If the maskless and much-envied crowds at Taylor Swift’s concerts are any indication, COVID-19 has left the building. But then again, Swifties would risk the plague to watch her sing. In bustling airports, restaurants and arenas, there is barely a mask in sight. Has COVID-19 been consigned to oblivion? The White House announced on Jan. 30, 2023 that the COVID-19 national emergency and public health emergency (PHE) declarations would expire on May 11. Does this imply the demise of COVID-19? Do we revert to our pre-pandemic ways? According to data and experts, not so fast. 

The end of the PHE and COVID-19 emergency simply signifies the end of using a set of technical tools and flexibilities set up to manage the healthcare crisis brought on by COVID-19, according to White House COVID Response Coordinator Dr. Ashish Jha. While effective and patient-centric care remains a top priority, significant changes to payments for COVID-19 services and a return to a more regulatory healthcare format will be implemented after May 11. For most of us, this means no more free at-home COVID-19 tests and the end of cost-sharing; insurance companies and patients will foot the bill for therapeutics and testing services. And contingent on the transmission rate, required masking in healthcare settings might still be required, as indicated by Dr. Jha.

Then, there’s the small matter of data stating the obvious: COVID-19 is very much still circulating, albeit not at the previous rates. CDC’s COVID-19 data tracker reported the current seven-day average of COVID-19 deaths as 228 people, which is down from the last seven-day average of 323. Recent COVID-related seven-day average hospitalizations (March 22-28) stand at 2,370, down from the previous 7-day average of 2,501. There’s a 9.2% reduction in reported new positive cases in the country, with the seven-day weekly average being 19,999 cases as of March 29. Furthermore, CDC data for Cuyahoga County states that the transmission levels are low, with the case rate per 100,000 individuals at 66.47. However, if COVID-19 is here to stay, how can we keep the vulnerable, immunocompromised and elderly safe? How do we mitigate the risk of long COVID? What behaviors need to become commonplace? Our post-pandemic reality warrants new regulations, legislation, conventions and sustained efforts to prevent widespread infection.

Besides federal and state policies, along with the funding of testing, research, vaccines and therapeutics, the focus must also be helping patients with long COVID. Several institutions are conducting research studies on long COVID sufferers, including Cleveland’s University Hospitals. But the government also needs to legislate on disability and healthcare impacts for the long haulers. Moreover, COVID-19 wastewater surveillance needs to be further funded and developed, along with the data continued to be studied. This data can help provide an early warning system of community spread, regardless of testing or reporting.

Another important aspect that needs to be addressed is air quality in high-density public spaces. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE)—an independent body that sets indoor air quality standards—will soon release new measures in response. Many states and institutions will then accordingly upgrade their systems in order to meet the new air quality standards. This is crucial to reducing viral transmission of respiratory illnesses in closed spaces; we must allocate resources for the upgrades. 

Lastly, we shouldn’t overlook efforts to prevent COVID-19 infection through our daily behaviors. Conveniently situated hand sanitizers should be a part of the landscape, as well as Zoom calls and work-from-home options for immunocompromised and COVID-positive employees. Mask-friendly spaces and attitudes are an absolute requirement to be able to conduct our lives harmoniously. Heckling and mocking mask wearers is an abomination that has no place in a civil society. And ultimately, taking personal responsibility when ill is crucial; masking and isolating are the best things to do in order to stop the virus from spreading.

COVID-19 is now a part of the infectious disease topography and we cannot simply “shake it off.”