The Never-Ending Emergency

I have been quiet lately, not wanting to add to COVID saturation.  The issues of the pandemic are well known—viral origin, vaccine safety, early treatment, repurposed therapeutics, pharma windfalls.  The word is out, everyone has an opinion, and most have dug in.  One way or another, we have all learned to cope with a virus that is here to stay.  

From this state of uneasy equilibrium, I must ask why we are still in a declared state of COVID-19 emergency.  Maybe we need to start with the meaning of emergency.

Many years ago, a good friend of mine was pulled over.  The officer invited him to the back of the car, put him in handcuffs, and hauled him to jail.  A check of his license plates revealed a warrant for his arrest, except it was a mistake.  My friend had done nothing wrong.  A clerical error associated his plate number with someone else’s warrant.  Nonetheless, he found himself in the county jail.  On the wall of the cell was a dirty red button, and under the button was a sign, “Press for emergency.”  He felt entitled to press the button.

“What is your emergency?”  Came the voice out of the speaker.

“Well, you see, I shouldn’t be here…”  Click.  

The speaker went silent, so he pressed the button again.

“What is your emergency?”

“I believe there must be some mistak…”  Click.  He pressed the button again.   

“What is your emergency?”

“I need to make a phone ca…”  Click.  By now, he realized that his situation, however unpleasant, inconvenient, and unjust, did not constitute an emergency, so he prepared to spend the night alone in the cell, which he did.  The next morning the mistake was realized, and he was released, unceremoniously, with barely an apology, and no compensation for his 17-hour ordeal.

COVID-19 is like this.  It is unpleasant, inconvenient, and even unjust, but it not an emergency. At least not anymore.

This view has gained broad consensus across the political spectrum.  Most states have ended emergency measures, and California will join that list soon.  With a nearly veto-proof bipartisan majority, the US Senate voted to end the emergency earlier this month.  Even President Biden has said the pandemic is over.  Yet his administration promises to veto the Senate bill if passed and to extend the emergency declaration again next year.  All for an emergency that is as real as the tooth fairy.

And why not?  The emergency declaration has been the tooth fairy for many.

The COVID emergency is a bonanza for manufacturers of counter-pandemic measures—vaccines, tests, and drugs among them.  Not only does it give them an endless market for their products, but bypassing FDA approval saves them millions.  And they also receive liability protection for any product manufactured under Emergency Use Authorization.  No wonder the healthcare manufacturing sector never wants the emergency to end.

The American Hospital Association also lobbies for continuing the emergency, and for similar reasons.  Hospitals get a 20% bonus for treating COVID patients.  CMS relaxed regulatory standards during the emergency.  And there is funding for “building vaccine confidence.”  But none of this would happen without the consent of government.  

The executive branch of government has used COVID-19 as excuse for a power-grab.  During a crisis, citizens—including members of congress—are willing to temporarily cede power to the executive in exchange for steady leadership through the emergency.  The trouble is that the executive branch jealously clutches power gained during turbulent times once calm is restored.  History backs me up.  World War I gave us the Espionage Act of 1917.  September 11 gave us the Patriot Act of 2001.  And the COVID Pandemic gave us the Declaration Under the PREP Act for Medical Countermeasures Against COVID-19.

Last month, right on cue, Xavier Becerra renewed the emergency for the twelfth straight quarter, extending the government’s emergency powers into 2023.  Many of these “emergency” measures are difficult to connect to the pandemic.  For example, the CDC issued an eviction moratorium that had to be struck down by the Supreme Court.  HHS approved use of Medicaid funds to pay for food and housing in Massachusetts and Oregon.  The emergency is even the basis for President Biden’s proposal to forgive student loans.  The emergency has allowed the administration to short-circuit the checks and balances in normal policymaking processes, giving it autocratic power.

The emergency has become an institution.  Many are dependent on emergency measures, so there will be pain when the emergency ends.  But delay will only increase the suffering we must endure later.

The emergency is over.  Policies must stand on their own merits.  Normal processes must return.