The pandemic emergency declarations are officially over. Here’s what that means for you.

The national COVID-19 emergency declarations that for three years gave the federal government powerful tools to combat a deadly pandemic and support struggling Americans are set to expire Thursday.

The national and public health emergency declarations, in place since early 2020, gave the federal government flexibility regarding policies and requirements related to public health. The White House announced in January the declarations would expire this week.

That doesn’t mean COVID-19, responsible for the deaths of more than 18,000 people in Philadelphia and its neighboring New Jersey and Pennsylvania counties since 2020, is gone.

The virus has killed more than a million people nationally. It was responsible for the deaths of 1,109 just in the week ending May 3, the most current data available from the Centers for Disease Control and Prevention. As of May 2, about 250 people in Pennsylvania hospitals had COVID, according to state data, though it does not specify how many were hospitalized specifically for COVID treatment.

“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,” said Eric Chow, chief of communicable disease epidemiology at Public Health – Seattle & King County.

COVID-19 continues to spread and mutate, but two years of vaccinations and infections created widespread immunity responsible for declines in serious illness and death.

The number of Americans COVID killed the week of May 3 was half the number killed in roughly the same week in 2022, and a quarter the number of deaths during the same period in 2021. Hospitalizations likewise have dropped precipitously.

In New Jersey, 161 people were hospitalized with COVID as of May 9, that state reported, roughly one-third the number hospitalized a year ago.

There were periods during the pandemic when 100 or more Philadelphians died in a week from COVID, the Philadelphia Department of Public Health reported. The virus killed 248 in Philadelphia the week of April 12, 2020, the city’s most deadly week of the pandemic. Since December, Philadelphia’s weekly COVID death counts have been in the single digits.

Still, health professionals caution, it is important to take the disease seriously and be mindful of preventative tactics.

» READ MORE: Coronavirus coverage

The declaration’s end comes on the heels of the World Health Organization lifting its pandemic public health emergency earlier this month.

“COVID-19 has been so much more than a health crisis, disrupting economies, travel, shattering businesses and plunging millions into poverty,” WHO director general Tedros Adhanom Ghebreyesus said at a press conference. “This [downward] trend has allowed most countries to return to life as we knew it before COVID-19. Therefore, with great hope, I declare COVID-19 over as a global health emergency.”

While in place, the emergency declarations allowed millions of people to receive Medicaid, the state and federally funded health coverage program for low-income families and individuals.

The emergency declarations also allowed the government to provide free COVID vaccines, tests, and some treatments to every American. That will now change, too. Here’s what you need to know.

Thousands of Pennsylvania and New Jersey residents qualified for Medicaid under the emergency declarations.

People on Medicaid typically renew their coverage annually and are required to prove they still meet income requirements. States suspended the plan-renewal process throughout the pandemic but it resumed last month.

Over the next year, people who signed up for Medicaid during the pandemic will receive renewal packets in the mail with instructions about how to continue their coverage if they’re still income-eligible. If someone’s renewal application is denied because they now earn too much to qualify, they’ll be able to enroll in private health insurance through the Obamacare marketplaces.

The Urban Institute, a Washington think tank, estimated in a December report that 18 million people nationwide are expected to lose Medicaid coverage within the next 14 months, including more than 3 million children who will transfer to Children’s Health Insurance Programs. An additional nearly 4 million people will lose their insurance entirely.

With the declarations lifted, COVID-19 at-home tests will no longer be mailed to households for free.

Most free COVID-19 PCR test sites have closed. People with insurance — including Medicare — will no longer have access to free COVID-19 home tests. Tests are still available for purchase and may be covered or partially covered by some insurance policies. People without insurance will have to pay for tests.

Those enrolled in government Medicaid programs will continue to be eligible for free home tests until next year.

Vaccines will no longer be free for every American.

Once the federal government’s supply of COVID-19 vaccines runs dry, vaccine manufacturers will start charging.

Vaccine stock is anticipated to last through the summer. From there, Pfizer and Moderna announced that they will charge for vaccines. Pfizer expects to charge $110 to $130 a dose.

People without insurance will generally have to pay to get vaccinated, unless the cost is waived by certain pharmacies or community health centers. Some areas are working on initiatives to provide free vaccines for children.

Private insurance companies — including those available through the Affordable Care Act — will continue to pay for COVID-19 vaccines administered by health-care providers within network. The Affordable Care Act requires those programs to cover recommended vaccines without co-pays.

The federal government continues to go through its millions of doses of Paxlovid — a primary treatment for people with COVID — and will distribute it for free while that supply lasts, said Ashish Jha, the White House COVID response coordinator.

Once the government’s supply runs out, treatments will be available through the commercial market. Some, including Paxlovid, will be covered by Medicare, while others will be partially covered, according to Kaiser.

Private insurers are also expected to cover the treatments, though some members may have co-pays.

People without insurance or support from other safety-net programs will be responsible for the full costs.

Virtual appointments were critical in keeping people connected to their doctors during the pandemic.

Medicare and Medicaid agreed to temporarily cover these visits as they would for in-person appointments. Once the health emergency ends, Medicare recipients can permanently use telehealth for behavioral and mental health care, according to the Department of Health and Human Services. They will also be able to use telehealth for other medical services through the end of 2024, unless they live in a rural area, according to KFF.

Doctors and patients both want telehealth to continue, and Pennsylvania legislators are considering measures that could require private insurers to pay for telehealth visits.

Philadelphia continues to require employers to provide workers with COVID 40 paid hours of sick leave in addition to any paid sick time already offered. That is expected to expire at the end of this year.