Month: May 2023

Providing simple and cheap healthcare measures to pregnant women — such as offering aspirin — could prevent more than a million babies from being stillborn or dying as newborns in developing countries every year, new research said on Tuesday.   

An international team of researchers also estimated that one quarter of the world’s babies are born either premature or underweight, adding that almost no progress is being made in this area.    

The researchers called for governments and organizations to ramp up the care women and babies receive during pregnancy and birth in 81 low- and middle-income countries.   

SEE ALSO: A related video by VOA’s Timothy Obiezu

Eight proven and easily implementable measures could prevent more than 565,000 stillbirths in these countries, according to a series of papers published in the Lancet journal.    

The measures included providing micronutrient, protein and energy supplements, low-dose aspirin, the hormone progesterone, education on the harms of smoking, and treatments for malaria, syphilis and bacteria in urine.   

If steroids were made available to pregnant women and doctors did not immediately clamp the umbilical cord, the deaths of more than 475,000 newborn babies could also be prevented, the research found.    

Implementing these changes would cost an estimated $1.1 billion, the researchers said.   

This is “a fraction of what other health programs receive”, said Per Ashorn, a lead study author and professor at Finland’s Tampere University.    

‘Shockingly’ common 

Another study author, Joy Lawn of the London School for Hygiene and Tropical Medicine, told AFP that the researchers used a new definition for babies born premature or underweight.   

She said the traditional way to determine a baby had a low birthweight — if it was born weighing under 2.5 kilograms — was “a bit randomly selected” by a Finnish doctor in 1919.   

 This “very blunt measure” has remained the benchmark for more than a century, despite plentiful evidence that “those babies are not all the same”, Lawn said.   

The researchers analyzed a database that included 160 million live births from 2000 to 2020 to work out how often babies are born “too soon and too small”, she said.   

“Quite shockingly, we found that this is much more common once you start to think about it in a more nuanced way.”   

The researchers estimated that 35.3 million — or one in four — of the babies born worldwide in 2020 were either premature or too small, classifying them under the new term “small vulnerable newborns.”   

While most of the babies were born in southern Asia and sub-Saharan Africa, Lawn emphasized that every country was affected.    

One reason progress has flatlined is that these problems tend “to be something that happens to families and women with less of a voice”, Lawn said.   

For example, pregnant African American women in the United States received a lower level of care than other groups, she added. 
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Tesla Inc on Monday broke ground on a Texas lithium refinery that CEO Elon Musk said should produce enough of the battery metal to build about 1 million electric vehicles (EVs) by 2025, making it the largest North American processor of the material. 

The facility will push Tesla outside its core focus of building automobiles and into the complex area of lithium refining and processing, a step Musk said was necessary if the auto giant was to meet its ambitious EV sales targets. 

“As we look ahead a few years, a fundamental choke point in the advancement of electric vehicles is the availability of battery grade lithium,” Musk said at the ground-breaking ceremony on Monday, with dozers and other earth-moving equipment operating in the background. 

Musk said Tesla aimed to finish construction of the factory next year and then reach full production about a year later. 

The move will make Tesla the only major automaker in North America that will refine its own lithium. Currently, China dominates the processing of many critical minerals, including lithium. 

“Texas wants to be able to be self-reliant, not dependent upon any foreign hostile nation for what we need. We need lithium,” Texas Governor Greg Abbott said at the ceremony. 

Musk did not specify the volume of lithium the facility would process each year, although he said the automaker would continue to buy the metal from its vendors, which include Albemarle Corp and Livent Corp. 

“We intend to continue to use suppliers of lithium, so it’s not that Tesla will do all of it,” Musk said. 

Albemarle plans to build a lithium processing facility in South Carolina that will refine 100,000 tons of the metal each year, with construction slated to begin next year and the facility coming online sometime later this decade. 

Musk did not say where Tesla will source the rough form of lithium known as spodumene concentrate that will be processed at the facility, although Tesla has supply deals with Piedmont Lithium Inc and others. 

‘Clean operations’

Tesla said it would eschew the lithium industry’s conventional refining process, which relies on sulfuric acid and other strong chemicals, in favor of materials that were less harsh on the environment, such as soda ash. 

“You could live right in the middle of the refinery and not suffer any ill effect. So they’re very clean operations,” Musk said, although local media reports said some environmental advocates had raised concerns over the facility. 

