Transitioning out of the COVID emergency phase could eventually spell the end of universal access to free vaccines, treatments and tests.
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Three years following the emergence of COVID-19, authorities at state and federal levels are preparing to lift emergency declarations originally issued to marshal pandemic responses.
While the moves will undoubtedly be cheered in some circles — particularly those eager to see the end of COVID restrictions or who have viewed the health measures as government overreach — such steps aren’t merely symbolic. Transitioning out of the emergency phase could eventually spell the end of universal access to free vaccines, treatments and tests.
But plans to rescind the emergency declarations also illustrate a turning in the years-long global battle against COVID-19. The World Health Organization this week said the pandemic “continues to constitute a public health emergency of international concern,” but “is probably at a transition point.”
Here’s what you need to know:
When will the emergency declarations end?
Gov. Gavin Newsom has announced the COVID-19 state of emergency in California will end Feb. 28.
“The state of emergency was an effective and necessary tool that we utilized to protect our state, and we wouldn’t have gotten to this point without it,” he said in a previous statement. “With the operational preparedness that we’ve built up and the measures that we’ll continue to employ moving forward, California is ready to phase out this tool.”
President Joe Biden informed Congress this week that he will end the COVID-19 national emergency and public health emergency declarations on May 11. That decision comes as the nation is “in a better place,” in terms of the pandemic, according to White House COVID-19 response coordinator Dr. Ashish Jha.
“We’re getting through this winter without a big surge or run on hospitals because we have the tools to manage this virus,” he wrote on Twitter this week.
Why not cancel the orders immediately?
The Biden administration is not looking to lift the federal declarations right away “because that would be hugely disruptive to the health care system and the people who rely on it,” according to Jha.
“The health care system still relies on flexibilities from these emergency declarations,” he wrote. “If they end abruptly, many veterans won’t be able to get the care they need; hospitals and nursing homes would see staffing and operations disrupted. It will harm America’s health.”
California’s timeline was unveiled in October but is contingent on the state’s success in navigating a potential winter coronavirus wave.
Though the state did see transmission and hospitalizations rise in the weeks following Thanksgiving, both metrics have since declined substantially. And barring a late-season resurgence, this winter will be the first that the state hasn’t been racked by a devastating surge.
What does the end mean?
The state of emergency allowed Newsom’s administration to waive certain state regulations and statutes and redirect funds in response to the public health crisis. Officials have said such flexibility was vital in the early days of COVID-19, though Republicans have criticized keeping the declaration in place for so long, calling it an unnecessary abuse of executive power.
California’s emergency declaration — issued March 4, 2020 — served as a prelude to more than 70 executive orders, including those aimed at scaling up testing and vaccinations, pausing evictions and expanding the scope of practice for health care workers. Newsom has since terminated many of those orders.
Almost a year ago, state officials unveiled what they refer to as the SMARTER plan, which focuses on preparedness anchored around seven key areas: shots, masks, awareness, readiness, testing, education and Rx (or anti-COVID drugs).
This plan “will ensure a level of operational preparedness to support communities and appropriately respond to future outbreaks,” the California Department of Public Health told The Times this week.
Newsom’s office previously called for legislation to allow lab workers “to solely process COVID-19 tests” and “nurses to dispense COVID-19 therapeutics” once the state of emergency ends. Assemblyman Marc Berman (D-Menlo Park) introduced legislation on the topic in January.
“The Newsom Administration looks forward to working with the Legislature on this measure to maintain California’s COVID-19 operational preparedness,” the governor’s office said.
What about vaccines and treatments?
“On May 12, you can still walk into a pharmacy and get your bivalent vaccine for free,” he said Wednesday. “On May 12, if you get COVID, you can still get your Paxlovid [anti-COVID pills] for free. None of that changes.”
How long that will be the case is anyone’s guess, however. Eventually, “we will transition from U.S. government-distributed vaccines and treatments to those purchased through the regular health care system, the way we do for every other vaccine and treatment,” Jha said. But when that happens, he added, vaccines will remain free “for nearly all Americans.”
“Over time, as we transition this to the regular health care system, we are going to make sure that COVID vaccines and treatments remain accessible and affordable for Americans,” he said.
In a statement to The Times on Thursday, the California Health and Human Services Agency said that even after the state and federal emergencies end, “Californians will continue to be able to access COVID-19 vaccines, testing and therapeutics with no out-of-pocket costs.”
Until Nov. 11, Californians with private health insurance or who are enrolled in Medi-Cal “can access COVID-19 vaccines, testing and therapeutics from any appropriately licensed provider without any out-of-pocket costs, even if the provider is outside the enrollee’s health plan network,” the statement continued.
After that date, residents may be subject to cost-sharing or coinsurance amounts if they access such resources from an out-of-network provider. “However, if the enrollee accesses the services from an in-network provider, the enrollee will not have to pay anything out-of-pocket,” according to the agency.
What about tests?
U.S. households became eligible again this winter for four free at-home COVID tests, which can be ordered through covid.gov/tests or by calling 800-232-0233. The federal government also ordered health insurers to reimburse customers for the cost of eight at-home COVID tests per month — of up to $12 per test — per covered individual. But the government’s order to insurers to reimburse people for the at-home tests may go away once the federal health emergency expires.
Insured people also have not had to pay for lab-based coronavirus tests, and the order to keep those costs free also could go away, too.
In light of decreasing COVID-19 activity, California already plans “to phase out underutilized state-run COVID-19 testing and treatment sites in the coming weeks,” according to the state Department of Public Health.
“These sites were an important part of the state’s COVID-19 testing strategy and response,” the department said in a statement. “A final plan for demobilizing the remaining sites is being prepared.”
That includes three sites in Santa Cruz County: The Veterans Building site in Watsonville closed Jan. 19; Friday will be the last day of testing at the county building on Ocean Street in Santa Cruz; and in Felton, the last day to get a test at the Felton Public Library is Sunday.
The agency is sending additional over-the-counter kits to local health departments that will be affected by the closure of testing sites.
Santa Clara County officials announced plans to demobilize their mass testing and vaccination sites by the end of the month.
“We are transitioning from a full-blown response where we have a sense of urgency every day to one where we are adapting to living with COVID,” Dr. Sara Cody, the county’s public health director and health officer, said during a news conference Wednesday.
She added, though, that she wants “to be very clear: The pandemic is not over. We can’t declare a day when it’s over and, as we’ve seen, it’s having a very, very long tail. We don’t know when it’s going to be over.”
“The states of emergencies, a lot of that is about how to do things faster, how to free up funds faster, but it doesn’t have to do with what the virus is doing because it’s still circulating,” she said.
Times staff writer Taryn Luna contributed to this report.
This story originally appeared in Los Angeles Times.