ALBANY COUNTY — On May 11, the COVID-19 public health emergency declared by the Trump administration in 2020 — and extended several times since — is set to end.

“This wind-down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the PHE,” the Biden Administration announced in January, reacting to two bills that would have ended the public health emergency and the national emergency earlier.

In April, President Joe Biden signed a bill that ended the COVID-19 national emergency but the public health emergency is still scheduled to end this month.

Some waivers for federal health programs designed to help health-care providers during the height of the pandemic ended with the national emergency.

This included flexibility for Medicare telehealth services; allowing  hospitals, psychiatric hospitals, and critical access hospitals to screen patients at offsite locations; and to address workforce concerns by allowing new physicians to practice before being approved by a governing body and also allowing physicians whose privileges will expire to continue practicing at their hospitals. 

The Office of the Inspector General, of the United States Department of Health and Human Services, explains the flexibilities that will cease at the end of the day on May 11.

The federal government, at the beginning of the pandemic, had boosted the matching rate for Medicaid payments to states, but only if the state would not drop anyone off Medicaid’s rolls for the duration of the public health emergency.

“In December, Congress enacted an orderly wind-down of these rules to ensure that patients did not lose access to care unpredictably and that state budgets don’t face a radical cliff,” the Biden administration said in its January announcement.

It also said that “millions of patients, including many of our nation’s veterans, who rely on telehealth would suddenly be unable to access critical clinical services and medications. The most acutely impacted would be individuals with behavioral health needs and rural patients.”

A “Transition Roadmap,” issued by Health and Human Services reported in February that, since the peak of the Omicron surge at the end of January 2022, daily COVID-19 reported cases were down 92 percent, COVID-19 deaths had declined by over 80 percent, and new COVID-19 hospitalizations are down nearly 80 percent.

“Significant flexibilities and actions … will not be affected” with the May 11 end of the public health emergency, the Transition Roadmap says.

“The Administration is committed to ensuring that COVID-19 vaccines and treatments will be widely accessible to all who need them,” it says, stating there will be continued access to pathways for emergency use authorizations for COVID-19 products such as tests, vaccines, and treatments, through the Food and Drug Administration, and major telehealth flexibilities will continue to exist for those participating in Medicare or Medicaid.

Vaccines recommended by the Advisory Committee on Immunization Practices, the Department of Health and Human Services says, are a preventive health service for most private insurance plans and will be fully covered without a co-pay.

“Currently, COVID-19 vaccinations are covered under Medicare Part B without cost sharing, and this will continue,” the roadmap says. “Medicaid will continue to cover all COVID-19 vaccinations without a co-pay or cost sharing through September 30, 2024, and will cover ACIP-recommended vaccines for most beneficiaries thereafter.”

Last month, the Biden administration announced that it would spend $1.1 billion to provide free COVID vaccinations to uninsured Americans after the vaccines are commercially marketed.

“The program will create a unique $1.1 billion public-private partnership to help maintain uninsured individuals’ access to COVID-19 care at their local pharmacies, through existing public health infrastructure, and at their local health centers,” says a fact sheet on the “HHS Bridge Access Program For COVID-19 Vaccines and Treatments.” 

Once the vaccines move from the control of the federal government to drug companies, the April 18 fact sheet says, “most Americans should continue to pay nothing out-of-pocket for COVID-19 vaccines.”

It continues, “For COVID-19 treatments such as Paxlovid and Lagevrio, out-of-pocket expenses for certain treatments may change after these products move to traditional health care models, depending on a person’s health care coverage. These expenses will be similar to costs one may incur for other drugs and treatments through traditional coverage.”

Medicaid programs will continue to cover COVID-19 treatments without cost-sharing through Sept. 30, 2024. After that, coverage and cost sharing may vary by state, the Transition Roadmap says.

The Department of Health and Human Services lists these policies that will change or expire after May 11:

— Certain Medicare and Medicaid waivers and broad flexibilities for health care providers are no longer necessary and will end;

— Coverage for COVID-19 testing will change. Medicare beneficiaries who are enrolled in Part B will continue to have coverage without cost sharing for laboratory-conducted COVID-19 tests when ordered by a provider, but their current access to free over-the-counter COVID-19 tests will end.

