It was over a hundred years ago. What was then deemed as perhaps the most widespread pestilence the world had ever witnessed was finally coming to an end. The Spanish flu, whose proliferation was certainly assisted by theater-wide troop movements during World War One, had wreaked havoc across the planet. It was particularly virulent and deadly, killing tens of millions of people in multiple countries. The scourge began in 1918—the last year of the war—and was effectively over by the middle of 1920. During those two years, whole families were decimated, and many were left orphaned. It has been estimated that more American service men died from the pandemic than in battle. Yet, by “the roaring 20s,” a global nightmare was becoming a faded memory.

This may be the state in which we find ourselves today as it concerns the latest planetary contagion. What was first identified in China at the end of 2019 would spread to all countries in 2020. COVID-19 has gone on to affect the global economy, societal norms and government elections. In 2021, large-scale vaccine campaigns were underway as the officially declared public health emergency (PHE) continued month after month, and then year after year. But as those denizens of a different era ultimately witnessed, pandemics do finally come to an end. Is it possible that we are at or nearing that point today?

Beginning of the End

On a network television program that aired September 18, 2022, the president of the United States signaled the end of the COVID pandemic. Joe Biden stated the following during an interview on the iconic CBS News staple, 60 Minutes:

The pandemic is over. We still have a problem with COVID. We’re still doing a lotta work on it. But the pandemic is over. If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And, so, I think it’s changing.

The president may be on the right track in this assessment. According to figures released by Becker’s Hospital Review, fewer than 70,000 coronavirus cases are currently announced each day in the United States. This marks the lowest level of cases since early May. In addition, fewer than 35,000 people are currently in American hospitals with COVID, from a daily average perspective. According to the New York Times, the number of deaths from COVID-19, on a daily average was at 464 at the time the 60 Minutes segment was aired.

And the president wasn’t alone in pointing out what appears to be the diminishing reach of the virus. His declaration came just after an announcement by the World Health Organization (WHO), which similarly indicated the winding down of the pandemic. WHO officials pointed to the fact that the number of new weekly COVID-related deaths were at their lowest levels—on a global scale—since the beginning of the pandemic, with WHO Director-General Tedros Adhanom Ghebreyesus, PhD adding on September 14:

We have never been in a better position to end the pandemic. We are not there yet, but the end is in sight.

Not Out of the Woods

It is important to note that while these positive statements by both the American leader and WHO officials are indeed encouraging, we still remain in a technical state of emergency—at least here in the United States. This is supported by the fact that the U.S. Department of Health and Human Services (HHS) appears prepared to extend, yet again, the COVID-19 public health emergency (PHE) past the current deadline of Oct. 13. The agency last renewed the PHE on July 15 for 90 days and had indicated, at that time, that it would provide a 60-day notice once it made the decision to terminate the PHE. The deadline for such a notice was this past Aug. 14. Since no such notice was issued, it is believed that the PHE will be extended past Oct 13 for another 90 days.

If, indeed, there is another renewal of the PHE, it would occur just as HHS plans to shift costs of COVID vaccines and treatments to the commercial market, according to Becker’s. This process is scheduled to begin this fall and is expected to take months to implement.

To what extent will the expected decline in COVID cases impact hospital profitability and case management strategies? Much of that depends on several factors, including the staffing shortage crisis that persists in much of the country, increasing supply chain costs and disruptions, as well as a rising demand on wages. So, while there may be a recovery currently under way in America’s health in terms of a reduced threat from COVID, it may take longer for America’s hospitals to recover.