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The number of people in the US without health insurance fell during the Covid-19 pandemic, even as millions lost insurance coverage from their employers due to layoffs.

The US uninsurance rate for people under 65 has fallen from 11% in 2019 to 10.5% in 2021, according to a report released Friday by the Department of Health.

By the first quarter of 2022, the uninsured rate had fallen to an all-time low of 8%, according to the report. It then rose slightly to 8.6% in the second quarter of 2022, HHS said.

The uninsured rate declined despite a huge spike in unemployment in early 2020, leading to an estimated 1.6 million to 3.3 million people losing insurance coverage from their employers, according to HHS.

But pandemic health policies have created a safety net for people who have lost their private coverage and made it easier for them to find insurance.

Congress essentially banned states from throwing people off Medicaid during public health emergencies in exchange for more funding for the states. As a result, Medicaid enrollments increased by more than 20 million from February 2020 to September 2022.

But that Medicaid protection is about to end. It is expected that millions of people will lose the insurance coverage they have acquired through the program. Federal spending laws passed by Congress in December allow states to begin throwing people out of Medicaid in April if they no longer meet eligibility requirements.

HHS has estimated as many as 15 million people could lose Medicaid if pandemic-era protections are shut down and the program returns to normal operations. Many of these individuals are expected to move to cover the Obamacare marketplace.

Enrollment in Obamacare through the marketplaces has also increased during the pandemic, according to HHS, due to a special enrollment window in 2021, expanded tax credits, and more means to reach out to beneficiaries.

Nearly 16 million people signed up during the current signup period, a 13% increase from last year. Three million of them will be covered via the marketplace for the first time. The current open registration period ends on Sunday.

HHS estimates for the 2019-2021 uninsured are based on data from the American Community Survey, which collects information from 3.5 million US households. The 2022 estimates come from the National Health Interview Survey, which uses a much smaller sample of more than 17,000 people.

The Centers for Disease Control and Prevention said Friday it was “very unlikely” that Pfizer’s Omicron booster posed a risk of stroke for seniors after they opened an investigation into a preliminary safety issue found by one of their surveillance systems would.

The CDC said in a statement posted on its website Friday that a monitoring system called Vaccine Safety Datalink has identified a possible risk of stroke in people aged 65 and older who received the Pfizer booster shot against the Omicron-Covid variant . A CDC spokesman said this problem was first discovered in late November.

In mid-December, the CDC concluded that the concern persists and launched an investigation into whether seniors are more likely to have a stroke in the first 21 days after receiving the Pfizer booster shot, the spokesman said. A similar preliminary signal was not detected for the Moderna booster.

The VSD surveillance system found that 130 people ages 65 and older had a stroke within 21 days of receiving Pfizer’s Omicron booster, among about 550,000 seniors who received the vaccine, the CDC spokesman said. No deaths were reported. The Washington Post previously reported on it.

According to the CDC, no other monitoring system has previously identified similar safety concerns for the Pfizer booster. Investigators, after reviewing data from the Center for Medicare and Medicaid Services, the Department of Veterans Affairs, the Vaccine Adverse Reporting System and Pfizer’s Global Safety Database, found no increased risk of stroke after the Pfizer booster shot.

“Although the body of data currently suggests that it is very unlikely that the signal in VSD poses any real clinical risk, we believe it is important to share this information with the public, as we have done in the past When it comes to our safety, surveillance systems detect a signal,” the CDC said in the post on its website.

According to the CDC’s Friday statement, the surveillance systems often detect safety signals stemming from factors other than the vaccine. The agency spokesman said investigators hope to have a clearer picture and more data in the coming weeks.

The investigation will be discussed at an upcoming meeting of the Food and Drug Administration’s Panel of Independent Vaccine Experts on Jan. 26.

In a statement Friday, Pfizer said there was no evidence that ischemic stroke was linked to the company’s Covid vaccine. Neither Pfizer and its German partner BioNTech, nor the CDC nor the FDA have observed such an association in numerous other surveillance systems in the United States and around the world, company spokesman Kit Longley said.

“Compared to the published incidence rates of ischemic stroke in this elderly population, the companies have seen a lower number of reported ischemic strokes after vaccination with the omicron BA.4/BA.5-adapted bivalent vaccine,” Longley said.

The CDC has not changed its recommendation for Pfizer’s Omicron shot. Everyone from the age of 5 is entitled to the booster vaccination after completing their basic series of vaccinations. The youngest children, aged 6 months to 4 years, receive the Omicron shot as the third dose of their primary series.

Singapore’s Health Minister Ong Ye Kung told parliament on Monday that the government is not imposing any new restrictions on travelers from China because limited flight capacity combined with its current border policy has resulted in few imported cases — and even fewer severe cases — from China came .

Ong said the government is “very aware” that some Singaporeans are concerned that an influx of visitors from China could lead to a spike in infections.

But he said travel between Singapore and China is “very low” – with fewer than 1,000 people arriving from China every day.