The requirement for private insurance companies to cover COVID-19 tests without cost sharing, both for over-the-counter and laboratory tests, will end. However, coverage may continue if plans choose to continue to include it;

— Reporting of COVID-19 laboratory results and immunization data to the Centers for Disease Control and Prevention will change.

“CDC COVID-19 data surveillance has been a cornerstone of our response,” the Department of Health and Human Services says, “and during the PHE, HHS has had the authority to require lab test reporting for COVID-19. At the end of the COVID-19 PHE, HHS will no longer have this express authority to require this data from labs, which may affect the reporting of negative test results and impact the ability to calculate percent positivity for COVID-19 tests in some jurisdictions.

“CDC has been working to sign voluntary Data Use Agreements (DUAs), encouraging states and jurisdictions to continue sharing vaccine administration data beyond the PHE. Additionally, hospital data reporting will continue as required by the CMS conditions of participation through April 30, 2024, but reporting may be reduced from the current daily reporting to a lesser frequency”;

— The Food and Drug Administration’s ability to detect early shortages of critical devices related to COVID-19 will be more limited; and

— The ability of health-care providers to safely dispense controlled substances via telemedicine without an in-person interaction is affected; however, there will be rulemaking that will propose to extend these flexibilities.

During the public health emergency, the Drug Enforcement Administration and Health and Human Services adopted policies to allow DEA-registered practitioners to prescribe controlled substances to patients without an in-person interaction.

Albany County COVID numbers

For the second week in a row, the entire state of New York is colored green by the Centers for Disease Control and Prevention, meaning that all 62 counties have a “low” community level of COVID-19.

It’s the sixth week in a row that Albany County has been so designated.

This follows two months of being labeled “medium,” which followed a month with a “high” designation after just two weeks at “low” preceded by a month of “medium” after 13 weeks of being labeled “high.”

Nationwide, following a positive trend over the last three months, under half of a percent — just 12 counties — are labeled “high.” Just 2 percent of counties are labeled “medium,” while those labeled “low” make up a whopping 98 percent.

The weekly metrics the CDC used to determine the current “low” level for Albany County are:

— Albany County now has a case rate of about 20 per 100,000 of population, up from 17  last week, the same as two weeks ago, but down from 28 three weeks ago, 35 four weeks ago, 30 five weeks ago, 42 six weeks ago, and a steady decrease from 120 fourteen weeks ago;

— For the important COVID hospital admission rate, Albany County has a rate of 5.8 per 100,000, up from 4.6 last week and 4.4 two weeks ago, but down from 6.2 three weeks ago, 5.6 four weeks ago, 9.6 five weeks ago and dramatically down from 22.2 fourteen weeks ago; and

— Albany County now has 2.8 percent of its staffed hospital beds filled with COVID patients, down from 3.1 last week but up slightly from 2.4 two weeks ago although down a bit from 2.9 three weeks ago, and also down from 4.3 four weeks ago, 5.1 five weeks ago, which had hovered near the same mark for about a month, down from the percentages for the previous thirteen weeks, which ranged from 6 to 8.

This week, Albany County’s 164th of dealing with COVID, numbers are continuing in the right direction with fewer new cases documented. The same is true statewide and nationwide.

Albany County’s dashboard, as of Tuesday, May 2, showed a death toll of 635, the same as last week, with 305 males and 330 females dying of COVID-related causes since the start of the pandemic.

Also as of May 2, according to Albany County’s COVID dashboard, 12 patients were hospitalized with COVID, one more than last week and the week before, but down from 16 four weeks ago, 22 five weeks ago, 26 six weeks ago, 30 seven weeks ago and 31 patients the week before, which was down from 39 nine weeks ago, near the same mark for a month but steadily down from 46 fifteen weeks ago.

In New York state, according to the health department’s most recent figures, from April 9 to 22, the Omicron variant continued to make up 100 percent of new cases.

The Omicron sublineage XBB.1.5 dominates at 56 percent, in decline since March 12 to 25, when it made up 87 percent of new cases, which before that had been increasing steadily from 39 percent for the twelve weeks prior.

