No more free test kits, less data: What the end of the COVID public health emergency means in Colorado

Starting this week, at-home tests for COVID-19 will no longer be free, but other changes from the end of the federal government’s public health emergency won’t be as obvious.

The public health emergency, declared in January 2020, will lapse Thursday, but many people may not notice a difference. Despite the association between the public health emergency and measures like mask mandates in many people’s minds, nearly all anti-COVID precautions already have been lifted. The end of continuous Medicaid coverage during the pandemic also is no longer linked to the end of the public health emergency, and the state has already started determining who still qualifies.

There will be some changes, however. A rule requiring insurance companies to cover eight at-home tests monthly for each member will end, though Medicaid and the Children’s Health Insurance Program will cover tests through September 2024. Emergency regulations allowing the Centers for Disease Control and Prevention to collect more data will also expire, meaning that the picture of how the virus is behaving will become fuzzier.

Colorado’s vaccine buses will make their last trip this week, though vaccines will remain free to everyone for the time being, since the federal government purchased them in bulk. People with insurance still won’t have to pay out of pocket when the stockpile runs out, but uninsured adults will have to pay the full cost. Free shots are available to uninsured kids through the Vaccines for Children program.

Dee Dee Gilliam, endemic COVID-19 manager at the Denver Department of Public Health and Environment, said she doesn’t foresee a problem when publicly run vaccine sites shut down, since most people have access to a pharmacy or a clinic. Denver recreation centers will continue giving out free at-home tests while supplies last, and the health department will provide them to settings like homeless shelters for the indefinite future, she said.

While the pandemic is no longer considered an emergency, it’s still important for people to protect themselves with vaccines and treatments, Gilliam said. Those who are over 65 or have compromised immune systems can get another booster with the omicron-specific formulation four months after their last booster if they so choose, though only about half of Colorado’s population over 65 has gotten a first omicron booster.

“There’s a long way we can go to building up community immunity,” she said.

The CDC released a paper Friday that said its ability to collect certain public health data will end this week, though it has plans to continue publishing some information:

• It will still track COVID-19 hospitalizations, though only weekly instead of daily
• The CDC can still gather information about mortality based on preliminary death certificate data
• About 6,300 hospitals will continue to report what percentage of their emergency room visits are related to COVID-19
• A network of about 450 labs will submit data about the percentage of tests coming back positive, though it will no longer be possible to track that information on the state or county level

Dr. Anand Parekh, chief medical adviser at the Bipartisan Policy Center think tank, said it’s good that the CDC is being “proactive” in coming up with ways to maintain some data collection, but the information won’t be as granular as earlier in the pandemic. Even then, data about who was getting sick and dying was sometimes lacking, which made it harder for people to make choices to protect themselves, he said.

There’s some discussion about whether Congress could add more money for data collection when it reauthorizes the Pandemic and All Hazards Preparedness Act, which will expire at the end of September if lawmakers don’t pass an extension, Parekh said. Doing so would create a clearer picture not only of COVID-19, but also of future pandemic diseases, he said.

“It’s not a question of if, but when” another disease causes a pandemic, he said.

The changes come as COVID-19 has moved into a more stable phase. The CDC estimated about 95% of Americans had either been vaccinated or had survived COVID-19 as of December 2021. Still, an average of 1,375 people were admitted to U.S. hospitals with the virus each day of the last week, and 1,109 deaths were attributed to it in the week ending Wednesday, according to the CDC.

It’s not clear how many people are developing long COVID.

In 2022, COVID-19 dropped to the fourth-leading cause of death, behind heart disease, cancer and unintentional injuries, a category that includes most drug overdoses, as well as accidents like car crashes. Just under 245,000 deaths were attributed to COVID-19 in 2022, down from more than 462,000 in 2021, according to preliminary data from the CDC.

On Friday, the World Health Organization declared COVID-19 is no longer a “public health emergency of international concern.” The designation allows the WHO to make recommendations under international health regulations, such as that countries not close their borders, but there’s no way to enforce them.