Monday’s announcement was not the first time that Tesla has attempted to venture into lithium production. Musk in 2020 told shareholders that Tesla had secured rights to 10,000 acres in Nevada where it aimed to produce lithium from clay deposits, which had never been done before on a commercial scale. 

While Musk boasted that the company had developed a proprietary process to sustainably produce lithium from those Nevada clay deposits, Tesla has not yet deployed the process. 

Musk has urged entrepreneurs to enter the lithium refining business, saying it is like “minting money.” 

“We’re begging you. We don’t want to do it. Can someone please?” he said during a conference call last month. 

Tesla said last month a recent plunge in prices of lithium and other commodities would aid Tesla’s bruised margins in the second half of the year. 

The refinery is the latest expansion by Tesla into Texas after the company moved its headquarters there from California in 2021. Musk’s other companies, including SpaceX and The Boring Company, also have operations in Texas. 

SEE ALSO: A related video by VOA’s Arash Arabasadi

“We are proud that he calls Texas home,” Abbott said, saying Tesla and Musk are “Texas’s economic juggernauts.” 
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Mexican officials and the conservation group Sea Shepherd said Monday that experts would set out in two ships in a bid to locate the few remaining vaquita marina, the world’s most endangered marine mammal. 

Mexico’s environment secretary said experts from the United States, Canada and Mexico will use binoculars, sighting devices and acoustic monitors to try to pinpoint the location of the tiny elusive porpoises. The species cannot be captured, held or bred in captivity. 

The trip will start Wednesday and run to May 26 in the Gulf of California, also known as the Sea of Cortez, the only place the vaquita lives. The group will travel in a Sea Shepherd vessel and a Mexican boat and try to sight vaquitas. As few as eight of the creatures are believed to remain. 

SEE ALSO: A related video by VOA’s Annika Hammerschlag

Illegal gillnet fishing traps and kills the vaquita. Fishermen set the nets to catch totoaba, a fish whose swim bladder is considered a delicacy in China and can fetch thousands of dollars per pound (0.45 kilograms). 

Sea Shepherd has been working in the Gulf alongside the Mexican navy to discourage illegal fishing in the one area where vaquitas were last seen. The area is known as the “zero tolerance” zone, and fishing is supposedly not allowed there. However, illegal fishing boats are regularly seen there, and so Mexico has been unable to completely stop them. 

Pritam Singh, Sea Shepherd’s chairman, said that a combination of patrols and the Mexican navy’s sinking of concrete blocks with hooks to snare illegal nets has reduced the number of hours that fishing boats spend in the restricted zone by 79% in 2022, compared with the previous year. 

Singh said that “the last 18 months have been incredibly impactful and encouraging,” while noting that “the road ahead for saving this species is long.” 

SEE ALSO: A related video by VOA’s Henry Wilkins

The last such sighting expedition in 2021 yielded probable sightings of between five and 13 vaquitas, a decline from the previous survey in 2019. The porpoises are so small and so elusive, and are usually seen from so far away, that it is hard for observers to be certain that they saw a vaquita, count how many they saw or determine whether they saw the same animal twice. 

Illegal fishing itself has impeded population calculations in the past. 

According to a report published in 2022, both the 2019 and 2021 surveys “were hindered by the presence of many illegal fishing boats with gillnets in the water. Some areas could not be surveyed at all on some days due to the density of illegal fishing.” 

The government’s protection efforts have been uneven, at best, and often face violent opposition from local fishermen. 

President Andrés Manuel López Obrador’s administration has largely declined to spend money to compensate fishermen for staying out of the vaquita refuge and not using gillnets, or to monitor the fishing boats or the areas they launch from. 
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Funding for a global initiative aimed at creating more environmentally friendly and climate-resilient farming has grown to $13 billion, co-leaders the United States and the United Arab Emirates said Monday.

That money means the Agriculture Innovation Mission (AIM) for Climate, launched in 2021, now exceeds its $10 billion target for the COP28 climate talks, to be hosted by the UAE in November and December.

“Climate change continues to impact longstanding agricultural practices in every country and a strong global commitment is necessary to face the challenges of climate change head-on,” U.S. Secretary of Agriculture Tom Vilsack said in a statement.

Vilsack and his Emirati counterpart Mariam bint Mohammed Almheiri, the UAE Minister of Climate Change and Environment, are co-hosting an AIM for Climate Summit in Washington this week.

“I think the beauty of this is that of the $13 billion, $10 billion comes from the government and three billion is coming from the private sector,” said Almheiri.

