Are you ready for this? May 11 is just a week away. And besides being National Eat What You Want Day, National Foam Rolling Day, and National Twilight Zone Day, May 11 is notable as the day that a couple Covid-19-related U.S. national emergency declarations will be coming to an end. That’s after over three years of the U.S. being technically in an emergency state. While that may sound like a good thing, keep in mind that the Covid-19 pandemic is not over yet. The the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still spreading, and new variants of the virus are still emerging. Plus, the end of these declarations will mean that a number of services and provisions that you may have gotten used to will abruptly expire. So it will be a good idea to know what’s in store for you after May 11, lest you end up getting some big surprises sort of like when a ferret hits you in the groin with a golf club.

One of the dual emergency declarations that will go bye-bye on May 11 is the public health emergency (PHE) that was declared near the end of January 2020, by then-Secretary of the Department of Health and Human Services (HHS) Alex M. Azar II. A PHE declaration typically lasts for 90 days and expires unless it is renewed. Well, as you probably have realized, this PHE has been renewed repeatedly over the past three years because, you know, the U.S. never really got the SARS-CoV-2 under control in 2020, 2021, or 2022. The last PHE renewal occurred on February 11, 2023, which is set to expire on May 11, 2023.

The other soon-to-end emergency declaration is the national emergency declaration that was issued on March 13, 2020 by then-U.S. President and current Mar-A-Lago resident Donald Trump. Such a declaration is supposed to stay in effect as long as the current President issues a continuation notice each subsequent year and either the President or Congress doesn’t act to terminate the declaration. Well, on January 20, 2023, the Biden Administration did indicate that the national emergency would extend to May 11, 2023, at which point it would go the way of the sweater vest and disappear.

So, how is your life going to be different after May 11? Here are 10 things that you should expect to change, in many cases pretty darn quickly:

1. While emergency use authorizations (EUAs) won’t end on May 11, Covid-19 vaccines, tests, and treatments could become less available.

The emergency declarations brought three important vowels to the public’s consciousness. No, not “OOOOO” or “OI.” It’s EUA, which stands for emergency use authorization. That’s when the U.S. Food and Drug Administration (FDA) has determined that while there is not yet enough supporting evidence to justify full approval of a medical product, there is enough scientific data showing that the benefits of that product far outweigh the risks. To be clear, a EUA doesn’t mean that the product hasn’t properly been tested. And it doesn’t mean that the FDA hasn’t critically reviewed the results of such testing. But an EUA is not the same as full approval. Technically, the lapsing of emergency declarations would take the E from the UA, which would mean that various Covid-19 boosters, tests, and treatments that do not have full approval yet would disappear from the market. However, the federal government has already decided that EUAs for various Covid-19-related products will continue past May 11. There’s a decent chance that these will continue until many of these products receive full approval, when the performance of these products have been observed for a long enough time.

One thing that’s clear is that many of these products won’t be as readily available. For example, it used to be that getting a Covid-19 PCR (polymerase chain reaction) test in some neighborhoods was about as easy as walking down the street. Nowadays, it can seem as difficult as getting Taylor Swift concert tickets as a lot of places have stopped offering such test.

2. Covid-19 vaccines, tests, and treatments may get a lot more expensive with less insurance coverage.

Even if you can find Covid-19 vaccinations, tests, and treatments after May 11, chances are they are gonna cost you a lot more going forward. Don’t expect Covid-19 vaccines and tests to be free as they have been, courtesy of the federal government paying manufacturers big bucks. Also, while the public health emergency declaration required insurance plans to cover different Covid-19-related products and services, that won’t necessarily be the case after May 11.

Meanwhile, take a wild guess as to what Pfizer and Moderna are already planning to do after receiving billions of dollars of taxpayer money. Yep, as I covered for Forbes in January, they’ve already indicated intentions to increase the price of their Covid-19 mRNA vaccines. And not just slight increases. Potentially four-fold increases, up to the $110 to $130 range.