“Up to now, we operate 38 weekly flights from China to Singapore, compared to around 400 flights before Covid,” he said.

Ong acknowledged that a new, more dangerous variant could emerge from China as the virus spreads through its population of 1.4 billion, but said that has not happened so far.

With comprehensive vaccination protection, we can treat Covid-19 as a widespread disease.

Ong Ye Kung

Singapore Health Minister

Ong said Singapore is monitoring this through GISAID, a non-profit organization which he said receives virus sequencing data from authorities in major Chinese cities and provinces such as Beijing, Shanghai and Sichuan, which is processed at GISAID’s Singapore office.

Although there are “gaps in the data,” Ong said, “the data so far show that the epidemic in China is driven by known variants circulating in other regions of the world” — namely BA.5.2 and BF.7.

The current rules apply

So far, more than a dozen countries have announced new rules for visitors from China. But Ong said Singapore has not done so because it has already put in place effective border measures.

“Many countries have dismantled all their border measures,” he said. “Singapore … has maintained relevant measures precisely because we foresaw these risks.”

Singapore’s Health Minister Ong Ye Kung attends a meeting at the G-20 summit in Bali, Indonesia, Oct. 27, 2022.

Sonny Tumbelaka | AFP | Getty Images

He said that although “many Singaporeans have forgotten”, all travelers must be either fully vaccinated or tested negative for Covid before entry, which is the same requirement Spain recently announced for travelers from China.

While South Korea has reported that up to 80% of its imported cases are from China, Ong said that in December less than 5% of Singapore’s imported cases – about 200 people – were from China, while “ASEAN countries account for over 50% .”

In the same month, seven imported cases became seriously ill, and only one came from China, he said.

“Most were Singaporeans returning from those countries and regions,” he said. “These aren’t big numbers, so the impact on our healthcare system has been very small.”

Singapore’s ‘biggest concern’

The government’s “biggest concern” is the emergence of a new, more dangerous variant that could evade vaccine protection – “a nightmare variant [that] can almost drop us back to first place,” said Ong.

In this case, “we may have to reintroduce measures such as strict border controls, quarantine for travelers, social restrictions, including limiting group sizes, until a new and effective vaccine is developed.”

To monitor this, Singapore will remain connected to the “global surveillance system,” he said.

Ong said the other main concern is protecting Singapore’s healthcare system. He said infections were the government’s main concern in the early stages of the pandemic, but since vaccines have been rolled out, it is now focusing on serious infections.

He said 60% of people aged 18 and over were up to date with their vaccinations by the end of 2022.

“Over the past 30 days, the number of Covid-19 patients in intensive care has been in the low single digits,” he said. “Therefore, with comprehensive vaccine coverage, we can treat Covid-19 as an endemic disease.”

Why other rules might not work

Ong questioned the effectiveness of some travel rules imposed on Chinese travelers:

1. PCR tests on arrival “are late because travelers are already within your borders” and they are sensitive, meaning they “reveal large numbers of positive cases from countries that are experiencing or have just experienced a big wave “. as recovered travelers can shed dead virus fragments for weeks.
2. Waste water tests from airplanes rely on solid waste, which will be of limited use as the flight time from China to Singapore is not that long.
3. Pre-departure testing “may be useful… [to] reduce the number of imported infections”, but the low volume of travel between Singapore and China “more restricts the number of imported infections”.

Ong added that if Singapore tested all travelers from China, it would raise questions about travelers from other regions, contributing to more infections and severe cases.

Ong called Covid outbreaks “the new norm” and said: “Today it’s China, tomorrow another region.”

Roslan Rahman | AFP | Getty Images

“Also by triggering [pre-departure tests] to travelers from a part of the world with high infection rates, are we contributing to an international precedent of testing being imposed on travelers from countries experiencing a surge in infection?”

Ong added, “How will other countries treat travelers from Singapore if we encounter another wave of infections?”

“We do not discriminate”

Increasing flights with China

Singapore appears to have remained in the favor of the Chinese government and its residents. Rein said Chinese travelers are now going to both Singapore and Thailand because “both countries welcome us.”

Singapore Airlines resumed passenger service from Singapore to Beijing in late December. Initially, the service will only run twice a month.

However, flights between Singapore and China account for “less than 10% of the number of pre-Covid flights” – accounting for about 1.5% of Singapore’s Changi Airport’s total flights, Singapore’s Transport Minister S Iswaran said on Monday.

Overall, passenger traffic and weekly flights at Changi Airport have returned to 80% of pre-pandemic levels, he said.

“Singapore and Chinese airlines have requested to operate more flights between the two countries,” Iswaran said, adding that the government was taking a “careful and calibrated” approach to restoring air connectivity with China.

Currently, more than 60% of Singapore citizens arriving from China are permanent residents or long-term passport holders, Iswaran said.

“China’s opening up to the world is great news that we look forward to,” Ong said, adding that the government will carefully adjust travel volumes “at least until the wave of infections in China has subsided significantly.”