Between a quarter and a third of global greenhouse emissions come from food systems, from factors like deforestation to make way for agricultural land, methane emissions from livestock, the energy costs associated with supply chains and energy used by consumers to store and prepare food.

At the same time, the changing climate is threatening food security across the world, as global warming increases the frequency of punishing heat waves, droughts and extreme weather events.

Projects underway include developing newer, greener fertilizers that use less fossil fuels to create, and returning to so-called “regenerative agriculture” practices that restore soil biodiversity, thus improving both yield and carbon sequestration while reducing the need for fertilization.

Artificial intelligence-enhanced tools meanwhile are being developed to take data from sources including satellites and ground sensors to then accurately estimate how carbon-rich any given plot of land is, which could help farmers boost soil health or enable the creation of a viable carbon offset market.

Also on the group’s agenda are efforts to adopt more efficient farming techniques and to switch to growing crops that require less water in some climate-impacted areas.

“Black farmers, Indigenous farmers, low-income farmers, they need access to this innovation as well,” former U.S. Vice President Al Gore and climate activist told the summit’s opening meeting.

U.S. climate envoy John Kerry, as well as ministers from Britain, the European Commission, Australia, Kenya, Mexico and Panama are all set to address the conference.
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For the first time, the U.S. government will pay for a large study measuring whether overdoses can be prevented by so-called safe injection sites, places where people can use heroin and other illegal drugs and be revived if they take too much.

The grant provides more than $5 million over four years to New York University and Brown University to study two sites in New York City and one opening next year in Providence, Rhode Island.

Researchers hope to enroll 1,000 adult drug users to study the effectiveness of the sites to prevent overdoses, to estimate their costs and to gauge potential savings for the health care and criminal justice systems.

The universities announced the grant Monday. The money will not be used to operate the sites, the universities said.

With U.S. drug overdose deaths reaching nearly 107,000 in 2021, supporters contend safe injection sites, also called overdose preventions centers, can save lives and connect people with addiction treatment, mental health services and medical care.

Opponents worry the sites encourage drug use and that they will lead to the deterioration of surrounding neighborhoods.

“There is a lot of discussion about overdose prevention centers, but ultimately, we need data to see if they are working or not, and what impact they may have on the community,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which awarded the grant.

Sites operate in 14 countries, including Canada, Australia and France, according to the Drug Policy Alliance, a group working for decriminalization and safe drug use policies.

In the U.S., New York City opened the first publicly recognized safe injection site in 2021, and Rhode Island became the first state to authorize them that year.

States including Colorado, Nevada and New Mexico have considered allowing them. The governors of California and Vermont vetoed bills allowing safe injection sites last year, and Pennsylvania’s Senate last week voted for a ban on them.

The grant marks another move by the Biden administration toward what is known as harm reduction, a strategy focused on preventing death and illness in drug users while helping them get care, as opposed to punishment.

The White House’s drug control strategy is the first to emphasize harm reduction, and the Justice Department has signaled it will allow safe injection sites.

In December, the National Institutes of Health established a harm reduction research network to study programs providing services and supplies, including naloxone, a drug that can reverse overdoses, and materials to test drugs for fentanyl, a powerful opioid driving record numbers of overdoses. The new study on safe injection sites will be part of that project.
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Most Democrats and Republicans agree that the federal government should better regulate the biggest technology companies, particularly social media platforms. But there is little consensus on how it should be done. 

Concerns have skyrocketed about China’s ownership of TikTok, and parents have grown increasingly worried about what their children are seeing online. Lawmakers have introduced a slew of bipartisan bills, boosting hopes of compromise. But any effort to regulate the mammoth industry would face major obstacles as technology companies have fought interference. 

Noting that many young people are struggling, President Joe Biden said in his February State of the Union address that “it’s time” to pass bipartisan legislation to impose stricter limits on the collection of personal data and ban targeted advertising to children. 

“We must finally hold social media companies accountable for the experiment they are running on our children for profit,” Biden said.

A look at some of the areas of potential regulation: 

Children’s safety

Several House and Senate bills would try to make social media, and the internet in general, safer for children who will inevitably be online. Lawmakers cite numerous examples of teenagers who have taken their own lives after cyberbullying or have died engaging in dangerous behavior encouraged on social media. 

