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Our institutions have given up on the COVID-19 pandemic. We should not.

William Zhu and Gregory Jasani, MD
Conditions
July 11, 2023
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The COVID-19 pandemic is over. On May 5, The World Health Organization announced that COVID-19 was no longer a public health emergency. The U.S. followed suit on May 11, allowing the public health emergency declaration to expire.

The pandemic did not end because of vaccination efforts nor from acquired herd immunity. The pandemic is over because of the capitulation and resignation of public health authorities as they concede that the COVID-19 pandemic is here to stay regardless of what we do. Rather than giving up, we should keep the public health emergency in place until COVID-19 has subsided and when we are prepared for the next pandemic.

It makes no sense to end the COVID-19 public emergency since the critical facts of the virus are unchanged. The infections are common and lethal, especially to the medically vulnerable. Additionally, the U.S. is still unprepared for the next pandemic, both not having learned lessons from the current one and not rebuilding degraded health care infrastructure.

According to the CDC, the end of the emergency declaration entails a shift of resources away from both disease prevention and tracking. The CDC will no longer report COVID-19 community spread. Additionally, COVID-19 tests, treatments, and vaccines will no longer be free to all and will be subject to conventional insurance coverage rules.

Pandemics can either end with the triumph of public health and medicine when infection and death rates plummet to nearly nonexistent or, the far the more common outcome, when society accepts the death and illness from the disease as a new normal. Unfortunately, we are in the latter scenario.

COVID-19 has killed more than a million Americans since 2020, and there are several times that amount to complications such as autoimmune conditions, brain fog, and lung disease. There are economic consequences to this as well, with Chairman of the Federal Reserve Jerome Powell, in a December 2022 speech estimating around 400,000 workers are missing from the workforce due to death from COVID-19. This doesn’t count workers who have left the workforce from both temporary and permanent disability, which could be in the millions. Lost economic productivity due to COVID-19 infection and long COVID is estimated to surpass $150 billion in wages annually. If the disease continues to cause losses in labor availability and wages to this scale, that is an emergency.

An even more sobering fact is that the U.S. life expectancy has been growing in the past few decades and has fallen in the past two years. This results from both COVID-19 deaths and an increase in opiate overdoses. Yet only one of those retains the designation of a public health emergency. Why the inconsistent approach to two similarly serious issues of public health?

While it’s true COVID-19 infections, deaths, and hospitalizations are at all-time lows, the risk of death with COVID-19 remains high for the elderly and immunocompromised. With the lifting of mask mandates—even in patient care areas of some hospitals, there are increasingly fewer safe spaces for individuals with weakened immune systems. According to the American Medical Association, this is nearly three percent of the whole population: around 9 million people.

Undergoing an organ transplant today and starting immunosuppressive therapy carries a higher risk of death than it did before COVID-19. We must protect vulnerable community members and not normalize this status quo as our new baseline.

The pandemic has ravaged the nation and left the U.S. health care infrastructure in tatters. Health care workers reported record levels of burnout and moral injury due to repeated death during COVID surges each winter. According to some reports, up to a third of nurses are considering early retirement. On top of that, thousands of public health employees will be laid off due to the emergency declaration ending, continuing a decade trend of cuts to public health positions across the country. This does not bode well for a future pandemic response.

The pandemic is over because government institutions have decreed such, not because the virus is absent. People are sicker, dying younger, and less able to participate in the economy and society. A new disease will appear every few years, as evidenced by the previous MERS, Ebola, and Zika outbreaks. It’s only a matter of time before the next COVID-19 pandemic. Making testing, vaccines, and treatments broadly available while also shoring up public health funding will be essential in ensuring a safe and healthy nation. We must not admit defeat but take stock and prepare for the future.

William Zhu is a medical student. Gregory Jasani is an emergency physician.

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Our institutions have given up on the COVID-19 pandemic. We should not.
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