts in the comments.)