COVID emergency ending: What does it mean for California?

Three years after the emergence of COVID-19, state and federal authorities are preparing to lift declarations of emergency originally issued to combat the pandemic.

While the moves will undoubtedly be hailed in some circles, such moves are not just symbolic. Transitioning out of the emergency phase could eventually mean the end of universal access to free vaccines, treatments and tests.

However, plans to lift the declarations of emergency also illustrate a turning point in the years-long global fight against COVID-19.

“My sincere hope is that we are moving into a new phase with less devastation, less serious disease and especially less deaths,” Barbara Ferrer, director of public health for the Los Angeles County, said Thursday.

Here’s what you need to know:

When do the declarations of emergency end?

Governor Gavin Newsom has announced that the COVID-19 state of emergency in California will end on February 28.

“With the operational readiness we have built and the actions we will continue to employ going forward, California stands ready to phase out this tool,” he said in a previous statement.

And President Biden notified Congress this week that he will end the national emergency and public health declarations of COVID-19 on May 11.

That schedule is reasonable from a public health perspective, according to White House COVID-19 response coordinator Dr. Ashish Jha.

“We haven’t fully weathered the winter yet, but we wanted to make sure we didn’t have a devastating flood with hospitals putting beds in parking lots,” Jha said during a discussion Thursday with Dr. Robert Wachter, chairman of the UC San Francisco School of Medicine.

Although coronavirus subvariant XBB.1.5 is still increasing in some places and there could be a bump in cases in the future, Jha said, “We’ve been pretty confident over the last few weeks that we’ve probably weathered the worst.”

But, he added, “Let’s be very clear: COVID is still a major public health burden in America,” so “ending the emergency isn’t the same as saying it’s no longer a problem.” Since October, 48,000 COVID-19 deaths have been reported nationwide, nearly triple the estimated 17,000 flu deaths over the same period.

In the city of Los Angeles, the local COVID-19 declaration of emergency ended on Wednesday. But the one for Los Angeles County remains, Ferrer said. It is the basis for the county’s pandemic eviction moratorium, which covers all unincorporated areas and cities that do not have their own moratoriums.

“We are not committed to escalating the emergencies. We’re looking closely at what safeguards the emergency declarations provide and, if things go away, what would be done to mitigate any unforeseen or unintended consequences,” Ferrer said.

The immediate lifting of the federal declarations, according to Jha, would be a huge disruption to health systems, which have changed their operations to better suit the needs of the pandemic era.

“We’re basically giving everyone a little over 90 days, and that should be plenty of time for health systems to get back to more normal functioning,” he said.

California’s schedule was unveiled in October, but depends on the state’s success in managing a potential winter coronavirus surge.

Though the state saw a spike in transmission and hospitalizations in the weeks following Thanksgiving, both metrics have since declined significantly. And barring a late-season resurgence, this winter will be the first in which the state hasn’t been hit by a devastating wave.

What does the end mean?

The state of emergency allowed the Newsom government to waive certain state regulations and laws and redirect funds in response to the public health crisis. Officials said such flexibility is critical to the state’s response to COVID-19, though Republicans have criticized keeping the declaration in place for so long, calling it an unnecessary abuse of executive power.

California’s March 4, 2020 declaration of emergency served as a prelude to more than 70 executive orders, including those aimed at expanding testing and vaccinations, suspending evictions, and expanding coverage for healthcare workers. Newsom has since canceled many of those contracts.

Almost a year ago, state officials unveiled what they called the SMARTER plan, which focuses on preparedness anchored in seven key areas: immunizations, masks, awareness, preparedness, testing, education and Rx (or anti-COVID drugs).

This plan “will ensure some level of operational readiness to support communities and respond appropriately to future outbreaks,” California’s Department of Health and Human Services told The Times this week.

Newsom’s office previously called for legislation that would allow lab workers to “process only COVID-19 tests” and “nurses to dispense COVID-19 therapeutics” once the state of emergency ends. Rep. Marc Berman (D-Menlo Park) introduced legislation on the issue in January.

“The Newsom Administration looks forward to working with the Legislature on this measure to maintain California’s COVID-19 operational readiness,” the governor’s office said.

In LA, the ending of the local emergency declaration means that “the city’s emergency response center has been disabled due to COVID-19,” according to a statement from the Emergency Management Department Thursday.

The department “will continue to work with the LA County Department of Health to ensure information sharing and to promote the importance of complying with COVID safety guidelines,” the statement continued. “Should conditions related to COVID deteriorate to the point where higher-level coordination and support is required, the EOC may be reactivated.”

What about vaccines and treatments?

In a Twitter thread earlier this week, Jha stressed that ending the public health emergency does not mean that “people will suddenly be unable to get the vaccines and treatments they need.”

“On May 12, you can still go to a pharmacy and get your bivalent vaccine for free.” he wrote Wednesday. “If you get COVID on May 12, you can still get your Paxlovid [anti-COVID pills] for free. Nothing changes about that.”

Ultimately, “we will transition from the vaccines and treatments distributed by the US government to those that are purchased through the regular healthcare system, just as we do for any other vaccine and treatment,” Jha said. But in the long run, COVID-19 vaccines will remain free for insured people, which is a requirement of the Affordable Care Act.

Even after the state and federal emergencies end, “Californiaans will continue to have access to COVID-19 vaccines, tests and therapeutics at no expense,” according to the state Health and Human Services Administration.

Through November 11, Californians who have private health insurance or are enrolled with Medi-Cal can “access COVID-19 vaccines, tests and therapeutics from any appropriately licensed provider at no cost, even if the provider is located outside of the United States enrollee’s Health Plan Network,” the agency wrote in a statement to The Times on Thursday.

After this date, Residents may be subject to cost sharing or co-insurance when accessing such resources from an off-grid provider. “However, if the registrant accesses the services of an in-network provider, the registrant does not have to pay anything out of pocket,” the agency said.

What about tests?

US households will again be eligible for four free at-home coronavirus tests this winter. The federal government also ordered health insurers to reimburse customers for eight home coronavirus tests per month — up to $12 per test — per insured person. But the government’s order for insurers to reimburse the cost of at-home testing could be lifted after the federal health emergency ends.

Insureds also didn’t have to pay for laboratory-based coronavirus tests, and orders to keep those costs free could also go away.

With COVID-19 activity declining, California is already planning to “phase out underutilized state COVID-19 testing and treatment centers in the coming weeks,” according to the state Department of Public Health.

“These sites have been an important part of the state’s COVID-19 testing strategy and response,” the department said in a statement. “A final plan to demobilize the remaining sites is being prepared.”

The agency is sending additional over-the-counter kits to local health officials, who will be affected by the closure of testing sites.

Santa Clara County officials announced plans to demobilize their mass testing and vaccination sites by the end of the month.

“We’re transitioning from a full-blown response, where we have a sense of urgency every day, to one where we adapt to living with COVID,” said Dr. Sara Cody, director of public health and county health officer, during a news conference Wednesday.

However, she added that she “want to be very clear: the pandemic is not over. We can’t give a day when it’s over and as we’ve seen it has a very, very long tail. We don’t know when it will be over.”

“Emergencies are a lot about getting things done faster, releasing funds faster, but it has nothing to do with what the virus is doing because it’s still circulating,” she said.

LA County, on the other hand, has no immediate plans to close its county-operated vaccination centers, and the testing centers will remain available based on demand, Ferrer said.

“I don’t expect any immediate impact on access to vaccines, testing or therapeutics in LA County in the near future,” she said. “But as I noted, there are some big changes here in terms of funding and we need to sort that out.”

Times contributor Taryn Luna contributed to this report.