Federal policy concerning COVID-19 and Long COVID is shifting after the three-year pandemic and health crisis. Recently, the American Medical Association (AMA) spoke with Andrea Garcia, J.D., MPH, AMA’s Vice President of Science, Medicine, and Public Health to discuss important developments in COVID-19 and Long COVID policy and research.*

Why the COVID-19 public health emergency is ending, and what that means

The COVID-19 public health emergency declaration by the Trump administration is set to expire on May 11, Garcia announced. Though the national emergency ended on March 29, the Biden administration extended the public health emergency to make a smoother transition possible. The emergency period has allowed hospitals, healthcare providers, and public health officials special regulatory and administrative flexibility. Once this period ends, the virus will be managed under normal authorities as an endemic threat (much like the flu). Other consequences will include:

• Increased vaccination costs, with Pfizer expected to charge up to $130 per dose, and people with private insurance potentially having to pay out-of-pocket for booster shots.
• COVID tests and treatments may no longer remain free to the public, with free at-home tests ending and hospitals no longer receiving extra funds to treat COVID patients.

That said, certain telehealth provisions have been extended, which has been a big part of the AMA’s recovery plan for U.S. doctors.

COVID treatment options

While average new COVID-19 cases and hospitalizations have seen a steady decline, over 500 Americans are still dying each day from COVID, and there were at least 170,000 COVID-related deaths globally in December and January. The now-dominant XBB.1.5 Omicron subvariant is a big driver of today’s infections. The “good news,” says Garcia, is that the Centers for Disease Control and Prevention recently said the updated bivalent COVID boosters are effective against infection from the new XBB subvariants.

Older adults and immunocompromised people are still at higher risk for COVID-19. Increased efforts have been made to ensure that these high-risk individuals are vaccinated and have prompt access to testing and treatment. Garcia says that COVID treatments still considered effective are the antivirals:

• PaxlovidTM (nirmatrelvir, ritonavir)
• LagevrioTM (molnupiravir)
• VEKLURY® (remdesivir)
• Convalescent plasma rich in COVID antibodies

Healthcare professionals can still refer to the Administration for Strategic Preparedness and Response for information on COVID-19 therapies.

The continuing burden of Long COVID

A recent study in The New York Times by New York’s largest workers’ compensation provider revealed eye-opening findings among Long COVID patients exposed to SARS-CoV-2 at work. Of more than 3,000 COVID-related claims filed between January 2020 and March 2022:

• 71% of Long COVID claimants required ongoing medical treatment or couldn’t work for six (6) months or longer.
• About 18% of these workers still hadn’t returned to work more than a year after developing COVID.
• More than 75% of these claimants were younger than 60 years old.

Garcia says this is a microcosm of the bigger picture. Not only is Long COVID preventing many Americans from returning to their jobs, but many still need ongoing medical care once they’ve returned.

Major symptom categories

As far as helping patients identify and treat Long COVID, Garcia points to a study in Nature Medicine that divided Long COVID into four major symptom categories. Listed in descending order of prevalence:

• Heart, kidney, and circulation issues (most common)

• Respiratory and sleep disorders, anxiety, headache, and chest pains

• Musculoskeletal and nervous system issues
• Digestive and respiratory disorders

Garcia notes that women accounted for two-thirds of the people suffering from respiratory and sleep disorders, anxiety, headache, and chest pains. 

“Of course,” she said, despite the end of the emergency period, “Long COVID is going to be something that we’ll continue to monitor and study to find out more.”

*American Medical Association & Unger, T. (Host). (2023, February 1). The latest research on long COVID symptoms, treatments & more with Andrea Garcia, JD, MPH [Video file]. AMA Update. https://www.ama-assn.org/delivering-care/public-health/latest-research-long-covid-symptoms-treatments-more-andrea-garcia-jd