3. There may be a lot less information about what’s happening with the SARS-CoV-2, new variants, upticks, and surges.

The already not-so-great U.S. national Covid-19 surveillance system is about to get even worse. Throughout the Covid-19 pandemic, one of the biggest weaknesses with the U.S. response has been the lack of a consistent proactive surveillance system that can better anticipate and thus help prevent Covid-19 surges. Well, the Centers for Disease Control and Prevention (CDC) and other federal agencies are about to have even less data at their disposal. When the emergencies expire on May 11, the U.S. Department of Health and Human Services (HHS) will no longer be able to require state and local public health departments and other labs to report data from Covid-19 testing. A number of states and municipalities have already indicated that they will make Covid-19 reporting a lot less frequent. So it will be a lot harder to tell when and where new variants and subvariants spread and upticks or even surges are beginning to occur. Gee, what could possibly go wrong?

4. Covid-19 vaccination and other requirements will essentially disappear, leaving questions about how the virus will be handled.

Again, the SARS-CoV-2 is still spreading, and new potentially more transmissible variants and subvariants of the virus continue to emerge. Earlier this week, the Biden administration indicated that it will lift most of the remaining federal Covid-19 vaccine requirements on May 11, such as mandates for federal workers, federal contractors, and those traveling to the U.S. from other countries. While 69.4% of the U.S. population has gotten the initial primary series of Covid-19 vaccinations—which is decent percentage but still lower percentage than many other high income countries—only 16.8% have gotten the latest bivalent booster, based on the CDC Covid Data Tracker. That’s certainly not a high percentage by any means. So the big question is how will upticks, surges, new variants and subvariants, and other potential badness be prevented or at least mitigated in some way going forward? Will our society simply say, “Oh, that kind of sucks,” when a surge occurs? Covid-19 may eventually become a lot more like other respiratory viruses that have adopted more seasonal patterns like the flu. But it isn’t there yet. It’s still deadlier than the flu and then there’s that whole long Covid thing.

5. The healthcare worker shortage may get even worse.

The Covid-19 pandemic hasn’t been good to healthcare workers. In fact, the past couple of decades haven’t been good for healthcare workers. Tough working conditions and burnout have been problems for doctors, nurses, and others in the healthcare profession long before the SARS-CoV-2 arrived on the scene. The Covid-19 pandemic along with all the personal protective equipment shortages in 2020 that forced healthcare workers to literally risk their lives delivered yet another kick in their collective groins. Sure, the applause and cowbells were nice at the beginning of the Covid-19 pandemic. But applause and more cowbell don’t pay the bills, help with exhaustion, or alleviate trying work circumstances. A 2022 report from Definitive Healthcare found that “since 2020, one in five healthcare workers have quit their jobs, and surveys suggest that up to 47% of healthcare workers plan to leave their positions by 2025.”

The emergency declarations did help healthcare systems temporarily fill labor gaps by relaxing the credential and experience requirements needed for people to serve different functions in healthcare facilities such as nursing homes and hospitals. However, “Go ahead and hire someone less qualified” is not a great long-term solution when it comes to people’s health. On top of that, many such temporary stopgap measures will go away after May 11, which can further pull down the metaphorical pants of a healthcare system that’s got existing labor shortages and a whole lotta problems.

6. Healthcare could get even more expensive.

Speaking of lotta. Guess what might get a lotta more expensive. A bargain may not be the first word that comes to mind when you think of healthcare in the U.S. Hospitals did receive additional funding during the public health emergency such as various types of funding infusions earlier in the pandemic and a 20% bump in what Medicare paid for the treatment of Covid-19 patients. With the loss of such funding after May 11, do you know who’s going to have to make up for that shortfall that hospitals and other healthcare facilities will be facing? Go to the bathroom, look straight into the mirror, point straight forward, and say a word that rhymes with “clue.” That’s assuming that you pay taxes, pay for healthcare, or pay for insurance.

7. Many people could lose their health insurance coverage.

“More expensive healthcare is fine because you can always get insurance, right?” is what basically no one has ever said in the U.S. Having insurance is not like having some kind of a “Sugar Daddy” or “Sugar Mamma.” You still end up paying for things via insurance premiums and taxes. Plus, many people cannot even afford to have insurance. The emergency declarations helped allocate funding to keep millions of people covered by Medicaid and prohibited states from changing the eligibility requirements, premiums, and benefits packages. But all of that may change after May 11.