The next most frequent sublineage is XBB at 13 percent, which peaked at 19 percent a fortnight ago. That is followed by XBB.1.16 and XBB.1.9, each making up about 11 percent of new cases.

BA.2 makes up 9 percent of new cases while BA.2, BA.5, BQ.1, and BQ.1.1 are now reported at zero.

Nationwide, according to the CDC, from April 23 to 29, the XBB.1.5 sublineage still dominates at 69 percent of new cases. But its percentage is declining since peaking at 88 percent four weeks ago after steadily rising from 49 percent fourteen weeks ago.

This is followed by XBB.1.16, a newcomer three weeks ago, now at 12 percent; XBB.1.9.1, at 9 percent, up from 5 percent four weeks ago; and XBB.1.9.2, a newcomer, at 4 percent of new cases.

XBB, last week at 1 percent, is now at 2 percent, followed by XBB.1.5.1, still at 2 percent; another newcomer three weeks ago, FD.2, is now at 1 percent, down from 2 percent. BQ.1.1 and CH.1.1 are each at less than 1 percent.

Meanwhile, in our region, which includes New York, New Jersey, the Virgin Islands, and Puerto Rico, 67 percent of new cases are caused by the XBB.1.5 sublineage of Omicron; the percentage had grown steadily to 99 percent five weeks ago but then began declining.

Also in our region, XBB.1.16 makes up 13 percent of new cases followed by XBB.1.9.1, at 9 percent, which was 3 percent four weeks ago.

Next in our region is XBB.1.9.2 at 4 percent of new cases followed by XBB at 3 percent and XBB.1.5.1, which continues at 3 percent. FD.2 is at less than 1 percent.

Although figures on infection rates are no longer reliable since tracing and tracking systems have been disbanded, the state dashboard shows that cases in Albany County as well as statewide have continued to decline in recent weeks.

In February, rates for both the state and county had jumped after having leveled off in November following two months of climbing.

Albany County, as a seven-day average, now has 1.9 cases per 100,000 of population, down from 3.2 last week, 2.0 two weeks ago, 3.1 three weeks ago, 4.0 four weeks ago, 5.2 five weeks ago, 4.1 six weeks ago, 6.5 seven weeks ago and 8.7 eight weeks ago, which has been in a more or less steady decline from 12.4 sixteen weeks ago.

Numbers hovered between 8 and 11 before that, which was a fairly steady decrease from 21.8 cases per 100,000 thirty-three weeks ago.

This compares with 2.5 cases per 100,000 statewide, down slightly from 2.6 last week, 3.1 two weeks ago,  3.5 three weeks ago, 4.4 four weeks ago,  5.1 five weeks ago, and markedly down over the last month-and-a-half in the twenties following a fairly steady decrease from 30.03 per 100,000 of population five months ago.

The lowest rates are in Central New York at 1.3 per 100,000 of population while the highest rate is in the Mid-Hudson region at 4.1, up from 3.4 last week.

The numbers for vaccination in Albany County have hardly budged for several months. The state’s dashboard now reports on these two categories:

— People with a primary series, for those who have completed the recommended initial series of a given COVID-19 vaccine product — two doses of Pfizer or Moderna vaccine or one dose of Johnson & Johnson vaccine; and

— People who are up to date, for those who have completed all COVID-19 vaccinations, including the bivalent booster, as appropriate per age and clinical recommendations.

As of Tuesday, 22.1 percent percent of Albany County residents were up to date on vaccines, a gradual increase from 17.9 twenty weeks ago, as opposed to the 61.5 percent of eligible residents who had received booster shots, as reported in prior weeks.

At the same time, 76.3 percent of county residents have completed a primary series, nearly the same as the last several months.

This compares with 76.6 percent of New Yorkers statewide completing a vaccination series, and 14.4 percent being up to date with vaccinations, up from 10.6 twenty weeks ago.

New Yorkers are still being encouraged by the state’s health department to get bivalent COVID-19 vaccine boosters from Pfizer-BioNTech for anyone age 5 or older and from Moderna for those 6 or older.

To schedule an appointment for a booster, New Yorkers are to contact their local pharmacy, county health department, or healthcare provider; visit vaccines.gov; text their ZIP code to 438829, or call 1-800-232-0233 to find nearby locations.