What to know about the COVID pandemic as public health emergencies end

The World Health Organization this week ended the global public health emergency it had declared three years ago as COVID spread around the world. The U.S. public health emergency is to come to an end this coming Thursday, the 11th. Both moves are largely symbolic, but the pandemic is waning. Government data shows that COVID was the fourth leading cause of death last year, dropping from third in the previous two years. And U.

S. COVID deaths are at the lowest they have been since 2020, although it still claims hundreds of lives each day. So where does the pandemic stand now, and what should we be doing about it? Caitlyn Jettalina is an epidemiologist at the University of Texas and the author of the popular newsletter, Your Local Epidemiologist. Caitlyn, the global health emergency ending, the U.S. health emergency ending, what does that mean, and maybe just as important, what does that not mean? Yeah, it's a big week for public health, I will say that. So the global public health emergency ending is basically administrative and financial.

It's a key mechanism within global health security. So officially that means ending the mobilization of international coordination, so funding, advancement of vaccines, et cetera. Unofficially, though, it is one of the strongest signs that WHO now sees COVID-19 as a threat in our repertoire of just things trying to kill us every day. So it's really quite a monumental moment. And I think it's important to recognize what it doesn't mean. And you touched on this a little, that it doesn't mean that COVID-19 is gone. In fact, SARS-CoV-2 is mutating still about twice as fast as flu right now.

So that means we're going to get future waves. We hope that they're wavelets, but we may get a big tsunami also from another variant of concern, which would be pie. And like you said, we can't ignore the fact that COVID-19 is a leading cause of death for Americans and people around the world still. So to me, as an epidemiologist, that means our work is not done. But this is a monumental moment and sometime for reflection as well. There is a lot of confusion about what to do now, how to react to this, how to respond. I have heard a lot of people asking about vaccine boosters.

Who should be getting a vaccine booster now? Yes, so this is confusing to a lot of people, including myself. If you've had one bivalent vaccine, you are considered up-to-date with your COVID vaccines in the United States. It doesn't matter if you've gotten previously infected. It doesn't matter what other vaccine series you've gotten. For those that got their fall booster, a bivalent booster, and they're over 65 or their immunocompromised, they can get a spring bivalent booster as well. And this really depends on if you have comorbidities, how old you are, if you should be getting one, and also how risk-adverse you are, because we don't know what the future is going to hold. So I'm recommending it to my grandparents, to my parents, to get their spring booster right now.

But it's certainly not available to everyone. And then moving forward, how often should people think about getting boosters? Is there any consensus on that yet? We have no idea. It really depends on what this virus continues to do. Like I said, it's mutating about twice as fast as flu. So I think we can expect at least an annual shot, if not a biannual shot. But there's a really important meeting coming up June 15th. The FDA is meeting to really decide what the fall is going to look like, what the formula and the vaccines are going to be, what type of Omicron variant, and then who should also get them.

So in about a month, we should have a lot more clarity on what this fall will look like. You'd say the virus is mutating and there are new variants. But we don't have the same reaction or same concern about these new variants as we did about Omicron. Why is that? There's a couple of reasons for that. One is we just have a really tall immunity wall right now from previous infections and from vaccine coverage. So it's really a good sign that we're not seeing these huge waves of hospitalizations. And that's because our immunity is working against it.

The other reason is that the SARS-CoV-2 may have started finding its path, meaning that it's making incremental mutations or incremental changes instead of these huge swing changes that we saw in the first two years of the pandemic. And that's actually a good thing. We want Omicron to keep mutating because that means that we'll be able to predict it better so we can predict and be proactive about our vaccines better around fall. We asked viewers what they were worried about, what questions they had. And one point that kept coming up was long COVID. Kate says she's had long COVID for the last year and a half. She says, the number of incoming patients at my local long COVID clinic is as high as ever.

What do you foresee the impact of long COVID being on American life? And then Jan asks a similar question. Has there been any progress in understanding who is at risk of getting long COVID, how to prevent it, and how to treat it? Yes. So long COVID is a thing. It is incredibly debilitating to some Americans. In fact, I think we estimate about 6 million Americans today are suffering from long COVID. And unfortunately, the more that this virus changes and transmits, the more possibility we are to get more people to have long COVID. We do have good news, though, that with immunity, it seems that our risk of long COVID is less if you get an infection.

Same with if treatments, Paxlovid reduces the risk of long COVID. And Omicron is reducing the risk of long COVID compared to Delta. We are starting to understand the patterns. For example, it looks like females are more likely to get long COVID than males. And younger people are more likely to get long COVID than older people. But we really are just on the surface of our understanding of long COVID and have a long way to go. Caitlin Gettelina, your local epidemiologist, thank you very much.

Thanks for having me.

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