What will happen to free testing, vaccination and treatment for COVID-19 under the Biden administration’s plan to end the coronavirus public health emergency in May?

Northeastern public health policy experts say lifting the emergency declaration is a natural next step in the evolution of the pandemic.

Those experts, Neil Maniar and Wendy Parmet, also say the administration needs to come up with plans in the next four months to make sure the people who can least afford coronavirus prevention and treatment—and who are also most susceptible to its ill effects—maintain coverage.

“It’s not good practice to maintain an emergency forever,” says Parmet, who directs the Center for Health Policy and Law at Northeastern’s School of Law.

“But what do we need to put in place to contain what is a continuing significant problem?” she asks, adding that telling people who can’t afford vaccinations not to get them “is very dangerous.”

The emergency declaration allowed the administration to shift money to cover the cost of free testing, vaccines and antiviral treatments for everyone, regardless of ability to pay or immigration status.

“They are not going to be able to do that” once the emergency is lifted without Congressional approval, and Congress has refused to provide additional funding for COVID-19, Parmet says.

The White House said Monday it planned to lift the COVID-19 emergency declaration May 11.

“It reflects the transition from a pandemic state to an endemic state,” says Maniar, director of Northeastern’s Master of Public Health Program.

Between vaccination campaigns, the evolution of the pandemic, improvement in coronavirus treatment and immune protections gained through natural infections, “we are in a much better place of coexisting with COVID than we were a few years ago or even a few months ago,” Maniar says.

That’s the positive news, he says.

“The negative aspect is that the emergency did provide a number of benefits in terms of access to testing to access to treatment, and it made vaccines widely available,” Maniar says.

The Republican majority in the House of Representatives voted Tuesday in a largely symbolic act to end the coronavirus public emergency immediately.

“There’s a degree of COVID fatigue,” Maniar says. “People are questioning whether the emergency is still necessary.”

But he says the next several months will be important “to ensure that we’re putting the right systems and processes in place to make testing and treatment and vaccination and all of these other resources that are necessary for people to be healthy in place once the emergency is lifted.”

“Some individuals and communities may not only continue to experience barriers to access testing, treatment, or vaccinations, but these barriers may become even more significant once the emergency is lifted,” Maniar says.

The COVID-19 pandemic exposed deep cracks in the health-care delivery system that have been patched up a bit to prevent and treat coronavirus but remain fundamentally in place, Parmet says.

The pandemic is taking the lives of 500 people on a daily basis still, and low-income people and those with underlying health issues will remain at highest risk of severe illness and death from COVID-19, she says.

“There are going to be a lot of people who fall through the hole” in the health-care delivery system, Parmet says.

COVID-19 “might not be the emergency it was, but it is still an infectious disease,” she says.

“If I can’t afford to get tested, and I can’t afford to get vaccinated, and I walk around with COVID and I spread it to you, you may be more vulnerable.”

“You not only hurt the person who can’t get tested, you hurt the people they interact with. So it affects population level risk,” Parmet says.

The country is in a period of transition now in regards to the pandemic, Maniar says.

“Unfortunately, we will face future pandemics so we can’t take our eye off the ball. There are a lot of things we learned over the course of this pandemic and a lot of areas for improvement that were identified,” he says.

“This is our opportunity to address those things to ensure that when the next pandemic arrives–because it’s not an if it’s a when—we will be far more prepared than we were this time around,” Maniar says.

Cynthia McCormick Hibbert is a Northeastern Global News reporter. Email her at c.hibbert@northeastern.edu or contact her on Twitter @HibbertCynthia