In the Senate, at least two bills are focused on children’s online safety. Legislation by Senators Richard Blumenthal, a Connecticut Democrat, and Marsha Blackburn, a Tennessee Republican, approved by the chamber’s Commerce Committee last year would require social media companies to be more transparent about their operations and enable child safety settings by default. Minors would have the option to disable addictive product features and algorithms that push certain content. 

The idea, the senators say, is that platforms should be “safe by design.” The legislation, which Blumenthal and Blackburn reintroduced last week, would also obligate social media companies to prevent certain dangers to minors — including promotion of suicide, disordered eating, substance abuse, sexual exploitation and other illegal behaviors. 

A second bill introduced last month by four senators — Democratic Senators Brian Schatz of Hawaii and Chris Murphy of Connecticut and Republican Senators Tom Cotton of Arkansas and Katie Britt of Alabama — would take a more aggressive approach, prohibiting children under 13 from using social media platforms and requiring parental consent for teenagers. It would also prohibit companies from recommending content through algorithms for users under 18.

Critics of the bills, including some civil rights groups and advocacy groups aligned with tech companies, say the proposals could threaten teens’ online privacy and prevent them from accessing content that could help them, such as resources for those considering suicide or grappling with their sexual and gender identity. 

“Lawmakers should focus on educating and empowering families to control their online experience,” said Carl Szabo of NetChoice, a group aligned with Meta, TikTok, Google and Amazon, among other companies. 

Data privacy 

Biden’s State of the Union remarks appeared to be a nod toward legislation by Senators Ed Markey, a Massachusetts Democrat, and Bill Cassidy, a Louisiana Republican, that would expand child privacy protections online, prohibiting companies from collecting personal data from younger teenagers and banning targeted advertising to children and teens. The bill, also reintroduced last week, would create an “eraser button” allowing parents and kids to eliminate personal data, when possible. 

A broader House effort would attempt to give adults as well as children more control over their data with what lawmakers call a “national privacy standard.” Legislation that passed the House Energy and Commerce Committee last year would try to minimize data collected and make it illegal to target ads to children, usurping state laws that have tried to put privacy restrictions in place. But the bill, which would have also given consumers more rights to sue over privacy violations, never reached the House floor. 

Prospects for the House legislation are unclear now that Republicans have the majority.

TikTok, China 

Lawmakers introduced a raft of bills to either ban TikTok or make it easier to ban it after a combative March House hearing in which lawmakers from both parties grilled TikTok CEO Shou Zi Chew over his company’s ties to China’s communist government, data security and harmful content on the app. 

Chew attempted to assure lawmakers that the hugely popular video-sharing app prioritizes user safety and should not be banned because of its Chinese connections. But the testimony gave new momentum to the efforts. 

Soon after the hearing, Missouri Senator Josh Hawley, a Republican, tried to force a Senate vote on legislation that would ban TikTok from operating in the United States. But he was blocked by a fellow Republican, Kentucky Senator Rand Paul, who said that a ban would violate the Constitution and anger the millions of voters who use the app. 

Another bill sponsored by Republican Senator Marco Rubio of Florida would, like Hawley’s bill, ban U.S. economic transactions with TikTok, but it would also create a new framework for the executive branch to block any foreign apps deemed hostile. His bill is co-sponsored by Representatives Raja Krishnamoorthi, an Illinois Democrat, and Mike Gallagher, a Wisconsin Republican. 

There is broad Senate support for bipartisan legislation sponsored by Senate Intelligence Committee Chairman Mark Warner, a Virginia Democrat, and South Dakota Senatpr John Thune, the No. 2 Senate Republican, that does not specifically call out TikTok but would give the Commerce Department power to review and potentially restrict foreign threats to technology platforms. 

The White House has signaled it would back that bill, but its prospects are uncertain. 

Artificial intelligence 

A newer question for Congress is whether lawmakers should move to regulate artificial intelligence as rapidly developing and potentially revolutionary products like AI chatbot ChatGPT begin to enter the marketplace and can in many ways mimic human behavior. 

Senate Democratic leader Chuck Schumer of New York has made the emerging technology a priority, arguing that the United States needs to stay ahead of China and other countries that are eyeing regulations on AI products. He has been working with AI experts and has released a general framework of what regulation could look like, including increased disclosure of the people and data involved in developing the technology, more transparency and explanation for how the bots arrive at responses.

