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President Biden Ends COVID National Emergency After Congress Acts
The U.S. national emergency to respond to the COVID-19 pandemic ended Monday as President Joe Biden signed a bipartisan congressional resolution to bring it to a close after three years — weeks before it was set to expire alongside a separate public health emergency.
The national emergency allowed the government to take sweeping steps to respond to the virus and support the country’s economic, health and welfare systems. Some of the emergency measures have already been successfully wound-down, while others are still being phased out. The public health emergency — it underpins tough immigration restrictions at the U.S.-Mexico border — is set to expire on May 11.
The White House issued a one-line statement Monday saying Biden had signed the measure behind closed doors, after having publicly opposed the resolution though not to the point of issuing a veto. More than 197 Democrats in the House voted against it when the GOP-controlled chamber passed it in February. Last month, as the measure passed the Senate by a 68-23 vote, Biden let lawmakers know he would sign it.
The administration said once it became clear that Congress was moving to speed up the end of the national emergency it worked to expedite agency preparations for a return to normal procedures. Among the changes: The Department of Housing and Urban Development’s COVID-19 mortgage forbearance program is set to end at the end of May, and the Department of Veterans Affairs is now returning to a requirement for in-home visits to determine eligibility for caregiver assistance.
Legislators last year did extend for another two years telehealth flexibilities that were introduced as COVID-19 hit, leading health care systems around the country to regularly deliver care by smartphone or computer.
More than 1.13 million people in the U.S. have died from COVID-19 over the last three years, according to the Centers for Disease Control and Prevention, including 1,773 people in the week ending April 5.
Then-President Donald Trump’s Health and Human Services Secretary Alex Azar first declared a public health emergency on Jan. 31, 2020, and Trump declared the COVID-19 pandemic a national emergency that March. The emergencies have been repeatedly extended by Biden since he took office in January 2021, and he broadened the use of emergency powers after entering the White House.
New COVID-19 Vaccination Rates Have Been Released
From the RUPRI Center for Rural Health Policy Analysis: In December 2022, the proportion of the population ages 12+ with a completed primary COVID-19 vaccination (i.e., have a second dose of a two-dose vaccine or one dose of a single-dose vaccine) was 75.5 percent in metropolitan counties, 60.9 percent in micropolitan counties, and 56.8 percent in noncore counties.
Brief Released on a National Initiative to Address COVID-19 Heath Disparities
The Southwest Rural Health Research Center released the results of a qualitative study on a CDC COVID grant, “National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities.”
The grant included a financial “carve-out” designed to provide support to rural areas (approximately 19%, or $427m allocated of the grant’s total funding) which required recipients “who serve rural communities” to “define these communities and describe how they will provide direct support (e.g., funding, programs, or services) to those communities.” State government recipients were also required to “engage their State Office of Rural Health or equivalent, in planning and implementing their activities.”
Key findings from the study:
- “The CDC’s COVID-19 rural carve-out, which explicitly designates a portion of funds for rural areas, has widespread support among stakeholders, with most encouraging the use of carveouts for future grant programs as well.
- The development of the carve -out at the CDC was a complex and multi-faceted process, in part because it was a new type of funding mechanism.
- The carve-out has provided many leaders in State Offices of Rural Health a ‘seat at the table’ in state public health decision-making.
- Funds are being used in interesting and creative ways, but it is too soon to evaluate the impact of funds on rural communities.
- Despite program support, the rural carve-out has seen some challenges tied to rural administrative capacity, sustainability, and timing, as has been seen with other rural health initiatives during the pandemic.”
Here You Can Read About Long COVID’s Lingering Effects on Rural Health
The latest feature article in The Rural Monitor shares what’s known about the post-COVID illness that’s estimated to affect as many as 3 million in rural areas. As of December 2022, data from the Centers for Disease Control and Prevention show that the top five states for self-reported symptoms are mostly rural: Montana, Wyoming, Mississippi, Kentucky, and Alaska.
Read About Guiding Rural Health Clinics at the End of the Public Health Emergency Here
The National Association of Rural Health Clinics first describes some of the COVID-related waivers and flexibilities that applied widely – such as those reducing barriers to telehealth – and then those that were specific to RHCs. These include relaxed requirements that physicians provide medical direction to nurse practitioners and justification to provide home nursing services, among others. These waivers will end with the public health emergency.
