A Message from The Center for Closing the Health Gap
By Clyde E. Henderson, MD
Cincinnati Medical Association
In January of 2023 President Joseph Biden announced that his administration was planning to end the COVID-19 public health emergency (PHE) as of May 11, 2023. That early announcement was designed to provide states and other shareholders time to wind down Medicare, Medicaid, and CHIP waivers put into place to allow for pandemic management. The national health emergency was initially put into place by the former President in March 2020. After a recent Republican House backed bill called the “Pandemic Is Over Act” was passed in the US House, and by a bipartisan vote in the Senate, President Biden signed the bill into law on 4/10/2023. Many experts opine that the month early elimination of pandemic mandated changes will have minimal impact since many of the mandates are no longer in use because the disease has slowed.
With that said, there remain practical changes that citizens will feel. Realize that these COVID era rules eliminations are occurring in the face of ongoing SARS-CoV-2 illnesses. Updated acute COVID-19 data since our last report six weeks ago reveals that weekly deaths are down 38%, and the daily average hospitalizations are down 42%. Nevertheless, 1,773 Americans died from this virus last week, there were 120,820 cases, and daily average hospitalizations were 2,080 people. Total US deaths since the beginning of the pandemic are at a staggering 1.1 million and the total number of cases is over 104 million. As previously stated, this number represents a dramatic underreporting due to the massive amount of unreported at-home testing. Our Hamilton County is at a LOW community level, as are ALL the adjacent counties in the Tri-State area.
What we have learned since early in this pandemic is that testing is key to fighting this disease. The US would likely be in a different space, with fewer dead and less disease, if testing had been made available and widespread early on. One of the major changes, as the PHE ends, is that free home testing will no longer be available for the uninsured. Those who have insurance may have variable out-of-pocket expense for home testing kits. It would be prudent to be sure that all our households have an adequate supply of Covid-19 tests. You may have appropriate concerns that the kits may reach their expiration dates before they are used, but the FDA has extended the expiration dates of many available test kits. The specifics and the duration of the extension can be accessed, by the lot number printed on the box, at www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-otc-covid-19-diagnostic-tests#list.
Vaccination and boosting have been miraculous tools in preventing death, hospitalization, and severe COVID-19 disease. Another casualty of the end of the public health emergency, and because Congress has failed to supply funds, is that individuals will have to bear some cost for their vaccinations. Moderna has reversed its earlier decision to charge for its vaccinations, and they will now be free throughout 2023. The Pfizer vaccines will cost in 2023 unless one has insurance, in which case the shots will be a covered expense under the guidelines of the Affordable Care Act. For low-income Americans Pfizer has an assistance program and some uninsured adults can be cared for through public health programs. Uninsured vaccine eligible children, six months of age and older, can still get free vaccinations under the auspices of the federally funded Vaccines for Children (VFC) program.
There are other less visible, but real-world changes which will result from the end of the public health emergency. Nursing homes, which were under severe stress early in the pandemic, were allowed a shorter training time for nurse assistants. They may now face even worse staffing shortages because the pre-pandemic longer training times will be reimplemented. Secondly, the disallowance for the telehealth prescribing of anti-addiction medication may lead to more lost lives. Thirdly, hospitals stays can be longer and the number of rural hospital beds allowed will return to their lower pre-pandemic levels. Additionally, physician’s assistants and nurse practitioners working in hospitals will return to their pre-pandemic roles.
We citizens should still protect ourselves despite the PHE ending. Stay up to date on your vaccines and boosters. Know your county COVID-19 level and govern yourselves accordingly. Have masks available and WASH your hands.