Additionally, there’s the COBRA problem—not a snake problem but changed to provisions in the Consolidated Omnibus Budget Reconciliation Act (COBRA). Since getting health insurance coverage in U.S. is so tied to employment—which is rather different from most other countries around the world— without COBRA options, those leaving a job could be kind of, how shall we say it, screwed. COBRA allows a person leaving employment to purchase health insurance coverage at the lower group rates offered to employers. But before the pandemic, there were time limits on when this could be done. The emergency declarations did extend the time period during which you could elect to have COBRA. But many such extensions will no longer hold after May 11.

Take a wild guess as to whom may be most affected by all of these insurance changes. People with a lot of money and a lot of power. Umm, no. These changes will disproportionately affect those who are already disadvantaged and most vulnerable such as many communities of color.

8. Various services may become less available.

One big positive about the Covid-19 pandemic has been the increasing use of telehealth services. Telehealth is an alternative to in-person visits to healthcare clinics in which patients get seen over a video platform. Of course, not everything can be readily done over telehealth such as a rectal exam. To get the full wonderful experience of such a thing, you have to be seen in person. However, there are many other types of care that can be done remotely, which can be a godsend for those who can’t afford to spend a half-day making a clinic visit and would like to be spared the joys of sitting in a waiting room where everyone is coughing on each other. Telehealth can also extend access to those who live a distance from healthcare facilities. The emergency declarations did facilitate the use of telehealth through various means. For example, they helped ensure that Medicare covered different types of telehealth and allowed telehealth visits to be delivered via smartphone when other audio-visual equipment was not available. The Consolidated Appropriations Act, 2023 did extend a lot of these provisions through December 31, 2024.But it’s not clear what will happen after that.

A number of services could effectively disappear much sooner, though. For example, the emergency declarations did allow healthcare professionals in appropriate situations to dispense controlled substances—such as buprenorphine—remotely via a telemedicine platform without actually having to see the patient in person. Now, being able to do this can be quite important when treating those suffering from substance use addiction. The Drug Enforcement Administration (DEA) may extend these capabilities but it’s not yet clear how and for how long.

9. People with long Covid and those at greater risk for Covid-19 complications could be left further behind.

It’s not as if our society has been taking great care of everyone with long Covid. For example, it’s not yet clear what the plan is for treating the many, many people saddled with persistent, often debilitating, symptoms. How will further research into these still rather mysterious conditions be funded? How will the conditions of those with long Covid be tracked? And over the past three years, many people—including a number of politicians and TV, radio, and podcasting personalities—have shown just how much they care about those who are more vulnerable to more severe Covid-19 complications. The answer is not a whole lot. For example, observe how quickly so many people ditched face masks as if they were soiled underwear once they were no longer required. So, with most Covid-19 precautions effectively lifted, those particularly vulnerable to Covid-19 could be facing a bit of a daily game of dodge ball with the ball in this case, having a bunch of spike proteins.

10. Research and other pandemic preparedness and response efforts could once again become neglected.

One of the broader effects of having these emergency declarations lapse will be a relative lack of attention to the Covid-19 pandemic and pandemic preparedness and response in general. Recall what happened soon after the 2009 H1N1 influenza pandemic ended. People soon forgot about trying to prevent possible outbreak, epidemics, and pandemics. The concern is that May 11 will catapult our society into another “neglect” portion of what the Pandemic Action Network has called the “cycle of panic and neglect,” as I covered for Forbes back in 2020. The big question is what is the plan going forward? How will the Biden Administrations and all future administrations prevent what has happened since 2020 once again? As our society shifts from discussing pandemic preparedness and response back to stuff like what the Kardashians are wearing, the real risk is that our society hasn’t really learned a whole lot from the Covid-19 pandemic. Nature has a way of re-teaching lessons when they haven’t been learned. And the next time, things could be even worse. As 2020 through 2023 should have taught everyone, you can’t wait until a real emergency to say, “Hmm, I think we really need to do something about this problem.”

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