At one of Seattle’s last remaining mass COVID-19 testing clinics, stretched out near the University of Washington’s Husky Stadium, the parking lot is much emptier than it used to be.
Hundreds of people filled the lot at peak times over the course of pandemic, but in recent months, the demand for tests has slowed significantly, said Hee Jin Oh, UW Medicine’s senior COVID testing site manager.
This week, the clinic — as well as King County’s other remaining mass testing site at Bellevue College — will close for good.
“It is time to close our doors, but it is a start for the next phase,” said Oh, who worked at the UW testing sites through the worst of the state’s delta and omicron surges.
Hospital and public health leaders ran the clinics under the federal government’s public health emergency declarations, first set by the Trump administration in January 2020 as the mysterious respiratory infection emerging around the world reached the United States. Nearly 1,200 days — and over 1 million deaths nationwide — later, the emergency proclamation expires Thursday, meaning certain resources, like testing, will not be free to the public for much longer.
“This has not been easy,” state Secretary of Health Dr. Umair Shah said in a news conference last week. “This has been a long, tiring road for all of us.”
In Washington, more than 16,000 people have died from the virus, and tens of thousands more have been hospitalized over the last three years. More than 300,000 have reported long COVID experiences, struggling with symptoms for at least three months if not longer.
“Let’s not forget that every single number [of deaths] represents a person, an individual, a family member, a co-worker, a community member or someone we knew … and that unfortunately is what this horrible virus has meant for all of us in our communities across the globe,” Shah said.
Hospitalizations and deaths have been declining since last fall, with the exception of a one-month bump around the holidays. As of mid-April, the state was averaging around 3.1 hospitalizations per 100,000 people, compared to about 27.9 per 100,000 during the peak of the January 2022 omicron surge.
Still, more than 25 Washingtonians die every week from the virus.
COVID infection rates in the state have also remained fairly stable in recent months, and are now at an average of around 28.4 cases per 100,000 people. However, public health leaders have acknowledged the official record is an undercount since those who test positive are less likely now to report their infection to the state.
Shah pointed to recent trends as signs of success that mass vaccination, widespread population immunity and available treatments have “done their part” to reduce the spread of COVID.
More than 70% of eligible Washingtonians have completed their primary vaccination series, while just over 60% have received a booster shot, according to state COVID data. Nationwide, about 74% of eligible Americans have completed their primary series.
Gov. Jay Inslee announced Wednesday that state employees will no longer be required to receive vaccinations.
Still, ongoing work to keep COVID levels low will remain a “priority” for the state, despite the end of the federal emergency, Shah said. Because the virus still lives in the state, it will likely continue mutating and evolving over time, according to public health officials.
“While we are now in a very different place in the COVID-19 pandemic with the availability of effective COVID-19 vaccines and other treatments, ensuring access to these interventions is critical,” Dr. Eric Chow, King County’s chief of communicable disease epidemiology, said in a statement this week.
While most state and federal COVID proclamations have already lapsed, including masking and vaccination requirements, Thursday’s expiration of the nationwide public health emergency will further “end the flexibility” the government has for some COVID-aid efforts, according to Public Health — Seattle & King County.
Among the changes, the state will begin renewing residents’ eligibility for Apple Health, Washington’s version of Medicaid. During the pandemic, eligibility was automatically extended, but states must now reconfirm enrollees’ income and household size to determine whether they are still eligible.
About 300,000 Washingtonians, including 100,000 in King County, will be up for Apple Health plan renewal over the next year, and thousands could lose coverage if, for example, they don’t receive renewal notifications from the state and miss deadlines to sign up. Others whose income has grown may have to sign up for paid plans.
Other changes as the federal emergency ends include the country’s future supply of vaccine, treatments and testing.
Vaccines
The federal government has a supply of COVID vaccines that’s expected to last through this summer, during which time the shots will remain free to the public, regardless of insurance status. But once the national supply runs out, vaccines will shift to the private market. Receiving a COVID shot will likely become similar to getting vaccinated against flu, according to King County public health officials.
In Washington, COVID vaccines will continue to be free for children, and adult vaccines will be covered by most private insurance plans, as well as Medicare and Medicaid, state health officials said.
Those without insurance will be able to get free shots at certain pharmacies and community health centers.
Most private health insurance plans will continue to pay for COVID vaccines given by a health care provider within their network, but people might still need to pay part of the cost if an out-of-network provider vaccinates them.
State health officials last week again recommended Washingtonians ages 6 and up get one updated bivalent COVID vaccine, regardless of whether they had completed their primary vaccination series. In addition, those 65 and older and those who are immunocompromised are eligible for a second dose of the bivalent booster, according to recent recommendations from the Centers for Disease Control and Prevention.
The original monovalent COVID vaccine — the initial shot about 80% of Americans received starting in winter 2020 — will no longer be recommended for use in the United States, state health officials said.
Treatments
Access to COVID treatments and medications, like Paxlovid, will likely look similar to that of vaccines once the national supply runs out. Depending on insurance type, people will likely have to pay part of or the full cost of COVID treatments.
Some clinics in King County will continue to provide treatment and adjust fees based on household size and income.
The U.S. Food and Drug Administration issued an emergency use authorization for Paxlovid during the pandemic, to help reduce chances of hospitalization and death if a COVID patient takes it soon after they become infected.
Health care teams have also used molnupiravir, another oral antiviral, and remdesivir, an intravenous infusion, to help ease the severity of COVID symptoms.
Testing
Many COVID testing sites, which have seen less and less demand as popularity for at-home tests has grown, will close up shop Thursday, though some community centers and libraries are working to continue providing free tests. Most mass testing sites have already stopped operating in the last year as federal funding has dried up, with public health officials pointing people toward community health clinics or pharmacies for tests.
The state Department of Health’s mail-order program, which distributed free testing kits for much of the pandemic, will end Thursday, though people can still order tests through the similar federal program.
The state will continue to provide schools with testing supplies through the end of the 2023-24 school year, but will also pull the plug on WA Notify, the state’s smartphone tech that tracks and alerts potential COVID exposure, on Thursday.
“It was an honor and a privilege to join this team,” said Oh, who used to work at Seattle Children’s in lab medicine. “We’ve been grateful for the opportunity to help support the broader community by providing accessible and reliable testing.”
