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February 2, 2023
Dear Friends:
The Biden administration will not renew the COVID public health emergency first declared in January 2020. That announcement came in a press release on January 30th.
To put things another way: The administration has decided to offload COVID risk to the poor and vulnerable. Look at the results of termination:
- Free COVID tests and vaccines from the federal will also end. The federal government will still require health insurers to cover these supplies. But uninsured Americans will have to pay market costs of up to $130 a dose for COVID vaccines.
- States will no longer be required to report COVID data to the CDC. That leaves little to no warning of surges or hot spots in many places.
- Hospitals will lose a 20% increase in payment for treating Medicare recipients with COVID.
- Emergency Use Authorizations for COVID medications will expire. Anti-viral medications like Paxlovid and vaccines for people under the age of 18 would have to receive approval through regular channels or be discontinued. (This may not happen immediately.)
- Pharmacists and pharmacy interns will no longer be able to administer COVID vaccines to children between the ages of 3 and 18.
Some of these effects will vary from state to state. That includes changes to Medicare and Medicaid and COVID reporting. I'll let you know when the Wisconsin picture becomes clearer.
But they all add up to one thing. The most vulnerable Americans are going to pay more and get less from COVID protections.
It was inevitable that emergency measures would end. And admittedly, given the decline in COVID cases and hospitalizations, it's hard to argue against. Katelyn Jetelina says we're in what might be called a "transitional phase" between pandemic and endemic COVID. That sounds about right.
So there's not much use arguing about the emergency's end. It was going to happen sooner or later. But it is important to understand the political dimensions of why this is happening now. Only then can we understand its long-term implications.
Because the Biden administration did not cite falling COVID rates in its declaration. Instead, it pointed to two bills under consideration in the House of Representatives. One would bring the emergency to an immediate end. Another aims to prohibit the use of COVID-related regulations to keep undocumented migrants from entering the United States. The administration claims that abrupt changes in policy would have disastrous consequences.
The Washington Post's Philip Bump correctly understands the underlying factors, I think. Over the course of the pandemic, Democrats have generally favored a community-based response. Republicans, on the other hand, have argued for a more individual approach. At the same time, COVID worries are declining across the political spectrum. That allows Pres. Biden to get ahead of Republicans and take credit for winding down pandemic-related emergency measures.
It is not our business to take sides in a partisan battle. And in any case, it's our society as a whole that's driving this shift, not one political party or another. America in general has decided to drop community response to COVID in favor of individual responsibility. In that, we're not different from many other nations.
It is our business to point out the consequences of that decision. On a basic level, we as a nation have decided to accept COVID as endemic. That is to say, a fact of life like colds or the flu. But COVID is highly transmissible, even more so than colds or flu.
Because of that, according to the authors of this pre-print paper on Medrxiv,* it's not realistic to expect that immunocompromised or otherwise vulnerable individuals can protect themselves against infection.
It's simply not possible for individuals to mask and socially isolate enough to avoid getting sick from COVID. That's particularly the case as people return to in-person work and other social settings.
So the risk for vulnerable individuals is acute, and unfair. But it's shaping up to be a chronic issue for everyone. Vaccinated individuals can expect to spend 6 days a year acutely sick with COVID. Each infection brings a 12% risk of developing long COVID. But Americans have few paid sick days and low rates of savings. COVID can quickly place enormous financial strain on many people.
High rates of COVID infection could also add up to losses in productivity and high inflation across the economy. And none of this includes the ways in which COVID leaves unaddressed or even makes worse underlying health inequities.
Little wonder, then, that the authors of the paper mentioned above conclude that "Permitting the unrestrained spread of SARS-CoV-2 in the population will inflict a heavy burden of infection and long COVID on society as a whole, which will be challenging if not impossible for individuals to opt out of in the long run."
But things are not completely hopeless. The authors do suggest a few strategies that might help mitigate the risk of endemic COVID:
- Investment in improving air quality in public spaces.
- Providing rapid testing kits to prevent the spread of COVID within households.
- Helping vulnerable individuals reduce their contact with potential sources of infection. One way of doing this might be to establish "mask-only" hours in public places. Think grocery stores, government buildings, pharmacies, medical facilities, or public transit. Another might be encouraging virtual or physically-distanced methods of accessing goods and services.
- Maintaining remote work and schooling options.
- Keeping COVID-safe precautions in hospitals and other health-care settings.
Katelyn Jetelina adds that there is much work to be done to repair and strengthen our health and health care systems. As she says, we are arguably less prepared to meet a pandemic than we were before COVID, a need we're likely to face before very long.
Churches can implement many of these things themselves. Imagine a mask-only worship service once a month! They can advocate for others on a local or national level.
To this agenda we can add the ongoing and necessary work of caring for the poor and vulnerable, and advocating for their needs.
Whatever you think about the financial supports implemented under the banner of COVID response, those supports will soon be ending. That means there will soon be a lot of people with less money in their pockets. That in turn means there will be more people in need, who will turn to religious communities for relief. There will also be more than a few people under ongoing threat from infection, or sick or even disabled long-term from being infected.
WCC's Community Health Program is moving into a new phase of its work. Over the next year, our attention will turn to equipping communities to respond to COVID outbreaks, reinforcing best practices, and building a coalition of public health allies able to respond effectively to future epidemics and pandemics.
That work is more urgent than ever. America is getting ready to do what it always does when an emergency passes, which is to step away from collective action and pass the burden back to individuals, no matter how ill-equipped they are to carry the weight.
Again, it's hard to argue with the end of the COVID emergency, but we should be realistic about what that means. Some people will die or be incapacitated permanently because we as a society have decided it's not cost-effective to prevent it.
But we as people of faith know a different truth. We are not our own. My health is your health, and vice versa. We owe it to ourselves and to one another as members of the one body to protect our collective health. We also owe it to ourselves to make sure that our bodies and our lives are not tossed aside the moment they become politically disposable.
That's the work we are called to, and there is plenty of it to go around. I hope that you will join our coalition, for everyone's sake.
Stay safe and stay together,
Rev. Daniel Schultz
WCC Community Health
Program Director
*This means the paper has not gone through the normal scholarly review process. Take it seriously, but don't take it as gospel.
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