An ongoing dialogue on HIV/AIDS, infectious diseases,
May 8th, 2023
As the Public Health Emergency Comes to an End, How Are We Feeling About This?
As you no doubt heard, on Friday, May 5, 2023, the WHO declared the end of the global health emergency from COVID-19.
Here in the U.S., the federal public health emergency will expire on May 11. That’s Thursday, just a few days from now.
These events reflect two realities that, while seemingly contradictory, make these decisions reasonable — my constitutionally worried ID-doc mentality notwithstanding.
On the one hand, COVID is far from gone. Our patients, family, and friends are still getting this pesky bug, many of them now repeat episodes. And it always bears mentioning that, for certain people with weakened immune systems or multiple other medical problems, COVID is the cause, or the trigger, of severe illness. Some will get long COVID, though fortunately the incidence of this complication has declined over time.
Some worry about the increase in cases that will likely occur in the South as summer heats up and people move indoors. Or they are concerned about the most recent genetic offspring of Omicron, the scarily named Hyperion (XBB.1.9.1) or Arcturus (XBB.1.16).
All valid points. But let’s look at the other side of the current reality. Deaths due to COVID globally and in the U.S. have been below April 2020 levels and stable for over a year. The same holds true for hospitalizations for severe COVID-related illness.
The cause? Widespread immunity, giving protection from severe illness:
By the end of 2022, an estimated 99% of the US population had some form of immunologic exposure to SARS-CoV-2 (infection or vaccination or both). https://t.co/7iioxJUG8h
— Paul Sax (@PaulSaxMD) May 2, 2023
If you don’t like that study, here’s the CDC’s version, which they presented last week:
So COVID isn’t gone. But it sure is different now.
Importantly, not gone also are innumerable other infectious threats, including RSV and influenza and tuberculosis and Lyme disease and malaria and Staph aureus and you-name-it. No global or federal emergency for them — though I suspect first-year ID fellows all think we should have one for staph.
The passing of the COVID emergency inevitably brings to us ID docs certain feelings and recollections, even if it’s just the creepy feeling that if we let our guard down this SARS-CoV-2 thing is going to pounce again.
Even writing that makes me nervous. To be concise, it’s a combination of relief and trepidation.
So … how are you feeling about this?
Interested in hearing from both the ID and non-ID community!