What the end of the COVID emergency means in Massachusetts

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We are at an important turning point in the era of COVID. On Thursday, after more than three years, state and federal public health emergencies ended.

The virus itself is still here. So is the deep sense of loss for all the lives taken by COVID.

But after years of battling so much disease, death, and social and economic upheaval, it feels like an important moment.

“It looks like we’ve finally entered that long-awaited endemic phase of COVID,” said Dr. Cassandra Pierre, an associate hospital epidemiologist at Boston Medical Center.

Several pandemic-era policies that allowed state and federal governments to respond to COVID are about to end. Here are some of the big changes:

Access to tests

Health insurers will continue to pay for COVID tests ordered by clinicians. But at-home COVID testing will become more expensive for most people. Private health insurers will no longer be required to provide free rapid antigen tests — and Massachusetts’ largest insurance companies say they will stop doing so. That means members will have to pay out of pocket, about $12 per test.

“When you have to start paying for COVID tests … you may very well think, understandably, that COVID is gone,” Pierre told me.

But that’s not the case, she said: COVID remains a problem, especially for people who are elderly or immunocompromised, or have challenges accessing health care due to poverty or structural racism.

Masking in healthcare facilities

Since 2020, we have become accustomed to wearing masks for our medical appointments and seeing our healthcare providers also wearing masks. On Friday, masks are optional in health facilities.

Hospital leaders said it was safe to do away with masks now that the number of COVID-19 cases had fallen to their lowest points since the pandemic began.

But several patients and public health advocates say they are concerned that ending universal masking will put people at risk. State health officials say they will continue to track the virus and adjust policies as circumstances change.

Mandatory vaccinations

COVID vaccination mandates are perhaps the most controversial strategies for managing the pandemic. Massachusetts, under former Gov. Charlie Baker, and Boston, under Mayor Michelle Wu, required state employees to be vaccinated. Protests and lawsuits followed, but that didn’t stop the mandates from going into effect.

City and state governments are now ending these vaccination requirements. Healy, in a a statement announcing the change said the requirement had saved lives. But she added: “We have reached the point where we can update our guidance to reflect where we are now.”

Medicaid coverage

Another big change that began in April: the end of the pandemic policy that allowed people to keep Medicaid coverage indefinitely. Hundreds of thousands of people in Massachusetts are expected to switch to new insurance plans in the next few months.

Data collection

Starting Thursday, the CDC will also stop regularly tracking and reporting the number of new COVID infections because states will no longer be required to report new cases. Instead, the CDC will focus on COVID hospitalization data.

Jennifer Nuzzo, director of the Pandemic Center at Brown University’s School of Public Health, said she is concerned that collecting less detailed data will make it harder to track COVID in the future.

She said the country must continue to use measures such as testing and vaccination to keep COVID and other viruses at bay.

“We cannot allow a virus to devastate our society the way this virus has,” she told me. “If anything has come out of this pandemic, it’s that we have a lot more understanding of what we can do to prevent that from happening.”

You can read more about the end of the COVID public health emergency from me here and from NPR here.

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