The communication about ending the COVID-19 public health emergency (PHE) has been atrocious. We’re confused. Everyone’s confused. Dr. Rivers and I have been asking a lot of questions and getting some answers. Here is our understanding of the situation right now and what it means for you.
I love how you close each section with "what this means to you". Thank you for making all this complicated information useful for those of us without a medical background.
A beautiful, clear and thoughtful piece as always. But just as the five emergencies didn't really exist for most Americans for the last several months (at least), the ending of the self-same five will be recognized in a totally opposite fashion. Specifically, most Americans will wake up only when free healthcare (Medicare expansion), free tests disappear, free vaccines disappear, and free drugs disappear. And by the time that happens, I predict that the ship has sailed, and it will be impossible to bring it back into port.
Wow, excellent job untangling a lot of complicated pieces and explaining things in simple terms that are easy to understand. Thank you!
Where I live (Marin County, CA) wastewater is at an all time high (higher than January 2022), reported cases and test positivity are low, and nearly everyone is back to normal. Our county has excellent public health, and vaccination/booster rates are among the highest on the planet.
I am having trouble reconciling the high wastewater level with low cases and test positivity. Does this mean there’s a lot of asymptomatic transmission going on that’s not being picked up through testing? How does this translate in to personal risk of catching covid when I’m out and about?
I expect our Covid future (and future pandemics) to be as unnecessarily shambolic and sociopathically omni-destructive as our behavior in the face of the far worse, elemental problems of carbon and plutonium.
As usual this is a good, levelheaded analysis, but it leaves out oh, so many, important considerations, such as
(1) The end of emergency restraints on rent payments and evictions.
(2) The specification of an actual concrete and transparent plan with explicit criteria to monitor for surges, new variants, and other infectious epidemics (Measles is sure to explode soon.)
(3) Draft legislation to strengthen central CDC data collection authority.
(4) Specific public health guidance on protecting the 10+ million medically high risk and the 40-50 elderly high risk Americans from COVID.
(5) The development of an all variant vaccine
(6) The federal creation of a memorial (day?) for those who died and their families.
(7) Expedited federal disability for people with long covid.
BTW It is impossible to consider exiting the emergency without attending to the continued infection and suffering of our fellow citizens, mostly the elderly, the unvaccinated and the Republicans.
Hi, Dr. Jetelina: thank you so much, once again, for coming to the rescue with clear public facing communications. I do have one question. You note, “After May, insurers will be able to choose whether to reimburse for those tests or not. We don’t have word yet, either way.” From what I have read, from calling my congresspeople, and in listening to Jha speak about this, it does not appear that “insurers” includes Medicare. In the case of Medicare (or at least those of us on traditional Medicare), my understanding is that Medicare will not cover antigen tests at all after 5/11. If you have information that indicates this is not the case, it would be great if you would pass it on.
Thank you for this information! Beautifully and clearly written as always. The skeleton monitoring of Covid that will occur is beyond disappointing. And the lack of access to testing will seem to mean we will be flying blind. Do you have any concrete recommendations for a better approach going forward? Covid is still a leading cause of death, but with no data, who will know?
High risk person --like Ron above, decreased antibody production/primary immune deficiency--with health insurance who already feels so constrained/abandoned. And the front page of the Boston Globe highlighted that there are no primary care physicians available in this area.
If it's any consolation, there was the same communication mess in France (I'm French) until a few weeks ago, when the government decided to form a new "scientific council" supervised by Brigitte Autran, a well-respected immunologist with a talent to communicate (almost) as good as yours! This will be the only voice (we hope!) for anything Covid and beyond. So you know what to do: reduce 5 to 1 (easier said than done). As always, highly useful information. Many thanks!
Again thank you Dr. Jetelina. You are outstanding. First of all the CDC should hire you so you could communicate to everyone. Actually I don't want that to happen because all they will do is muzzle you. As someone who is elderly and immune compromised and suppressed (I don't produce natural antibodies) the end of the emergency declaration sound so bad. Our health policy is helping to destroying the lives of so many. The only good thing is that we don't live in the UK where the National Health Service is so underfunded and understaffed that many are dying because of these situations. But no one cares. That could likely happen here when the emergency declarations are removed. My understanding is that a reformulation of Evershield is in clinical trial with availability??? in second half of 2023. Can you confirm this? Thank you again. Assuming this is the case I am already standing in line for it.
Excellent review of the meaning/impact of ending the national Pandemic emergency in May. Thank you for breaking it down in five buckets.
In my opinion, looking backward, there was a critically important sixth bucket that has already been dismantled. This sixth bucket is the “emergency preparedness” bucket. This $22 billion bucket was dismantled by Congress last March and was not restored in the final spending bill for this year that was passed in December.
