Biden extends public health emergency as omicron XBB spreads.1.5

People wearing masks walk near a coronavirus (COVID-19) testing site in New York City, New York, USA December 12, 2022.

Eduardo Munoz | Reuters

The Biden administration has extended the Covid-19 public health emergency until April as the highly contagious sub-variant omicron raises fears that the US could face another wave of hospitalizations due to the disease this winter.

“The public health emergency for COVID-19 remains in effect and, as previously decided by HHS, we will notify states 60 days prior to any possible termination or expiration,” a spokesman for the Department of Health and Human Services said.

USA resumption of 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 huge impact on the US healthcare system over the past three years. It has protected millions of people from public health insurance, given hospitals more flexibility to respond to surges in patients, and expanded telemedicine.

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

In August, HHS ordered local and state health officials to start preparing for an end to the emergency in the near future. HHS has committed to notifying state governments and health care providers 60 days prior to canceling a declaration.

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President Joe Biden said the pandemic ended in September, with infections, hospitalizations and deaths declining. But HHS secretary Xavier Becerra told reporters during a phone call in October what the virus does this winter will determine whether the emergency needs to continue.

Once U.S. officials decide to end the public health emergency, hospitals will lose flexibility in how they allocate staff, add beds and care for patients when there is a spike in hospital admissions. The lifting of the emergency may also affect the greatly expanded role of pharmacies in vaccine administration during the pandemic, although the extent of this impact is not yet clear.

Millions of Americans are expected to lose their Medicaid health insurance in the coming months. Congress has barred states from removing people from the program during the public health emergency. As a result, Medicaid enrollment increased by 30% to over 83 million.

Last month, Congress tore up Medicaid’s public health emergency protection and said states could start removing people from Medicaid in April if they no longer meet eligibility requirements.

Omicron XBB.1.5 is spreading rapidly

The XBB.1.5 omicron sub-variant is rapidly becoming dominant in the US. Scientists believe that it has a growth advantage because it binds better to human cells and is also able to evade immunity. It has been described by the World Health Organization as the most contagious subvariant, although there is no data yet to indicate that it makes people more sick.

Since the emergence of omicrons in the US in late 2021, causing massive waves of infection in the US and around the world, Covid has split into an alphabet soup of sub-variants that are evolving to better and better evade vaccination immunity and infection.

Columbia University scientists a study published in December found that the BQ and XBB families of omicron subvariants pose the greatest threat to Covid vaccines and could cause a surge in breakthrough infections. These subvariants are also resistant to all approved antibody therapies used to protect people with weak immune systems.

In a series of tweets last week, Jha said he was concerned about the rapid growth of XBB.1.5, but didn’t think the sub-option represented a huge setback. He urged people to get a booster dose of omicron if they haven’t already, and the vulnerable to get antiviral treatment if they have a breakthrough infection.

According to the Centers for Disease Control and Prevention, only 38% of older adults aged 65 and over have received an Omicron booster so far. There are fears that as XBB.1.5 spreads, it could cause a surge in hospitalizations and deaths among older Americans.

Jha said most of the people now hospitalized and dying from Covid are people aged 70 and over who are either not up to date with their vaccines or not receiving treatment when they have a breakthrough infection.

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