Francisco R. Velázquez: With the public health emergency ending, what will change? Here’s what you need to know

By Francisco R. Velázquez, M.D., S.M., FCAP

Recently, the World Health Organization’s Regulations Emergency Committee met for the 15th time and recommended to the WHO director-general to declare an end to the COVID-19 public health emergency of international concern – its highest level of alert – which has been in place since Jan. 30, 2020. This was made effective on Friday.

On Jan. 31, 2020, the U.S. Department of Health and Human Services declared a public health emergency because of the emergence of a novel virus that was spreading globally. Since then, this declaration has been renewed 13 times. It will expire Thursday.

What does this mean?

There are several reasons why this is happening now. We have gained considerable knowledge of the virus. We have widely available testing options, vaccines and treatments. There is significant community immunity because of vaccines and infection. Cases and mortality rates are down substantially as compared with previous springs.

And, very importantly, though the current variant, omicron, continues to make incremental changes through mutations, these changes are different from the significant changes we saw earlier in the pandemic. To be clear, the virus continues to mutate twice as fast as the flu, but in terms of disease burden the results are less severe. Each mutation increases its transmission ability, but clinically, the infection continues to be milder than before for people without risk factors.

We still see many patients every day, and unfortunately, some of those have severe disease and mortality outcomes. Risk factors include age and other comorbidities such as certain chronic diseases or treatments that suppress your immune system. For many of these individuals this virus still poses a risk, making up-to-date vaccination even more vital. Recently, the CDC recommended an additional bivalent vaccine to people 65 and older and for those who are immunocompromised. Bivalent vaccines are also recommended for children. You should consult your primary care provider or pediatrician for advice on when to get these vaccines. Over the next few months, we will have additional information regarding the recommendations for ongoing protection, which could be an annual vaccine for all of us.

The end to the emergency status has many asking, “Is the pandemic over?” The answer is not yet. A couple reasons for this are:

• We still have COVID-19 disease present globally with differing levels of impact based on population characteristics, such as immunization rates.

• We have not seen a defined seasonality as we see with the flu each year. Transmission has increased thanks to new variants, regardless of the month or season.

We must remain vigilant to the possibility of a new, more severe variant in the future. From a protection perspective, it would make sense for many of us to consider the risk during respiratory illness season, October through May, and add the bivalent vaccine to our annual vaccine protection.

In addition to therapeutic interventions, such as vaccines, it is important for us to remember nontherapeutic interventions that decrease the risk of transmission of respiratory viruses in general.

• Stay home if sick

• Get tested

• Wear a mask if exposed or symptomatic

• Wash your hands

• Cover your nose and mouth if you cough or sneeze

And, as a courtesy to others, if you see someone wearing a mask, be kind. We don’t know other people’s individual or family risks. Perhaps you can ask: Would you like me to also wear a mask? Read the room, and respect the rules of the house you are in.

The end of the emergency declaration has administrative and financial implications that you should be aware of.

Testing, vaccines and therapeutics will follow the path of all other medications and treatments. This means it will be based on your provider and your insurance coverage. Make sure you know the rules of coverage as we go forward. At this time, the COVID-19 at-home test will still be available without a prescription at local pharmacies. SRHD published an informative blog at srhd.org which goes over many of these changes and how to navigate them.

We are entering a new phase of this pandemic with the emergency declaration soon to expire. It is a testament to the significant progress we have made, and confirmation that we can once again enjoy many of the activities impacted by the pandemic. Although we shouldn’t forget the lessons learned, we can look with hope and optimism to the future and to a great summer in Spokane.

Francisco R. Velázquez, M.D., S.M., FCAP, is the public health officer for the Spokane Regional Health District.