The White House has been focused on the issue as well, with a recent announcement of a $140 million investment to establish seven new AI research institutes. Vice President Kamala Harris met Thursday with the heads of Google, Microsoft and other companies developing AI products.
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Immigrants in the western U.S. state of Colorado have a unique place to go when they are not feeling well: a health care clinic that serves newcomers from many countries. For VOA, Svitlana Prystynska has more about the facility, which was founded by a Ukrainian immigrant. Camera: Olena Andrushenko 
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The U.S. Centers for Disease Control and Prevention says America’s leading cause of overdose deaths is synthetic opioids, mostly fentanyl, which can be up to 50 times stronger than heroin. U.S. law enforcement says illicit fentanyl is cheaply made from chemicals mostly coming from China, trafficked through Mexico, and then smuggled into the United States. VOA’s Natasha Mozgovaya looks at fentanyl in Washington state in a series that today explores how stigmas about fentanyl abuse complicate treatment for addicts.
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The U.S. Centers for Disease Control and Prevention says America’s leading cause of overdose deaths is synthetic opioids, mostly fentanyl, which can be up to 50 times stronger than heroin. U.S. law enforcement says illicit fentanyl is cheaply made from chemicals mostly coming from China, trafficked through Mexico, and then smuggled into the United States, says U.S. law enforcement. VOA’s Natasha Mozgovaya looks at fentanyl in a series from the state of Washington that concludes by showing how breaking free from addiction can be a lifelong journey.
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Tracking down accurate information about Philadelphia’s elections on Twitter used to be easy. The account for the city commissioners who run elections, @phillyvotes, was the only one carrying a blue check mark, a sign of authenticity.

But ever since the social media platform overhauled its verification service last month, the check mark has disappeared. That’s made it harder to distinguish @phillyvotes from a list of random accounts not run by the elections office but with very similar names.

The election commission applied weeks ago for a gray check mark — Twitter’s new symbol to help users identify official government accounts – but has yet to hear back from the Twitter, commission spokesman Nick Custodio said. It’s unclear whether @phillyvotes is an eligible government account under Twitter’s new rules.

That’s troubling, Custodio said, because Pennsylvania has a primary election May 16 and the commission uses its account to share important information with voters in real time. If the account remains unverified, it will be easier to impersonate – and harder for voters to trust – heading into Election Day.

Impostor accounts on social media are among many concerns election security experts have heading into next year’s presidential election. Experts have warned that foreign adversaries or others may try to influence the election, either through online disinformation campaigns or by hacking into election infrastructure.

Election administrators across the country have struggled to figure out the best way to respond after Twitter owner Elon Musk threw the platform’s verification service into disarray, given that Twitter has been among their most effective tools for communicating with the public.

Some are taking other steps allowed by Twitter, such as buying check marks for their profiles or applying for a special label reserved for government entities, but success has been mixed. Election and security experts say the inconsistency of Twitter’s new verification system is a misinformation disaster waiting to happen.

“The lack of clear, at-a-glance verification on Twitter is a ticking time bomb for disinformation,” said Rachel Tobac, CEO of the cybersecurity company SocialProof Security. “That will confuse users – especially on important days like election days.”

The blue check marks that Twitter once doled out to notable celebrities, public figures, government entities and journalists began disappearing from the platform in April. To replace them, Musk told users that anyone could pay $8 a month for an individual blue check mark or $1,000 a month for a gold check mark as a “verified organization.”

The policy change quickly opened the door for pranksters to pose convincingly as celebrities, politicians and government entities, which could no longer be identified as authentic. While some impostor accounts were clear jokes, others created confusion.

Fake accounts posing as Chicago Mayor Lori Lightfoot, the city’s Department of Transportation and the Illinois Department of Transportation falsely claimed the city was closing one of its main thoroughfares to private traffic. The fake accounts used the same photos, biographical text and home page links as the real ones. Their posts amassed hundreds of thousands of views before being taken down.

Twitter’s new policy invites government agencies and certain affiliated organizations to apply to be labeled as official with a gray check. But at the state and local level, qualifying agencies are limited to “main executive office accounts and main agency accounts overseeing crisis response, public safety, law enforcement, and regulatory issues,” the policy says.

The rules do not mention agencies that run elections. So while the main Philadelphia city government account quickly received its gray check mark last month, the local election commission has not heard back.

Election offices in four of the country’s five most populous counties — Cook County in Illinois, Harris County in Texas, Maricopa County in Arizona and San Diego County — remain unverified, a Twitter search shows. Maricopa, which includes Phoenix, has been targeted repeatedly by election conspiracy theorists as the most populous and consequential county in one of the most closely divided political battleground states.