Sadly, we still have not learned the lessons about the importance of Covid response and pandemic preparedness primarily for:
• developing, manufacturing and distributing new vaccines and therapies,
But also, as partially addressed in YLE assessment:
• surveillance/testing capacity to track existing/emerging infectious diseases;
• targeting public awareness efforts about treatments and vaccines (with special emphasis addressing vaccine hesitancy); and,
• supporting international efforts to track, prevent and treat infectious diseases.
While we are in a better place with Covid today than we were last year, there are still more than 500 Covid deaths every day (as of February 6) and mutations continuing to lead to new variants.
To stay ahead of the threat of this virus, NIH and drug companies need to develop new vaccines to more effectively prevent severe illness, and improved antiviral treatments. Public-private partnerships with robust government funding and direction are essential to make sure this happens.
Unfortunately, without a public announcement, this sixth Covid emergency bucket was dismantled last year, and our country is at risk. We have learned so much from the Covid pandemic and now is not the time to drop the preparedness ball. And yet it has been more than 18 months since new funding was approved for Covid-fighting programs. Congressional funding support is needed to make this a winnable battle.
Consider the wisdom of Yogi Berra when he said - “it ain’t over ‘til it’s over.”
Excellent newsletter. You mentioned that we may have more clarity regarding a second bivalent booster after a meeting of experts in mid February. When exactly is that meeting? Thanks for all you do. I am a non scientist (with deep admiration for the scientific community) and I appreciate the vibe of inclusion and non judgment for those of us who are from other fields but follow to be informed citizens.
This was an excellent article--but you still agree that the public health emergency should end, as you clearly stated in your last newsletter. You clearly stated *here* what is at stake for millions of uninsured/underinsured/low-income/disadvantaged people when this is allowed to expire. How do you square these two wildly opposite points-of-view? Clinically vulnerable people are waiting to know.
Re: vaccines -- the current EUAs prohibit parties other than the federal government from purchasing or distributing the vaccines. Either the EUAs will need to be revised to allow for private purchase and distribution (as was previously done with bevtelovimab), or BLAs will have to be issued.
I'm sure one or both of those things will happen, but if they hypothetically did not, then there would be no legal way for people to obtain COVID-19 vaccines after current supplies run out.
Thank you so much for this. I'm sure it took a lot of time to figure out and even more time to explain in a clear way. I wish this explanation was given out everywhere. The Medicaid check thing was a big problem before COVID, and I am sorry to see that situation return.
I love how you close each section with "what this means to you". Thank you for making all this complicated information useful for those of us without a medical background.
A beautiful, clear and thoughtful piece as always. But just as the five emergencies didn't really exist for most Americans for the last several months (at least), the ending of the self-same five will be recognized in a totally opposite fashion. Specifically, most Americans will wake up only when free healthcare (Medicare expansion), free tests disappear, free vaccines disappear, and free drugs disappear. And by the time that happens, I predict that the ship has sailed, and it will be impossible to bring it back into port.
Wow, excellent job untangling a lot of complicated pieces and explaining things in simple terms that are easy to understand. Thank you!
Where I live (Marin County, CA) wastewater is at an all time high (higher than January 2022), reported cases and test positivity are low, and nearly everyone is back to normal. Our county has excellent public health, and vaccination/booster rates are among the highest on the planet.
I am having trouble reconciling the high wastewater level with low cases and test positivity. Does this mean there’s a lot of asymptomatic transmission going on that’s not being picked up through testing? How does this translate in to personal risk of catching covid when I’m out and about?
Nicely done—keep digging!
I expect our Covid future (and future pandemics) to be as unnecessarily shambolic and sociopathically omni-destructive as our behavior in the face of the far worse, elemental problems of carbon and plutonium.
As usual this is a good, levelheaded analysis, but it leaves out oh, so many, important considerations, such as
(1) The end of emergency restraints on rent payments and evictions.
(2) The specification of an actual concrete and transparent plan with explicit criteria to monitor for surges, new variants, and other infectious epidemics (Measles is sure to explode soon.)
(3) Draft legislation to strengthen central CDC data collection authority.
(4) Specific public health guidance on protecting the 10+ million medically high risk and the 40-50 elderly high risk Americans from COVID.
(5) The development of an all variant vaccine
(6) The federal creation of a memorial (day?) for those who died and their families.
(7) Expedited federal disability for people with long covid.
BTW It is impossible to consider exiting the emergency without attending to the continued infection and suffering of our fellow citizens, mostly the elderly, the unvaccinated and the Republicans.
Hi, Dr. Jetelina: thank you so much, once again, for coming to the rescue with clear public facing communications. I do have one question. You note, “After May, insurers will be able to choose whether to reimburse for those tests or not. We don’t have word yet, either way.” From what I have read, from calling my congresspeople, and in listening to Jha speak about this, it does not appear that “insurers” includes Medicare. In the case of Medicare (or at least those of us on traditional Medicare), my understanding is that Medicare will not cover antigen tests at all after 5/11. If you have information that indicates this is not the case, it would be great if you would pass it on.
