The End of the Covid-19 Global Health Emergency: Where Do We Stand? How Does the NIH Surveill the Overhead?

“I don’t know if any other single grantee from NIH has been subjected to this level of oversight,” says Peter Daszak, president of EcoHealth Alliance. He’s positive and optimism about the grant restart despite all the restrictions. The organization has nearly 300 partial or complete genomes of SARS-related coronaviruses from samples collected prior to the funding halt, which will be a key priority to analyze using the newly released grant funds, he says.

The NIH regularly reviews processes and measures for strengthening its oversight of federal funds and it has been working with EcoHealth to strengthen its administrative processes to meet its expectations.

Lawrence Gostin, a health-law and policy specialist at Georgetown University, says that the restrictions are reasonable in light of the enormous attention to and scrutiny of gain-of-function research. Still, Gostin says he is surprised the agency restarted its funding for EcoHealth, given that it has been the “third rail of politics” the last few years.

Congressional Republicans have alleged that this research, which attached spike proteins from wild bat coronaviruses to an unrelated virus to determine if the wild pathogens could infect human airway cells, should have undergone HHS review. Anthony Fauci, the former director of the National Institute for Allergy and Infectious Disease, said the experiments did not meet the bar to be reviewed because they did not intend to enhance the viruses.

This type of research is crucial for the development of vaccines and for understanding how likely a pathogen will cause a mass outbreak. It is likely that the oversight of such research will be tightened in the United States because of the recently finished guidance from the NIH and HHS.

The emergency stage of Covid-19 is over, at the official level. The World Health Organization declared an end to the Covid global health emergency last week, and the US will end its federal public health emergency for Covid on Thursday. The European Union ended its emergency declaration a year ago.

And with less data, it will be harder to track new variants, which in turn will complicate the puzzle of updating vaccines to provide the most protection, although in some areas wastewater surveillance and genomic surveillance will continue. Should new variants begin circulating and bring Covid-19 roaring back in the fall, there will be less data available. The Texas Children’s Hospital Center for Vaccine Development is led by Peter Hotez, codirector and dean, who said that at- home testing always leaves gaps in national statistics. He now says we are flying blind.

It will be more difficult for public health officials to communicate how dangerous a future variant could be because of the shift. “The messaging around ‘it’s over, we’ve won’ is setting us up for a huge betrayal of trust if there is another variant that shows up,” says Sam Scarpino, a professor of health sciences and computer science at Northeastern University. Without that trust, it will be difficult to get significant public buy-in on taking updated vaccines or returning to masking or social distancing. Just 17 percent of people in the US received last year’s bivalent booster shot, according to the CDC, and only 14 percent of people in the EU have their third booster.