UPDATED: This story has been updated to reflect that the federal government now says that it will send out free COVID-19 test kits through the end of May.
At the end of the day Thursday, for the first time in more than three years, there will no longer be a federal Public Health Emergency for the COVID-19 pandemic.
With the flip of a legal switch, the government wind down sending out free COVID tests. Publicly shared data about COVID cases and community spread may be reduced or eliminated. A ticking clock will start for other pandemic services that are set to wind down, including free vaccinations from the federal stockpile.
The pandemic is ebbing. Deaths, hospitalizations, and cases have plummeted. Compared to the peak of the Omicron variant, deaths and hospitalizations due to COVID-19 are down 80% nationwide, according to the Centers for Disease Control and Prevention. Last week in Georgia, there were 23 COVID-19 deaths, according to the CDC—compared to 975 in the peak week of January 2021.
While some of the emergency changes raise concerns — think the loss of some data surveillance to detect and stop COVID outbreaks as soon as possible — it’s time to ramp up alternatives and chart a long term course, some experts say.
“We’ve all gotten used to the dashboards and the immense amount of data that’s reported, daily in most cases,” Georgia Department of Public Health Deputy Commissioner Chris Rustin said in a DPH board meeting Tuesday. “But many of the these data reports and dashboards will actually end when the the federal emergency ends.”
CDC officials say even with the changes, there will still be enough data to fight outbreaks.
“It is not the end of COVID-19. COVID-19 remains a risk,” CDC Principal Deputy Director Dr. Nirav Shah told reporters in a briefing last week. However, he said, “We have the right data for this phase of COVID-19... In short, we will still be able to tell that it’s snowing, even though we’re no longer counting every snowflake.”
President Joe Biden made similar remarks Tuesday while officially pulling back his pandemic restrictions on air travel. “Today, we are in a different phase of the response to the coronavirus,” Biden said. “We have the tools to detect and respond to the potential emergence of a variant of high consequence.”
Georgians involved in the pandemic fight said it was time to build for the future.
“I think it’s going to be difficult to know what’s here and what isn’t right,” said Dr. Carlos del Rio, distinguished professor of infectious diseases at Emory University. “But I also will tell you, I think it’s time to get over the public health emergency,” he said. “I think it’s time to incorporate COVID” into life longer-term.
Public officials are grappling with that. They’re trying to gather data in sustainable ways; trying to arrange ways for COVID tests and drugs to be paid for in the insurance system; and trying to create a soft landing for the other transitions like the loss of pandemic supports for video health visits.
Who pays?
Until now, the government has mandated free COVID testing and treatment for virtually anyone. That is going to change and become more complicated.
The Georgia Department of Public Health said that it would continue to provide free test kits at locations throughout the state, as long as its own supplies remain.
A representative answering the federal information line this week for dispensing free COVID tests didn’t know whether it would shut down or not. Her eventual answer: yes it will. Federal officials say free tests can be ordered on the site through the end of May.
The biggest difference in who pays will depend on how the patient is insured: Private insurance, government insurance like Medicare and Medicaid, or no insurance. This is a big deal in Georgia as it has one of the highest uninsured rates in the nation, estimated in 2021 at 1.3 million people.
So what’s still free?
If you want a last batch of free COVID tests from the federal website, the address for people in the U.S. to order them is www.covid.gov/tests.
A lot of medical needs will still be free for a few weeks or months as governments and doctor’s offices work their way through millions of COVID tests, vaccines and antiviral treatments already in hand.
Once that federal stockpile runs dry, insurance and the health care market will begin to handle the cost.
People without insurance may have to pay for tests, vaccines and antiviral medications. The federal government is attempting to contract with some pharmacies to provide them to the uninsured for free. The number of uninsured in Georgia is uncertain right now, but at last measure, in 2021, the rate in Georgia was third highest in the nation, at more than 1 in 10.
Private insurance, including Medicare Advantage plans, will have to make most things free or accessible. There will be some cost-sharing though.
Scientists are concerned that if people have to pay, they won’t get tested as much. Fewer tests could allow new surges to go undetected for longer.
Some free provisions, such as COVID medicines for Medicaid and PeachCare patients, will continue through September of 2024.
Disappearing data
Data about COVID cases will change, in a big way. For example, the CDC will no longer be allowed to require states to provide the number of negative COVID-19 test results in a state, meaning one key measure — what’s know as a “positivity rate” — can no longer be calculated. It’s also the reason the CDC’s “COVID-19 Community Level,” ratings of low, medium or high is ceasing.
The daily fountain of data on outbreaks across the nation down to the community level will all but stop, according to briefings this week by the CDC and the Georgia DPH.
However, they will have other sources of data, many of which CDC notes they didn’t have before the pandemic. For example, hospitals across the nation now report COVID data directly to the CDC, bypassing the state. CDC’s Shah told reporters they had cross-checked the hospital data with other data sources and found it matched 99%.
At the moment, data on outbreaks is not an urgent problem. COVID spread is much lower now and is not up-ending hospital operations.
How’s COVID now?
For the week ended May 3, there were 1,109 COVID-19 deaths in the U.S., and 23 deaths in Georgia. That’s down from 975 in Georgia’s peak week of January 7, 2021. The number of infections is difficult to know, because so many people test at home now.
Hospitalizations have been the main driver of the pandemic response. When hospitals overflowed with COVID patients there were not enough workers or space to properly care for them, impacting other non-COVID patients and leading to extra deaths.
For the week ending May 3, Georgia reported 208 new COVID hospitalizations, down from this year’s spike of 1,635 hospitalizations for the week ended Jan. 4.
Pandemic freedoms
A range of other freedoms will be affected in different ways.
Telehealth visits used to be highly restricted. They’re still regulated, but medical professionals and patients have seen their value, so the federal government is letting those flexibilities continue longer, and evaluating how much to keep.
The end of the federal Public Health Emergency won’t change state laws.
Under the federal emergency, vaccine shots could be administered not just by pharmacists and nurses, but by a pharmacy technician if they were under the supervision of a pharmacist. That federal freedom is going away, but the Georgia Legislature passed its own law this year allowing it to continue in the state.
Visit the updated AJC COVID-19 dashboard for the latest data on cases, hospitalizations and deaths in Georgia at https://www.ajc.com/news/coronavirus/
A PANDEMIC’S RISE AND FALL
COVID-19 deaths per week in Georgia
For the week ending May 3, 2023: 23
Peak week, ending January 20, 2021: 975
New COVID-19 hospitalizations per day in Georgia
Average during the week ending May 7, 2023: 28
Average of peak week, ending January 15, 2022: 1,609
New COVID-19 cases per week in Georgia, confirmed and suspected:
This week, 2023: Uncertain due to at-home testing
The peak week, ending Jan. 26, 2022: 182,097
Source: U.S. Centers for Disease Control and Prevention
Data Reporter Stephanie Lamm contributed to this story.
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