The Biden administration said in February that while “an orderly transition” from the dual emergencies was necessary, the impact of the virus in the United States has changed since they were first implemented.

“Today, we are in a different phase of the response to that pandemic than we were in March of 2020,” he said at the time.

National emergency

The national emergency, which ended with the bill signed Monday, gave the federal government the ability to take blanket measures to prop up the healthcare system, federal healthcare plans and the welfare system in the face of the outbreak and its many economic implications.

It activated certain provisions in the Stafford Act, through which federal funding was provided to U.S. states and territories to support their response to the pandemic.

The national emergency granted then-President Donald Trump and eventually Biden the ability to place student loan repayments on hold.

Biden used the power granted by the emergency as a basis for his student debt forgiveness plan which has since been placed on hold by federal courts and now faces scrutiny by the Supreme Court.

Ending the national emergency over COVID-19 is also symbolic of transitioning from one phase of the pandemic response to another. The new phase is focused on providing long-term, sustainable support for states addressing the challenges that stem from the pandemic, rather than an emergency response.

The eventual end of the public health emergency will bring more apparent changes to everyday people.

Public health emergency

Biden’s signature did not bring an end to the public health emergency that the United States entered in January 2020. The public health emergency created emergency procedures within healthcare systems, as well as blanket waivers in federal health coverage programs.

“An end to the COVID-19 national emergency does not impact current operations at HHS, and does not impact the planned May 11 expiration of the federal PHE for COVID-19 or any associated unwinding plans,” a spokesperson for Health and Human Services said in an email to UPI.

“Any existing waivers currently in effect and authorized under the 1135 waiver authorization for the pandemic will remain in place until the end of the federal PHE for COVID-19.”

When the public health emergency does end, so too will many of these waivers.

While, most telehealth services will remain untouched, the public health emergency created a waiver to allow more types of healthcare professionals, such as physical therapists, occupational therapists, speech language pathologists, to provide telehealth services. These waivers will end 151 days after the end of the public health emergency, as will waivers for certain audio-only telehealth services.

Over-the-counter COVID-19 tests will no longer be free for Medicare Plan B recipients. Private insurance companies will no longer be required to cover the costs of COVID-19 tests without cost-sharing plans. However, HHS is encouraging insurance companies to continue offering this service. State Medicaid must continue offering cost-sharing for tests for a year after the end of the emergency.

Many processes established under the emergency will not change after May 11.

Most people will still have access to COVID-19 vaccines without paying out-of-pocket costs. Medicaid will continue to cover the cost of vaccines until Sept. 30, 2024.

Title 42

Along with the significant changes to healthcare processes and insurance coverage, the May 11 end of the public health emergency will also end the Trump-era immigration policy Title 42.

Title 42 is a federal law that allows the federal government to activate a stringent immigration policy geared toward preventing the spread of a communicable disease to and from other countries. It was first used in 1944 and the Centers for Disease Control and Prevention used the law in March 2020 in an effort to slow the spread of COVID-19.

Biden attempted to end the use of the law in the fall. More than 2.5 million migrants have been expelled at the southern border under Title 42, according to the Washington Office of Latin America, a non-profit organization that advocates for human rights.

Because migrants were “expelled” rather than “deported,” they are unable to appeal the decision before a judge.

The Supreme Court took up the issue before ruling in December to put its decision on hold until June.

While the president has supported lifting Title 42, in January he enhanced security and enforcement at the U.S.-Mexico border when the law is deactivated. These enhancements include stiffer consequences for unlawful entry and increased use of expedited removal.

The White House said in a statement that it supports an orderly lifting of Title 42 restrictions but warned that a bill aiming to end the public health emergency early, which has stalled in the Senate, would create disruption at the border.

“Enactment of H.R. 382 would lift Title 42 immediately, and result in a substantial additional inflow of migrants at the Southwest border,” the White House statement said.

“The Administration supports an orderly, predictable wind-down of Title 42, with sufficient time to put alternative policies in place. But if H.R. 382 becomes law and the Title 42 restrictions end precipitously, Congress will effectively be requiring the Administration to allow thousands of migrants per day into the country immediately without the necessary policies in place.”

The pandemic continues

As the government takes its next step toward a pre-pandemic status quo, the COVID-19 pandemic continues to claim lives and lead to hospitalizations around the country.

The CDC reports 120,820 new cases, 1,773 new deaths and 1,956 new hospital admissions related to COVID-19 in the last week and 10,480 people are currently hospitalized with infection. More than 1.12 million COVID-19 deaths have been recorded in the United States throughout the pandemic.

John Swartzberg, clinical professor emeritus at the University of California, Berkeley School of Public Health, worries that hope is leading policy decisions, rather than data.

“In the last two weeks we averaged nearly 1,800 deaths per week due to COVID. This translates to 93,600 deaths in a year,” Swartzberg said in an email to UPI. “An average number of deaths from influenza is about 25,000. A very bad year would be about 60,000. Should we be accepting this number?”

According to Swartzberg, low-income patients will be the most negatively affected by ending waivers for Medicare, Medicaid and CHIP. Meanwhile, nearly everyone will be impacted with what he believes will be a lack of “easy and inexpensive” access to testing.

As for what the next phase of pandemic response looks like post-May 11, Swartzberg fears what a new variant could bring.

“If a new variant that is more transmissible and virulent (e.g., XBB.1.16) causes a new surge, we’re going to regret the abdication of governmental and personal responsibility that were keys to saving lives,” he said. “If things continue to smolder as they are now, this will be our new normal.”

“Two things that could dramatically change this are better vaccines and more widely available therapeutics.