Biden expands public well being emergency as omicron XBB.1.5 spreads

People wearing masks walk next to the coronavirus disease (COVID-19) testing site in New York City, New York, the United States, December 12, 2022.

Eduardo Munoz | Reuters

The Biden administration has extended the Covid-19 public health emergency until April as a highly transmissible omicron subvariant is raising concerns the US could face another wave of hospitalizations for the disease this winter.

“The COVID-19 public health emergency remains in effect, and as HHS has previously committed, we will provide states with 60-day notice in advance of a possible termination or expiration,” a spokesman for the Department of Health said Health and Human Services.

The US has renewed the Covid public health emergency every 90 days since the Trump administration first issued the declaration in January 2020.

The declaration of a state of emergency has had a tremendous impact on the US healthcare system over the past three years. It has protected public health insurance coverage for millions, given hospitals greater flexibility to respond to increases in patient numbers, and expanded telemedicine.

The White House Covid Task Force, led by Dr. Ashish Jha has repeatedly tried to reassure the public that the US is in a much stronger place today due to the widespread availability of Covid vaccines and treatments that prevent serious illness and death from the virus.

In August, HHS urged local and state health officials to prepare for the emergency to end soon. HHS has committed to providing state governments and healthcare providers with 60 days’ prior notice before the statement is lifted.

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President Joe Biden said the pandemic was over in September, a time when infections, hospitalizations and deaths were falling. But HHS Secretary Xavier Becerra told reporters during a call in October what the virus does this winter would determine whether or not the emergency must go ahead.

Once U.S. officials decide to end the public health emergency, hospitals will lose flexibility in how they deploy staff, add beds and care for patients as admissions spike. The lifting of the state of emergency could also impact the greatly expanded role pharmacies have played in administering vaccines during the pandemic, although the extent of that impact is not yet clear.

Millions of Americans are also expected to lose health insurance coverage under Medicaid in the coming months. Congress prohibited states from kicking people out of the program for the duration of the public health emergency. As a result, Medicaid enrollments have increased by 30% to over 83 million.

Last month, Congress severed Medicaid protections from the public health emergency and said states could begin withdrawing people from Medicaid in April if they no longer meet eligibility requirements.

Omicron XBB.1.5 is spreading rapidly

The subvariant omicron XBB.1.5 quickly becomes dominant in the USA. Scientists believe it has a growth advantage because it attaches better to human cells and is also adept at bypassing immunity. The World Health Organization has described it as the most transmissible subvariant to date, although there is no data to suggest it makes people sicker.

Since the arrival of omicron in the US in late 2021, unleashing massive waves of infection across the US and around the world, Covid has splintered into an alphabet soup of subvariants that evolve to become increasingly adept at promoting immunity from vaccination and to avoid infections.

Columbia University scientists found in a study published in December that the BQ and XBB families of Omicron subvariants pose the biggest threat to the Covid vaccines and could be causing a surge in breakthrough infections. These subvariants are also resistant to all approved antibody treatments used to protect people with compromised immune systems.

In a series of Twitter posts over the past week, Jha said he’s concerned about XBB.1.5’s rapid rise, but doesn’t think the subvariant will be a major setback. He encouraged people to get an Omicron booster shot if they haven’t already, and encouraged the susceptible to get antiviral treatment if they have a breakthrough infection.

According to data from the Centers for Disease Control and Prevention, only 38% of seniors age 65 and older have received an omicron booster shot to date. There is concern that the proliferation of XBB.1.5 could lead to an increase in hospitalizations and deaths among older Americans.

Jha said most people who are currently being hospitalized and dying from Covid are aged 70 and over and are either not up to date on their vaccines or not receiving treatment if they have a breakthrough infection.

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