What Happens When COVID-19 Emergency Declarations Go Away?

Many countries, including the United States, Japan and South Korea, are already moving to end COVID-19 emergency declarations, restrictions and mandates that have been in place for the past three years. What does the end of mandates and emergency declarations mean? How will it impact individuals and companies?

COVID-19 cases and deaths have decreased significantly from the high rates of the past few years. In the U.S., there are effective mRNA vaccines and masks that prevent transmission. There are antiviral medications that treat those who are at risk for severe illness and reduce deaths. These are positive mitigation strategies to lessen the harmful impacts from COVID-19 and move it to a regularly occurring disease.

The virus, however, continues to be a threat, and COVID-19 remains a leading cause of death among adults in the United States. There are and will continue to be surges in cases, often with great variation by geographic area. 

As we transition from responding to COVID-19 as an emergency to viewing it as an endemic disease, actions to mitigate the risks associated with COVID-19 infections are largely now up to individuals and organizations. Worldwide, people have fatigue from long-standing restrictions and mandates. Although there is less patience with requirements and a desire for individual decision-making, protective measures may be implemented in the future if needed. 

Businesses Management of Risk

Enterprise businesses will continue to own the risk of disease impact for COVID-19 to the degree the business is affected by the disease. Employers can:

  • Help normalize employees’ choices if they want to continue masking even without a policy that requires it;
  • Promote strategies that protect against COVID-19, including vaccinations, staying home when ill and reporting positive cases;
  • Prepare for future surges in COVID-19 cases with policies that are ready for implementation when needed. When real-time data indicates an increased risk, these policies can easily be put in place; and
  • Provide accurate information about COVID-19 to combat public perception that COVID-19 is no longer a health risk

Building a resilient system for COVID-19 doesn’t have to end with this disease. The best parts of these systems should be kept up and integrated so businesses are ready for the next biorisk. 

As the virus continues to surface on a regular occurrence, so will Long COVID. There will be long-term impacts to a group of employees, most likely those that opt not to get vaccinated or take steps to reduce individual risk. 

Based on the most recent data, 5% of the adult population is struggling with activity limitations from Long COVID. Indeed, nearly one third of COVID-19 related workers’ compensation claims submitted to the New York State Insurance Fund between January 2020 and March 2022 met the definition of Long COVID. The CDC has found that nearly one in five American adults who have had COVID-19 still have Long Covid. This data is based on a 20-minute online survey conducted multiple times beginning in April 2020 and continuing through January 2023. 

Broader Impacts

The end to the US Public Health Emergencies (PHE) on May 11, 2023, will have a moderate impact on residents and businesses. There are implications for medical insurance coverage, costs and payment for COVID-19 testing, treatments and vaccines. States will receive a change in the federal matching rate for healthcare services if they meet specific criteria. Disaster-related eligibility requirements, waivers for Medicaid and other system flexibilities will end, potentially negatively impacting many who were previously uninsured or underinsured. A sample of some of the changes are noted below:

  • Private health plans will no longer be required to cover COVID-19 tests in and out of network, and costs may be passed on to individuals;
  • Private health plans will no longer be required to cover the cost of COVID-19 vaccines by out-of-network providers;
  • Flexibilities in physician licensing to provide telehealth services will end in some states;
  • Penalty waivers for HIPAA violations, which had allowed clinicians to provide care using standard communication methods (FaceTime, Skype) that are normally HIPAA non-compliant, will end; and
  • Additional policy changes that apply specifically to recipients of Medicare, Medicaid, and the Children’s Health Insurance Program.

When COVID-19 emergency declarations end, COVID-19 and Long COVID will continue to be a threat. Leaders and businesses should monitor local conditions, recognizing some impacts from the disease may continue.


  1. Statement on the fourteenth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic
  2. CDC Deaths and Mortalities
  3. Long COVID: What Do the Latest Data Show?
  4. New NYSIF Report: Long Covid
  5. Nearly One in Five American Adults Who Have Had COVID-19 Still Have “Long COVID”
  6. CDC — Long Covid
  7. What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access

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