Some counties contacted by The Associated Press said they have minimal concerns about impersonation or plan to apply for a gray check later, but others said they already have applied and have not heard back from Twitter.

Even some state election offices are waiting for government labels. Among them is the office of Maine Secretary of State Shenna Bellows.

In an April 24 email to Bellows’ communications director reviewed by The Associated Press, a Twitter representative wrote that there was “nothing to do as we continue to manually process applications from around the world.” The representative added in a later email that Twitter stands “ready to swiftly enforce any impersonation, so please don’t hesitate to flag any problematic accounts.”

An email sent to Twitter’s press office and a company safety officer requesting comment was answered only with an autoreply of a poop emoji.

“Our job is to reinforce public confidence,” Bellows told the AP. “Even a minor setback, like no longer being able to ensure that our information on Twitter is verified, contributes to an environment that is less predictable and less safe.”

Some government accounts, including the one representing Pennsylvania’s second-largest county, have purchased blue checks because they were told it was required to continue advertising on the platform.

Allegheny County posts ads for elections and jobs on Twitter, so the blue check mark “was necessary,” said Amie Downs, the county’s communications director.

When anyone can buy verification and when government accounts are not consistently labeled, the check mark loses its meaning, Colorado Secretary of State Jena Griswold said.

Griswold’s office received a gray check mark to maintain trust with voters, but she told the AP she would not buy verification for her personal Twitter account because “it doesn’t carry the same weight” it once did.

Custodio, at the Philadelphia elections commission, said his office would not buy verification either, even if it gets denied a gray check.

“The blue or gold check mark just verifies you as a paid subscriber and does not verify identity,” he said.

Experts and advocates tracking election discourse on social media say Twitter’s changes do not just incentivize bad actors to run disinformation campaigns — they also make it harder for well-meaning users to know what’s safe to share.

“Because Twitter is dropping the ball on verification, the burden will fall on voters to double check that the information they are consuming and sharing is legitimate,” said Jill Greene, voting and elections manager for Common Cause Pennsylvania.

That dampens an aspect of Twitter that until now had been seen as one of its strengths – allowing community members to rally together to elevate authoritative information, said Mike Caulfield, a research scientist at the University of Washington’s Center for an Informed Public.

“The first rule of a good online community user interface is to ‘help the helpers.’ This is the opposite of that,” Caulfield said. “It takes a community of people who want to help boost good information, and robs them of the tools to make fast, accurate decisions.”
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“Being in hospitals during the early days of COVID-19 was terrifying, like I was going to war. But as far as I’m concerned, those days are done, Danielle King, a nurse working in Luling, Louisiana, told VOA.

“I think it’s pretty obvious that the pandemic was over a year ago,” she added. “The government’s lagging behind that reality, so maybe they’ll finally catch up.”

The U.S. government will take a big step in that direction Thursday as Washington officially declares an end to the coronavirus pandemic by allowing the COVID-19 Public Health Emergency (PHE) to expire.

The emergency was first instituted more than three years ago to provide funding and resources that would keep Americans safe during the then-growing global pandemic.

While many health care officials agree the time is right to end the national emergency and let state and local governments allocate resources to the COVID-19 response, some worry the move will harm Americans — particularly the impoverished — who will be less likely to afford vaccinations and risk being dropped from government programs such as Medicaid.

“It’s regrettable, but we have no certainty on what impact the PHE’s end will have on the public,” said Amy Pisani, CEO of Vaccinate Your Family, a national nonprofit organization.

“Public health advocates haven’t had a seat at the table to discuss how the end of the PHE declaration will look,” she said. “We know, for example, that COVID-19 vaccinations have been essential in keeping us safe, but how will uninsured adults access and afford the vaccines when the PHE is done? How long will free vaccines be available? Will it vary from region to region? We have no idea. All we know is it’s going to affect a lot of people.”

‘No longer a threat’

The PHE was first declared in January 2020 by former Health and Human Services Secretary Alex Azar.

Since entering office in 2021, President Joe Biden has repeatedly extended the emergency. Many public health officials, including Dr. Jeffrey Elder, associate chief medical officer for emergency management at LCMC Health in New Orleans, Louisiana, believe the emergency allowed the government to take sweeping steps to support the country’s economic, health and welfare systems throughout the crisis.