Read About Recent COVID-19 Vaccine and Therapeutics Updates
Moderna bivalent COVID-19 vaccine for children under six is available for ordering through the Health Center COVID-19 Vaccine Program. However, due to limited availability nationwide, Pfizer-BioNTech bivalent COVID-19 vaccine for children under five is not available for ordering. A new supply of Novavax is now available to order, with a cap of 100 doses per site and an expiration date of April 30. A few important reminders:
- The monovalent formulation of COVID-19 vaccine products is authorized for the primary series only. Please order only what you anticipate using over the next 7-10 days and track your supplies to assess the need and adjust current ordering patterns to avoid stockpiling.
- Moderna has recently expanded expiration dates for the monovalent vaccine for children under six. Always check the Pfizer BioNTech and Moderna expiry dates for the products in your inventory before wasting them.
- The Emergency Use Authorization (EUA)-labeled Pfizer adult (12+) monovalent vaccine is no longer available to order. Health centers requiring the Pfizer adult (12+) monovalent vaccine should order the Biologics License Application (BLA)-labeled (COMIRNATY) product (NDC 00069-2025-10).
- Centers for Disease Control and Prevention (CDC) released a fact sheet for single-dose vials of the updated Pfizer BioNTech COVID-19 vaccines for people 12 years and older.
- ASPR updated the Federal Response to COVID-19: Therapeutics Clinical Implementation Guide, a comprehensive review of available COVID-19 therapeutic treatment options and key prescribing, implementing, and administering information.
New Information Has Been Released on COVID-19 Waivers and Flexibilities
Earlier this week, the Centers for Medicare & Medicaid Services released a fact sheet with updates to policy on vaccines, testing, and treatments; telehealth services; continuing flexibilities for healthcare professionals; and expanded hospital capacity through care in a patient’s home. Last week, the agency provided updates specific to Rural Health Clinics and Critical Access Hospitals, describing the Medicare and Medicaid waivers and flexibilities that have been terminated, made permanent, or that will end with the public health emergency (PHE) on May 11, 2023.
COVID-19 Public Health Emergency (PHE) New Overview Fact Sheet
As part of the Centers for Medicare & Medicaid Services’ (CMS) ongoing efforts to provide up-to-date information to prepare for the end of the Public Health Emergency (PHE) for COVID-19, which is expected on May, 11, 2023, we are providing a new overview fact sheet on CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency. COVID-19 efforts have been a significant priority for the Biden-Harris Administration, and with the use of whole-of-government approach, the country is in a better place. Over the next several months, CMS will work to ensure a smooth transition back to normal operations.
The CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency provides clarity on several topics including:
- COVID-19 vaccines, testing, and treatments;
- Telehealth services;
- Health Care Access
In the coming weeks, CMS will be hosting stakeholder calls and office hours to provide additional information. Please visit the CMS Emergencies Page for continuous updates regarding PHE sunsetting guidance as information becomes available to the public.
A Penn State Study Finds that COVID-19 Increases Diabetes Risk By 66%
COVID-19 survivors have a 66% higher risk of developing type 1 or type 2 diabetes following their diagnosis compared to those who were not infected with the coronavirus, according to a study by Penn State College of Medicine researchers published Monday. The researchers found that SARS-CoV-2 — the virus that causes COVID-19 — binds to an enzyme receptor found on the surface of many organs and tissues, including cells found in the pancreas, small intestine, and kidneys, affecting insulin levels. Read more.
A New Study Finds Fewer COVID-19 Deaths and Infections Where There’s a Health Center
There are fewer COVID-19 deaths and infections in areas of the country where there is a Community Health Center according to findings from NACHC and the Morehouse School of Medicine’s National COVID-19 Resiliency Network (NCRN). Health centers, which serve nearly 29 million Americans in nearly 1400 communities, are a critical component of the national vaccination strategy launched by the Biden Administration to ensure equity in the fight against COVID-19. Health centers have been vaccinating people who have been disproportionately affected by the pandemic — essential workers, agricultural and migrant workers, public housing residents, the elderly, and people experiencing homelessness. To date, health centers have provided more than 19 million COVID-19 vaccinations, with over two in three shots at a health center administered to people of color. The joint analysis from NACHC and Morehouse School of Medicine’s NCRN compared the rate of infection and mortality from COVID-19 in areas with a health center and areas without, determining that there are 200 fewer cases of infection and nine fewer deaths per 100,000 people.