The COVID-19 pandemic state of emergency is over, lifted by both the World Health Organization and the U. S. Centers for Disease Control and Prevention.

Yet we find ourselves in an odd moment: The coronavirus is both an ever present danger and, in some sense, old news. We asked readers what was on their minds at this inflection point in the world's pandemic response. They shared reflections that run the gamut – from relief to anxiety to disappointment – but also reveal some clear themes, three years into the pandemic.

Lingering fear of long COVID

"Long COVID," the stubborn, persistent symptoms that last well after a SARS-CoV-2 infection, remains one of the least understood challenges of the post-emergency era. Between 10-20% of COVID-19 patients experience these long-term problems, depending on how researchers define the condition. A majority of long COVID sufferers recover but just how long and widespread a problem post-COVID illness will be has plenty of people concerned.

"The emergency isn't gone, it just looks different!" writes Lea Bossler, of Missoula, Montana. "I wish it could mean that we now focus all the same energy on people with long COVID, like myself. Millions of people lost their health, their abilities, their careers, their hobbies, their housing, and sometimes, their close relationships and support systems."

For Robbie Moreland of Fort Collins, Colorado, the uncertainty around long COVID means it's worth continuing to take precautions, even if they come at a cost.

"Considering the fact that scientists do not understand how to prevent or treat long COVID, and they don't yet know the long-term effects of having COVID multiple times, my husband and I can't completely move on, " Moreland writes. "We continue to wear masks and avoid crowds and indoor venues. It has caused us to lose friends who have long ago moved on and cycle through COVID every few months with a shoulder shrug."

A time for renewal

For some, ending the pandemic emergency measures is like lifting a burden. Readers such as Debra Saylor of Huntsville, Alabama say they are looking forward to renewing social connections.

"I feel absolute joy and relief that this prison sentence is finally over!" writes Saylor. "My church was closed for a time, and online church is not the same. I thought I would go crazy without my church, and I'm proud to say that I have not missed one service since we opened again on May 9 2020. I went out to restaurants again when they partially re-opened on May 11 2020. I just needed to be around people. I didn't care. It should have been the choice of individual people if they wanted to isolate themselves or not."

At the same time, returning to "normal" social settings feels fraught to some readers.

"I became really withdrawn during COVID, and it heightened my anxiety in crowds and public spaces," writes Alex Orford of Lakewood, Colorado. "The fact that I'll have to go back to a life and a type of 'normal' I haven't known since high school feels incorrect. I spent almost three years of important developmental moments inside, and I can feel the effects of that now. I still feel like a kid, but I'm expected to be an adult in a world I didn't get a chance to become familiar with."

Then there was the respondent who compared reemerging into the wider world, with its familiar-yet-somehow-strange ways, to Rip Van Winkle's awakening from his 20-year nap.

The plight of the immunocompromised

To the extent the pandemic has eased, we can largely thank increased immunity due to vaccines and past infections. However, 2-3% of U.S. adults have compromised immune systems and cannot rely on their bodies' own defenses. That's an issue facing people around the globe.

"For me as a healthy person it means I can get back to a normal(ish) life," says Abigail Potter of Hudson, Wisconsin. "But in reality it will never be over. Especially for those who can't take the vaccine or who are immunocompromised (such as my grandma). My little sister just had a classmate's mother die of COVID last week. They're 5th graders. The virus will never go away and the risk for those compromised will never go away."

For some immune-compromised people, the end of the emergency brings worries that the population-level measures they have depended on, such as widespread masking and social distancing, will also fall by the wayside.

"That the WHO is ending its status as a public health emergency seems quite irresponsible to me, " writes Pat Baker of Orlando, Florida. "I live in a senior apartment complex and there are still cases. Many people will consider this an 'All Clear' to do whatever they want and it's frightening to think of the repercussions!"

Who's counting cases?

With the emergency ending, responsibility for staying healthy will fall less on governments and institutions, and more on individuals. However, many of the data points people have been using to calculate their own risk tolerance and make informed decisions will be harder to come by. COVID-19 case reporting has become less and less reliable, given the reduced reporting and widespread use of at-home tests, and some readers worry they will lose access to this crucial information.

"I tried contacting our health department to report our cases," writes Sherry Pelosky of Wilmington, North Carolina, who says she and her husband are still recovering from a bout with COVID last month. "It's horrible. I've been dealing with issues for five weeks now. They're saying there are hardly any cases in our area but no one seems interested in tracking real numbers."

In the United States, many state and local health authorities continue to track COVID-19 cases, hospitalizations and deaths. Experts say that even if overall case numbers are less reliable now, hospitalization rates continue to provide helpful insight into the COVID-19 trends in most communities.

Worries about the cost of COVID care

For many, the most practical benefits of the official state of emergency were financial. Pandemic response measures in the U.S., for instance, included increased access to health insurance, reimbursement for vaccines and tests, and low- or no-cost therapeutic treatments. As we shift toward a world where COVID-19 is treated as one more infectious disease among many, plenty of readers are asking where the increased financial burden will fall, and what happens when a person can't afford life-saving care.

"Governmental support for weathering this pandemic — health insurance, free tests, free immunizations — is no longer guaranteed," writes Melissa Rohs of Portland, Oregon. "That support wasn't sufficient, but it was way better than nothing."

'Forever changed'

Ending the state of emergency does not simply turn off the pandemic. "What this news means is that it is time for countries to transition from emergency mode to managing COVID-19 alongside other infectious diseases," said Tedros Adhanom Ghebreyesus, the WHO's director-general.

As countries and institutions figure out how to make that transition, individuals will find having to make their own decisions, likely with less and less guidance from the government.

"I am skeptical of the end of the COVID-19 public health emergency," writes a reader named Christine. "I will continue to wear a mask in public when I feel I need one. I will continue to avoid places that I feel have a significant yet unnecessary risk, such as restaurants. I will continue to get booster shots as recommended."

"I will never forget watching the death toll from COVID go up. It still makes me tear up thinking about it. So many deaths so quickly. Nothing like that had ever happened before. It was frightening and depressing. I am forever changed having gone through that horror."

After that trauma, some readers say lifting the state of emergency provides at least a little bit of comfort.

"It seems almost cosmetic, but it's nice to have a sense of closure," writes Earnie Painter of Elgin, Texas. "About six months into the pandemic I was wondering how we would know it was over. Would there be a hard end? Or would the world just kind of drift into being somewhat normal? We drifted, but it's good to have this official end to the state of emergency, even if the virus will still be around."