WASHINGTON (AP) — President Joe Biden informed Congress on Monday that he will end the twin national emergencies for addressing COVID-19 on May 11, as most of the world has returned closer to normalcy nearly three years after they were first declared.

The move to end the national emergency and public health emergency declarations would formally restructure the federal coronavirus response to treat the virus as an endemic threat to public health that can be managed through agencies’ normal authorities.

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It comes as lawmakers have already ended elements of the emergencies that kept millions of Americans insured during the pandemic. Combined with the drawdown of most federal COVID-19 relief money, it would also shift the development of vaccines and treatments away from the direct management of the federal government.

Biden’s announcement comes in a statement opposing resolutions being brought to the floor this week by House Republicans to bring the emergency to an immediate end. House Republicans are also gearing up to launch investigations on the federal government’s response to COVID-19.

Then-President Donald Trump first declared the COVID-19 pandemic a national emergency on March 13, 2020. The emergencies have been repeatedly extended by Biden since he took office in January 2021, and are set to expire in the coming months. The White House said Biden plans to extend them both briefly to end on May 11.

“An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans,” the Office of Management and Budget wrote in a Statement of Administration Policy.

Congress has already blunted the reach of the public health emergency that had the most direct impact on Americans, as political calls to end the declaration intensified. Lawmakers have refused for months to fulfill the Biden administration’s request for billions more dollars to extend free COVID vaccines and testing. And the $1.7 trillion spending package passed last year and signed into law by Biden put an end to a rule that barred states from kicking people off Medicaid, a move that is expected to see millions of people lose their coverage after April 1.

The costs of COVID-19 vaccines are also expected to skyrocket once the government stops buying them, with Pfizer saying it will charge as much as $130 per dose. Only 15% of Americans have received the recommended, updated booster that has been offered since last fall.

Once the emergency expires, people with private insurance will have some out-of-pocket costs for vaccines, tests and treatment, while the uninsured will have to pay for those expenses in their entirety.

Legislators did extend telehealth flexibilities that were introduced as COVID-19 hit, leading health care systems around the country to regularly deliver care by smartphone or computer.

The Biden administration had previously considered ending the emergency last year, but held off amid concerns about a potential “winter surge” in cases and to provide adequate time for providers, insurers and patients to prepare for its end.

A senior administration official said the three months until the expiration would mark a transition period where the administration will “begin the process of a smooth operational wind-down of the flexibilities enabled by the COVID-19 emergency declarations.” The official spoke on the condition of anonymity to discuss the announcement before it had been released.

More than 1.1 million people in the U.S. have died from COVID-19 since 2020, according to the Centers for Disease Control and Prevention, including about 3,700 last week.

Case counts have trended downward after a slight bump over the winter holidays, and are significantly below levels seen over the last two winters — though the number of tests performed for the virus and reported to public health officials has sharply decreased.

Moments before the White House’s announcement, Rep. Tom Cole, R-Okla., accused the president of unnecessarily extending the public health emergency to take action on issues like forgiving some federal student loan debts.

“The country has largely returned to normal,” Cole said Monday, introducing a Republican-backed bill calling for an end to the health emergency. “Everyday Americans have returned to work and to school with no restrictions on their activities. It is time that the government acknowledges this reality: the pandemic is over.”

The U.S. is poised to make COVID-19 vaccinations more like a yearly flu shot, a major shift in strategy despite a long list of questions about how to best protect against a still rapidly mutating virus.

The Food and Drug Administration asked its scientific advisers Thursday to help lay the groundwork for switching to once-a-year boosters for most Americans — and how and when to periodically update the shots’ recipe.

“This is a consequential meeting to determine if we’ve reached the point in the pandemic that allows for simplifying the use of current COVID-19 vaccines,” said FDA’s Dr. David Kaslow.

The advisory panel mostly agreed with the FDA’s approach.

COVID-19 vaccines have saved millions of lives and booster doses continue to help the most vulnerable even as more contagious variants have popped up. But protection does wane and the shots don’t fend off milder infections for long.

And people are tired of getting vaccinated. While more than 80% of the U.S. population has had at least one COVID-19 shot, only 16% of those eligible for the latest boosters — so-called bivalent doses updated to better match more recent virus strains — have gotten one.

That makes for tough decisions on how to move forward: Who really needs another shot, how often and what kind?

“We’re still protected against severe disease, thank goodness,” even after the latest mutated omicron strains cropped up, noted FDA adviser Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia.

The first step: The FDA advisory panel voted unanimously that people should get the same vaccine formula whether they’re receiving their initial vaccinations or a booster. Today, Americans get one formula based on the original coronavirus strain that emerged in 2020 for their first two or three doses — and their latest booster is a combination shot made by Pfizer or Moderna that adds omicron protection.

The FDA would have to decide how to phase in that change.

But “this isn’t only a convenience thing” to ease confusion about different kinds of shots, said Dr. Archana Chatterjee, dean of Chicago Medical School. Since the original coronavirus strain has disappeared, “moving towards the strains that are circulating is very important.”

Who needs another shot and when sparked more debate.

Looking ahead, the FDA said most Americans should do fine if they get a once-a-year booster targeted to the newest variants in the fall. The agency asked if some people might need two doses — adults with weakened immune systems and very young children who’ve never been previously vaccinated. That’s similar to how youngsters get their first-ever flu vaccination.

But more data is needed to show exactly who might need two yearly doses — such as a careful count of who still gets hospitalized with COVID-19 despite being up-to-date with today’s vaccinations, Offit said.

“Only then can we really best make the decision about who gets vaccinated with what and when,” he said.

Nor is it clear that younger, healthier people would need a COVID-19 booster every year.

“It’s hard to say it’s going to be annual at this point,” said Harvard’s Dr. Eric Rubin.

Fall might not even be the best time to boost, something that would depend on when infections start rising and how long a booster’s protection might last, said FDA adviser Dr. Arthur Reingold of the University of California, Berkeley.

Unlike flu which in the U.S. circulates mostly during late fall and winter, COVID-19 waves have occurred year-round.

As for the recipe, the FDA’s plan is to call its advisory panel for another meeting in late May or early June to decide if the vaccine recipe needs tweaking — including which virus strain to target and whether it should be a single-strain or multi-strain shot. Pfizer and Moderna said that would give enough time to produce needed doses by fall while a third manufacturer, Novavax, urged an earlier start to any recipe change.

Also Thursday, U.S. officials updated how they’re tracking that the newest COVID-19 boosters are safe. The Centers for Disease Control and Prevention spotted a possible warning signal that seniors getting Pfizer’s updated booster might have a slightly higher risk of stroke. But FDA safety expert Richard Forshee said data from Medicare and multiple other health systems — including in other countries — found no sign of trouble, leading the government to conclude it’s unlikely the red flag was real.