COVID-19 Public Health Emergency End: What Is Changing and What Is Not?

With the conclusion of the Department of Health and Human Services Public Health Emergency [PHE], many people may need clarification about what infection prevention and control strategies and systems for COVID-19 are ending and what are not. Jenny Bender, MPH, BSN, RN, CIC, clinical science liaison, Northeast Region, PDI, detailed the changes and when they will happen for Infection Control Today®’s (ICT®’s) listeners. She also covers the Centers for Medicare and Medicaid Services factsheet that outlines the flexibilities physicians, and other clinicians are granted under the public health emergency.

Bender said, “The PHE ending doesn't mean that infectious disease [threats] are over, whether from COVID-19 or otherwise.”

“In many ways, guidance changes like this [PHE] have become the status quo for infection preventionists [IPs],” Bender said. “COVID-19 guidance has changed so many times throughout the pandemic that IPs have learned how to quickly adapt to these changes to the guidance coming down from federal and their state or territory level. And we all need to ensure that our facility policies align with the guidance, however fast the changes may be. So just because the public health emergency expired today, May 11, it doesn't mean everything automatically goes away.”

Bender then explained some of the regulatory requirements that won’t change with the end of the PHE. “Some things that aren't going away [include] our health care staff must stay fully vaccinated with our primary series.*** That's in effect until May of next year, 2024. Education on vaccines and offering the vaccine, including all current booster doses, is also in effect until May 2024. “Reporting changes are a huge concern for IPs, and recording COVID-19 cases is no different. [National Healthcare Safety Network] reporting of COVID-19 will be in effect until December 31, 2024. Testing does technically expire [on May 11, 2023]. But your [infection prevention and control] program includes testing appropriately for COVID-19 because that's a nationally accepted standard for preventing the transmission of COVID-19, and it'll likely continue. And IPs will also need to monitor the CDC guidance for any further changes and updates coming down the pike. So to ensure that their policy aligns with the current guidance.”

Bender discussed how the focus on infection prevention due to COVID-19 impacted the issue of antimicrobial resistance in any way. “There are many factors that play into that. If you're talking about antimicrobial resistance, telehealth flexibilities have expanded, which may affect it negatively. It's brought infection prevention to the forefront of people's minds, but there are many infections that have gotten worse since the pandemic. Things like catheter-associated urinary tract infections and methicillin-resistant Staphylococcus aureus bacteremia also tie into the resistance [consideration]. It could go either way. So we adopted some things during the pandemic that we'll want to keep around as strategies, and some we adopted that we'll have to work on.”

***On May 9, 2023, this was published in regards to federal workers.

CMS published a final rule withdrawing the health care mandate, meaning impacted facilities also no longer need to have policies and procedures in place to ensure staff are vaccinated under the Conditions of Participation (CoPs) for Medicare and Medicaid.

(Bender's quotes have been edited for clarity.)