Even though the patient has been discharged from the hospital, there is still some nursing and rehabilitation to do.
The patient, in this scenario, is the United States. The Biden administration today is ending the public health emergency for COVID-19, discharging Americans with the general finding that the country no longer needs — and really can’t afford — the same acute level of care.
This week, repercussions of the shift that are spreading outward through society are particularly visible. The end of the emergency has meant the lifting of an immigration restriction at the southern border that is manifesting in a major surge of migrants seeking asylum.
More centrally to the health concerns themselves, the change will mean an end to the free-to-all home test kits the federal government provided, and increased medical costs and care disruption for many people.
This is especially true for those who may lose the expanded Medicaid coverage the emergency authorized — more of a problem in some states than in Hawaii, where coverage for lower-income groups is already relatively broad.
Despite an official end to the health emergency status, there is an acknowledged risk that remains. The virus, in its ever-evolving variants, is going to keep mutating to evade human protections.
And like many illnesses, this one left bruises on the economy, education system and society at large that still haven’t healed. Students continue to struggle to overcome the learning loss of long-term remote classes.
Many businesses and households still haven’t recovered financially from the lockdowns and closures imposed worldwide. Hawaii, which relies on the support of tourism, was basically shuttered for months.
So why is it that so many people here and across the country are convinced that COVID is a thing of the past? Revisionist history is already in play among humans, but the virus is still ready to strike. It helps to be clear-eyed about what’s really out there when we venture out from our front door.
Tim Brown, who directs a team of epidemiologists and programmers at the East-West Center and has commented on the course of the disease through the pandemic, compares the current state of Hawaii to a zone that’s prone to brush fires. As the general population immunity levels gradually decline between vaccinations or infections, it’s like dry brush building up, he said.
Then when a spark ignites the tinder, Brown added, there’s a widespread blaze, an outbreak, as there was around spring-break season here. These infections boost temporary immunity, burning off the brush, and for a time, infection counts subside, only to build up again over time.
From the public-health standpoint, the ones who need to keep worrying about this cycle, he said, are elders and others with health vulnerabilities. Additionally, even younger people, who mostly have put COVID-19 behind them, remain potential victims of “long COVID,” a persistent form of the disease that is not well understood.
There have been beneficial adaptations generated by the pandemic that should persist into the future. Telemedicine and virtual work meetings have expanded options that Americans have embraced. The advent of MRNA technology is now being applied to development of vaccines for flu and other diseases.
Although the White House is downshifting on its COVID oversight, President Biden in April launched the $5 billion “Project Next Gen” to research next-generation vaccines. This is an important first step toward preparedness for the next pandemic.
And there will be a next one, as much as we’d all like to forget the last three years of pain.
