The End of the Public Health Emergency

When I recall the early days of the pandemic, I remember first the quality of the light that March and April, casting soft shadows over a city emerging from winter, then gradually growing harsher and more angled as we moved deeper into the season. From my apartment, I watched the trees outside my window tentatively put forth tiny buds that eventually flowered and turned into leaves. One day that spring, I ventured out for a bi-weekly grocery run and saw a man in a full hazmat suit standing on the sidewalk outside the store, fiddling with his phone as he awaited his turn to go in and shop like the rest of us.

We are now more than three years into Covid, living with a disease that has affected our entire global population in ways both predictable and unanticipated. Covid has upended families and communities, launched new vaccines and medications, and shaped our collective response to suffering. Although much has changed culturally and medically, here in the United States, much more has not changed. The initial Covid shutdowns were abrupt, with businesses open one day and unavailable the next. Each week brought new disruptions and reconfigured routines as we learned the vocabulary of epidemiology and infectious disease. Governments and public health officials muddled through, doing their best to offer recommendations in the midst of constantly shifting information. But each time we were faced with something incomprehensible, like refrigerated morgue trucks outside NYC hospitals, we adjusted just enough for it to become comprehensible. We slowly became numb to the rising death counts, the incredible losses in Black and brown communities, and the ways in which the inequality of American society was being replicated once more.

For a brief moment, the United States more closely resembled a Western European country, with free Covid testing and vaccinations, expanded health insurance, and more generous unemployment benefits. But the last of this assistance ceased in May with the official end of the Covid public health emergency. Rather than making some of these policies permanent and working toward a society that takes better care of its citizens, we have instead decided to return to our old, broken system . We could have continued the expansion of Medicaid, instead of removing health insurance for up to 24 million people. We could have shored up our public health apparatuses to focus on disease prevention and overall wellness, rather than leaving it up to individuals to avoid getting sick. Most of all, we could have internalized the lesson that when we are linked within in a community, one person’s vulnerabilities become everyone’s.

Much has been written about what Covid has taught us about pandemics, and, knowing what we now know, whether we are better prepared to deal with the next one. (We are not.) We have squandered an opportunity to shift our priorities toward the more equitable and the more humane, not just for the sake of public health, but to build a better society. It is a colossal failure of imagination and one that will affect our response to future pandemics, as the incomprehensible will become comprehensible yet again.