Declarations and loosened restrictions aside, for millions of Americans COVID is still a major concern.

Who are they? The many who are immunocompromised, chronically ill, or struggling with long COVID.

• Last week, the public health emergency first declared by federal health officials in January 2020 ended, bringing about a number of changes to resources and the government response.
• The federal government will stop buying tests and treatments to be given out for free, and those will now be covered by health insurance.
• The Centers for Disease Control will sunset some COVID data tracking, but will continue genetic analysis on variants and monitor hospitalizations and deaths.

What's the big deal? For those who are at higher risk from COVID, the end of the public health emergency doesn't mean they can let their guard down against the coronavirus.

• Vivian Chung, a pediatrician and research scientist from Bethesda, Md. is immunocompromised, and could face serious health complications if she were to contract COVID.
• She spoke to NPR about how she is still forced to take precautions that many have left behind — like avoiding long flights and indoor dining — and how she still wears a mask in public.
• "I have people walk up to me just on the street to say, 'Oh, don't you know that COVID is over?'"
• About 7 million people in the U.S are immunocompromised. World Health Organization records show that, globally, nearly 7 million deaths have been reported to the organization. However, WHO director general Tedros Adhanom Ghebreyesus said earlier this month "we know the toll is several times higher — at least 20 million."

Want more on policy changes? Listen to Consider This explore what comes after the Biden administration ends title 42.

What are people saying?

The White House COVID-19 response coordinator, Dr. Ashish Jha, spoke with NPR's Mary Louise Kelly last week and said "a country can't be in emergency mode forever." But also stressed that there were still risks.

It's still a real problem. I mean, people often ask me, you know, is this now like the flu? And I'm like, no, it's like COVID. It is a different virus. Flu has a very specific seasonality to it. That's not what we see yet with COVID. Even at 150 deaths a day, which is way below where it was — even if today is the new standard, that's 50,000 deaths a year. I think that should be unacceptable to us. So I see COVID as an ongoing threat, a real challenge to the health and well-being of the American people. And, you know, we know how to defeat this thing, but we've got to keep pressing. And we've got to build better vaccines and better treatments to make sure that we get even more and more effective over time.

COVID long-hauler Semhar Fisseha, 41, told NPR about her experience.

Now there's kind of, like, a stop button happening to it. Like, OK, we're done with this public health emergency. But there are thousands of people that are still left dealing with the impact of it.

A lot of long-haulers were mild — managed it at home, so they're not going to be captured. New long-haulers will not be captured [in data tracking].

So, what now?

• Both Fisseha and Chung acknowledge progress in accessibility because of the pandemic: the normalization of telehealth appointments; working from home; and vaccines getting healthcare coverage. But both feel there is plenty of progress still to be made.
• Chung on those developments: "As a community of people with disabilities, we're still being marginalized. But I think that as that margin widens, in some way, that there is more acceptance."

Learn more:

• As the pandemic winds down, anti-vaccine activists are building a legal network
• Coronavirus FAQ: 'Emergency' over! Do we unmask and grin? Or adjust our worries?
• Long COVID scientists try to unravel blood clot mystery

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