Is the COVID 'emergency' over?

The World Health Organization (WHO) has said the COVID-19 pandemic is nearing its "inflection point." Does this mean that, after nearly three years, the emergency is over? Here's everything you need to know:

What's a pandemic 'inflection point'? 

It's the point at which enough people have immunity to a pathogen to "limit the impact" it has on death rates globally. At an executive board meeting, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said the COVID-19 pandemic "may be" approaching this milestone. This is largely thanks to the global vaccination campaign: More than 13.1 billion doses of COVID-19 vaccines have been administered worldwide, according to WHO. Natural immunity helps, too, and more than 700 million infections have been confirmed worldwide since early 2020.

So is COVID no longer a threat?

"There has been a decoupling between infection and severe disease," the WHO said. And while Tedros said "there is no doubt that we're in a far better situation now" than a year ago when the omicron variant was at its peak, he warned that COVID had killed at least 170,000 people across the globe just in the last eight weeks. There are still more than 100,000 cases and hundreds of deaths every day. The U.S. alone still has approximately 4,000 deaths per week due to COVID and is experiencing a "tripledemic" of COVID, the flu, and RSV. 

While 71.8 percent of the world population has had at least one dose of the COVID vaccine, there is a lot of regional variability in uptake, per The New York Times. The vaccination rate in low-income and developing countries is far lower than in developed ones. "The global community must reckon with the politics and power dynamics that undermined initiatives to ensure that all nations had access to vaccines when they needed them," explains an article in the journal Nature. Even in the U.S., where about 70 percent of the U.S. population completed the primary series of vaccines, just 16 percent of the population received the bivalent booster shot.

What is the U.S. government doing? 

President Biden announced plans to end both the national emergency and public health emergency for COVID-19 on May 11 of 2023. This will "restructure the federal government's response to the pandemic," The Washington Post writes. It means an end to free vaccines, tests, and treatments. It will also mean health-care providers will no longer have special flexibility on things like hospital capacity. "People will have to start paying some money for things they didn't have to pay for during the emergency," according to Jen Kates, senior vice president at the Kaiser Family Foundation. This means that some Americans will likely have to pay out-of-pocket for vaccines and tests that were previously free through insurance, per CNN.

As for vaccinations, the FDA announced a proposal to make the COVID vaccine a single yearly injection like the flu shot. It also wants to put an end to the original vaccines and offer the current bivalent booster shots as both the first and second doses. Medical experts still recommend two doses of the annual booster for older adults, immunocompromised people, pregnant women, those with underlying medical conditions, and young children, all of which have a higher chance of experiencing severe symptoms, the Times reports.

What's been the response?

Health experts advise caution. The journal Nature reminds readers that globally, vaccine uptake has been "dismal" and "repeated surges in infection and death are giving way to a constant thrum of loss, as well as debilitation caused by long COVID." Indeed, "we cannot afford to be complacent," warns Seth Berkley, CEO of Gavi, the Vaccine Alliance.

There are still some doubts regarding an annual vaccine schedule, the Times writes. "I'd like to see some data on the effect of dosing interval, at least observational data," said Dr. Eric Rubin, FDA adviser and editor-in-chief of the New England Journal of Medicine. Dr. Céline Gounder, an infectious disease physician, adds most people are "well protected against severe COVID disease with a primary series and without yearly boosters."

The political response to Biden's plan to end the national emergency has been mixed. House Republicans want to end the declaration immediately, rather than wait until May. Democrats say a slow lifting of the declaration will prevent chaos.    

What might the next year bring?

"There is little doubt that this virus will remain a permanently established pathogen in humans and animals for the foreseeable future," WHO said in a statement. There are likely to be new variants constantly emerging and spreading. Tedros called for at-risk groups to be fully vaccinated, as well as more testing and access to antiviral drugs, and a crackdown on COVID "misinformation." 

"We remain hopeful that in the coming year, the world will transition to a new phase in which we reduce hospitalizations and deaths to the lowest possible level," he said.