Recently, President Joe Biden has signaled that he will allow the standing public health emergency concerning COVID-19 to expire when it next comes up for renewal on May 11, 2023. Considering how many COVID-related restrictions have already been dropped, the most obvious sign of the end of this order will be that COVID-19 testing and COVID-19 vaccines will no longer be paid for by the government.
Some sources have suggested that the vaccine could cost hundreds of dollars following May 11. Moderna had originally signaled that their cost might rise from the $26 per dose the government now pays to $130 a dose for individuals. However, following heavy criticism, Moderna has announced that their COVID-19 vaccine “will continue to be available at no cost for insured people whether they receive them at their doctors’ offices or local pharmacies. For uninsured or underinsured people, Moderna’s patient assistance program will provide COVID-19 vaccines at no cost.”
A widely circulated statement on social media indicated that the vaccines would no longer be available after May 11 because they are only approved for “emergency use.” This is not the case. Not only have some vaccines now been fully approved in adults, but the emergency use authorization from the FDA that allows the vaccines to be used in multiple scenarios is also unrelated to the public health emergency. So vaccines should remain available for free or at a low cost. That’s the good news.
The bad news is a new study that indicates we’ve only begun to see the real health cost of COVID-19.
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The study was published on Wednesday in the Journal of the American Medical Association (JAMA) Network. The study noted that, early in the pandemic, doctors saw expansive evidence that people who were infected by COVID-19 were more likely to develop cardiometabolic diseases, “including diabetes, hypertension, and hyperlipidemia.” That last one means high-fat levels in the blood, and like both diabetes and hypertension, it increases the chance of heart attacks and strokes as well as damage to other organs.
But it’s been more than a year now since the omicron variant became dominant in most areas. Many of those variants have proven elusive of the protection provided by past infection, are massively infectious, and have made some treatments—such as monoclonal antibodies—essentially useless. However, they’re also widely regarded as “less virulent.” Unlike previous years, where the post-holiday period brought on spikes in COVID-related deaths that reached 23,000 per week in 2021 and 17,000 per week in 2022, this year saw deaths reach “only” 4,400 a week.
It’s difficult to determine just how many cases of COVID-19 are now appearing in the U.S. each week. Testing rates are lower than they have been since April 2020, a time when tests were still unavailable in many areas, and the cumulative number of COVID cases recorded was still fewer than 1 million. Over 102 million cases later, it’s safe to say that the level of COVID circulating right now is simply “a lot.”
But with deaths down and hospitalization rates declining, is it really time to take off the masks and deal with COVID as “just another endemic disease?” The report has nothing but bad news on that front.
Researchers took the same set of people and looked at health issues that appeared in a 90-day window previous to a known infection with COVID-19, and compared it to a 90-day window after the COVID-19 infection. The study once again confirmed that infection with COVID-19 was tied to a sharp increase in risk of developing diabetes. In fact, the chances of contracting diabetes in the months following infection with COVID-19 increased by 58%. And this hasn’t changed over the course of the pandemic.
Our results suggest that this risk persisted as the Omicron variant became predominant, and the association remained even after accounting for temporal confounders.
The fact that omicron variants are circulating more widely, often with few symptoms, does not make them safe or harmless. The long-term cardiometabolic threat seems to be the same as it was from the original disease, right through delta. This was actually slightly lower than a pair of previous reports, one looking at 11 million veterans and the other at a combined pool of more than 45 million patients, suggesting that COVID-19 infection was related to a 63-66% increase in chances of contracting diabetes, as well as a similar risk in heart attacks and strokes. But this study is the first to look specifically to see if omicron is safer long-term. It’s not.
However, there was some good news.
Diabetes risk after COVID-19 infection was higher in unvaccinated than vaccinated patients, suggesting a benefit of vaccination.
In some groups, that difference was so low as to be statistically insignificant. In others, it represented a drop of some 40% in the risk. In no group was vaccination connected with any increase in long-term issues. So make sure you’re vaccinated and that you have the latest available boosters.
The overall message is simply that there is a serious long-term health risk associated with COVID-19 infection, even if it’s omicron, and even if it’s mild.
Whether or not you’ve ever had COVID-19, the thread below is a good one to bookmark. It covers not just what you should do to take care of yourself and your family, but brings home a very important point: “go get a rapid PCR or molecular test for COVID at an urgent care.” That’s not because the home tests are unreliable. It’s because if you do need to be hospitalized, or if you develop health issues related to COVID-19 infection later, you need documentation of that positive test result.
This is especially true should you come down with “long COVID.” Securing tests, treatment, and potential disability pay are all going to be a lot easier if you can tap your finger on an actual test from a medical facility showing a positive result. Even if it came from the drive-thru at CVS.
