May 16, 2022 - Health

What the end of America's public health emergency could mean

Illustration of a covid particle reflected in a rearview mirror

Illustration: Natalie Peeples/Axios

The Biden administration is expected to signal this week whether it's ready to end the COVID-19 public health emergency — which would affect a host of health care policies, including vaccines for kids.

Why it matters: Ending the emergency would allow a president who campaigned on ending the pandemic to declare victory over the virus. But the complex series of policy changes — and the continued threat of more COVID waves — could leave the government ill-prepared for whatever comes next.

Driving the news: The Department of Health and Human Services in April extended the emergency declaration through July 15, and has said it would give states and health providers 60 days' notice before it ends.

  • That makes Tuesday the decision deadline.

What they're saying: The public is eager to put COVID in the rearview and generally unwilling to give Biden much credit for the recovery. Extending a state of emergency in that kind of climate could almost be seen as an admission of failure.

  • But hospitals, physician groups and advocacy organizations like AARP say keeping the emergency status is essential to maintain flexibility in the health care system as new variants emerge and the effectiveness of currently available vaccines wanes.
  • A decision to end the emergency "will be based on political considerations and not likely the consensus of the scientific community inside and outside of the administration," Raymond James analyst Chris Meekins wrote in a recent report.

Between the lines: Congress stalling on emergency COVID funds to secure additional boosters for the fall only adds further complication.

Yes, but: The administration still could go halfway and undo selected policies it thinks aren't necessary while keeping others.

  • Where officials draw the line will determine questions like whether vaccines for children 6 months to 5 years old go through an expedited process or will need full FDA approval, which would take longer.

What’s at stake: Lifting the emergency would bring major policy shifts to insurance markets, drug approvals and telehealth.

Among the potential changes:

  • Emergency approvals: Emergency use of COVID-19 diagnostics, vaccines and therapies is also tied to any declaration. HHS could pull products off the market, rewrite the authorizations or reclassify products if the emergency ends.
  • Free shots: The emergency declaration helps ensure that COVID-19 tests, vaccines and therapies are free or available at a reduced cost.
  • Relaxed telehealth boundaries: Virtual doctor's visits and health tools boomed during the pandemic, thanks to emergency flexibilities. Providers can more easily prescribe controlled substances using telemedicine as part of those rules.
  • Liability protections: The declaration provides liability protections to businesses and individuals who make, distribute or administer COVID-19 countermeasures.

The bottom line: Many states have already let their public health emergencies expire by now, and it'll hardly be surprising if HHS does. But ending the federal public health emergency is much more complex than flipping a switch — and could be hard to unwind if COVID-19 decides to surprise us again.

Go deeper