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REPUBLICA PRESS
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States Close Mass Test and Vaccine Sites, but Virus May Swell Anew

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CHICAGO — As Americans shed masks and return to offices and restaurants, local and state officials are scaling back the most visible public health efforts to address the coronavirus pandemic.

States like Illinois are shuttering free Covid-19 testing sites after nearly two years of operation. Arizona, Nevada, Hawaii and Ohio have stopped releasing daily data on virus hospitalizations, infections and deaths. And, perhaps most notably, some places are diminishing their campaigns to vaccinate residents even as federal authorities announced on Tuesday that people 50 and older could get a second booster shot.

The slowing of state and local efforts comes as the virus in the United States appears, at least for now, to be in retreat, with cases falling swiftly in recent weeks.

But the cutbacks also arrive at a moment when a more transmissible version of the Omicron variant of the coronavirus, known as BA.2, is spreading through Europe, Asia and is now the dominant version of new virus cases in the United States. New coronavirus infections are edging upward once again in several states, including New York.

Americans have received initial shots, and less than one-third of Americans have had a first booster shot.

If another surge in the pandemic is ahead, public health officials said, it could be a challenge to quickly ramp up the vaccination and testing sites and other measures that are now being shut down.

impasse in Washington over Covid spending.

In San Antonio, with a majority of residents already immunized and case numbers at a low, demand for vaccines at the mass site outside the city’s Alamodome has dropped, said Miguel Cervantes, the city’s public health administrator. The site closed on Friday after 15 months of continuous operation and more than 200,000 Covid-19 vaccine doses. At its peak, it administered roughly 3,500 vaccinations a day. Last week, it averaged fewer than 50.

“We haven’t seen the numbers to support a need for a site,” Mr. Cervantes said.

The high price of maintaining the site’s staffing and equipment is a less cost-effective use of those resources than smaller, community-based events, he added. And with the 64,000-seat Alamodome stadium now hosting a full slate of sports and concerts, the parking lot has returned to its prepandemic use.

fund designated to reimburse tests and treatment for the uninsured is no longer accepting claims. State and local officials, alarmed by debates in Washington over the future of Covid funding, have anticipated that they will face tighter budgets in the near future if federal funds are cut.

stopped accepting claims because of lack of funding, forcing the health center to halt its mobile clinics.

“I’m concerned about what’s next, because when I shut it down and all these people go find other jobs and the next variant comes along, will I be ready?” said Robert Spencer, chief executive of Kintegra Health.

In many states, services that local and state governments administered are shifting to traditional health care providers.

By mid-April, pharmacies and health care providers will deliver all vaccines in Vermont as the state government winds down its vaccine sites. Demand for vaccines from the state-run sites has plummeted by 77 percent in the last 30 days. The only providers that reported a modest uptick in vaccinations were primary-care offices.

“The reintegration back into the health care system of vaccination is really the path forward,” said Dr. Mark Levine, commissioner of the state’s Department of Health. “People aren’t going to those other sites; they’re showing drop-off. And they’re going to the health care system, where they belong and where immunization has always occurred.”

In Vermont, the state has also transitioned its state-run testing sites primarily into distribution centers for rapid at-home tests, rather than PCR tests. That means that the state has a blurrier picture of the number of Covid cases, but Dr. Levine said state health officials had already moved away from focusing on case counts, relying instead on wastewater surveillance and genome sequencing to keep track of the virus.

The state still posts a report of new daily Covid cases five days a week on its website but is planning to soon follow the lead of many other states in posting a weekly report instead.

Many states have switched to weekly from daily reporting of new cases on public dashboards. Officials say it is time-intensive to publicly update data every day and that daily variation in the data makes it less meaningful than weekly reports. Instead, some are releasing it on public dashboards only once a week, in keeping with reports on other ailments, like the flu.

In Chicago, Dr. Arwady said the city was still trying to vaccinate every Chicagoan — keeping its at-home vaccine option open four days a week instead of seven, telephoning residents who are eligible for boosters and tracing contacts in high-risk settings such as prisons and nursing homes.

Even at a time when Covid infections are low, she worries that cuts in federal funding could be detrimental in the long run and threaten the country’s ability to face future surges of the pandemic.

“I am concerned about this idea that ‘Covid’s over, we can stop funding public health,’” she said. “That will put us right back where we were.”

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