“The PHE supported and funded nationwide coronavirus testing, the research and distribution of vaccinations and treatments, telehealth services, disaster responses, hospital-at-home services, nurse aide training for nursing homes and so much more,” Elder told VOA.

“And it gave our patients the comfort of knowing they couldn’t be kicked off their Medicaid insurance coverage during the emergency,” he added. “It was invaluable.”

Most public health officials, however, acknowledge the coronavirus no longer presents the crisis it once did, and the PHE may no longer be necessary.

“While we continue to see illness and deaths from COVID-19, it is no longer the threat it once was, thanks to testing, vaccines and treatment,” said Dr. Susan Kansagra, director of the North Carolina Department of Health and Human Services Division of Public Health.

She believes COVID-19 will soon be treated as routinely as other respiratory illnesses the country regularly faces.

Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said this is a good thing.

“To call this an emergency is to elevate it above other viruses that are causing basically the same number of hospitalizations and deaths,” he said.

“I think there’s a danger to that, and I see that danger with some of my friends,” Offit said. “When their 8-year-old is sick they say, ‘Oh, I hope it’s not COVID,’ and then they test them. If they test negative, they just send them to school or to their grandparents or wherever they are going, as if it’s OK to pass on whatever disease they do have. Maybe putting coronavirus on the level of these other diseases will encourage us to take their spread all a little more seriously, as well.”

‘Wide-ranging chaos’

Coronavirus cases and deaths continue to drop, but thousands of Americans are still affected by the disease. According to the Centers for Disease Control and Prevention, 1,773 people died of COVID-19 during the week ending April 5.

Some fear that with so many people still being impacted, suddenly ending the declaration could create a new set of problems.

“An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and most importantly, for tens of millions of Americans,” the Office of Management and Budget wrote in a Statement of Administration Policy earlier this year.

Dr. Joe McLaughlin, Alaska state epidemiologist, believes ending the PHE can reduce government spending and help the country return to a more traditional health care model. But he warns of downsides.

“We’re going to see fewer health care provider flexibilities, a reduction in access to over-the-counter tests and a decrease in some social safety net benefits. This is definitely going to affect people,” he said.

Of particular concern to health care providers is that states will no longer be forbidden from dropping enrollees from Medicaid, a federal health care program for the poor and disadvantaged, as they were during the PHE. In the months following the emergency’s conclusion, the Kaiser Family Foundation estimates that between 5.3 million and 14.2 million of America’s most vulnerable will lose their Medicaid coverage.

Additionally, it is expected that COVID-19 tests and vaccinations will no longer be offered free of charge. Once the government stops buying vaccines, the cost is expected to skyrocket. Pfizer announced it could charge as much as $130 per dose.

Challenge and opportunity

“I think it’s the right time to end it,” New Orleans nurse Brandon Legnion said of the PHE.

“I don’t think I’ve seen or heard of a single COVID-positive admission at our hospital in the last six months,” he told VOA. “The demand for PPE [personal protective equipment] and vaccines are way down, so maybe it’s time to treat coronavirus patients with the same well-researched protocols we use for other airborne transmitted diseases like tuberculosis or varicella [chickenpox].”

Ending the PHE will restructure the federal government’s COVID-19 response as an endemic, rather than a pandemic, managed through government agencies’ normal authorities. In addition to tapering coronavirus relief funds, the development of vaccines and treatments will be shifted away from federal government control.

State health department officials say the transition will be a challenge, but they are ready.

“We’ve been preparing for the possibility of the end of the federal public health emergency for some time now, and we released our state’s plan in a roadmap last year,” said AnneMarie Harper, communications director at the Colorado Department of Public Health and Environment.

“It’s a sustainable, continued response to COVID-19 that features partnerships between public and private entities that ensure all Coloradans are being taken care of, including those without insurance,” she said.

In Maryland, similar work has been done to prepare for what has become a critical transition in the country’s health care system.

Chase Cook, acting director of communications at the Maryland Department of Health, said ending the PHE makes sense because it aligns with a decrease in COVID-19 hospitalization and severity, as well as an increasing integration of coronavirus-related services into existing public health infrastructure.

“The end of the public health emergency can be seen as a challenge,” Cook told VOA, “but it’s also an opportunity … to continue responding to the effects of the pandemic on public health, to strengthen relationships within the health care system, to maintain public-private partnerships, to grow the public health workforce, and to build on renewed efforts to decrease health disparities in Maryland. It’s an opportunity, and we’re ready.” 
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