Thank you for this information! Beautifully and clearly written as always. The skeleton monitoring of Covid that will occur is beyond disappointing. And the lack of access to testing will seem to mean we will be flying blind. Do you have any concrete recommendations for a better approach going forward? Covid is still a leading cause of death, but with no data, who will know?
High risk person --like Ron above, decreased antibody production/primary immune deficiency--with health insurance who already feels so constrained/abandoned. And the front page of the Boston Globe highlighted that there are no primary care physicians available in this area.
If it's any consolation, there was the same communication mess in France (I'm French) until a few weeks ago, when the government decided to form a new "scientific council" supervised by Brigitte Autran, a well-respected immunologist with a talent to communicate (almost) as good as yours! This will be the only voice (we hope!) for anything Covid and beyond. So you know what to do: reduce 5 to 1 (easier said than done). As always, highly useful information. Many thanks!
Again thank you Dr. Jetelina. You are outstanding. First of all the CDC should hire you so you could communicate to everyone. Actually I don't want that to happen because all they will do is muzzle you. As someone who is elderly and immune compromised and suppressed (I don't produce natural antibodies) the end of the emergency declaration sound so bad. Our health policy is helping to destroying the lives of so many. The only good thing is that we don't live in the UK where the National Health Service is so underfunded and understaffed that many are dying because of these situations. But no one cares. That could likely happen here when the emergency declarations are removed. My understanding is that a reformulation of Evershield is in clinical trial with availability??? in second half of 2023. Can you confirm this? Thank you again. Assuming this is the case I am already standing in line for it.
Excellent review of the meaning/impact of ending the national Pandemic emergency in May. Thank you for breaking it down in five buckets.
In my opinion, looking backward, there was a critically important sixth bucket that has already been dismantled. This sixth bucket is the “emergency preparedness” bucket. This $22 billion bucket was dismantled by Congress last March and was not restored in the final spending bill for this year that was passed in December.
Sadly, we still have not learned the lessons about the importance of Covid response and pandemic preparedness primarily for:
• developing, manufacturing and distributing new vaccines and therapies,
But also, as partially addressed in YLE assessment:
• surveillance/testing capacity to track existing/emerging infectious diseases;
• targeting public awareness efforts about treatments and vaccines (with special emphasis addressing vaccine hesitancy); and,
• supporting international efforts to track, prevent and treat infectious diseases.
While we are in a better place with Covid today than we were last year, there are still more than 500 Covid deaths every day (as of February 6) and mutations continuing to lead to new variants.
To stay ahead of the threat of this virus, NIH and drug companies need to develop new vaccines to more effectively prevent severe illness, and improved antiviral treatments. Public-private partnerships with robust government funding and direction are essential to make sure this happens.
Unfortunately, without a public announcement, this sixth Covid emergency bucket was dismantled last year, and our country is at risk. We have learned so much from the Covid pandemic and now is not the time to drop the preparedness ball. And yet it has been more than 18 months since new funding was approved for Covid-fighting programs. Congressional funding support is needed to make this a winnable battle.
Consider the wisdom of Yogi Berra when he said - “it ain’t over ‘til it’s over.”
Excellent newsletter. You mentioned that we may have more clarity regarding a second bivalent booster after a meeting of experts in mid February. When exactly is that meeting? Thanks for all you do. I am a non scientist (with deep admiration for the scientific community) and I appreciate the vibe of inclusion and non judgment for those of us who are from other fields but follow to be informed citizens.
This was an excellent article--but you still agree that the public health emergency should end, as you clearly stated in your last newsletter. You clearly stated *here* what is at stake for millions of uninsured/underinsured/low-income/disadvantaged people when this is allowed to expire. How do you square these two wildly opposite points-of-view? Clinically vulnerable people are waiting to know.
Wow. Huge thank you for this very clear article.
Re: vaccines -- the current EUAs prohibit parties other than the federal government from purchasing or distributing the vaccines. Either the EUAs will need to be revised to allow for private purchase and distribution (as was previously done with bevtelovimab), or BLAs will have to be issued.
I'm sure one or both of those things will happen, but if they hypothetically did not, then there would be no legal way for people to obtain COVID-19 vaccines after current supplies run out.
Thank you so much for this. I'm sure it took a lot of time to figure out and even more time to explain in a clear way. I wish this explanation was given out everywhere. The Medicaid check thing was a big problem before COVID, and I am sorry to see that situation return.
We are wondering, as a couple in our seventies, if we will still be able to get vaccines every six months, even if we have to pay for them.