The U.S. public health emergency declared in response to Covid-19 comes to an end Thursday more than three years after the pandemic began.

The Biden administration’s decision to end the emergency comes as deaths and hospitalizations have declined dramatically due to the availability of vaccines, antiviral treatments and widespread exposure to the virus.

Deaths from Covid have fallen to their lowest point since March 2020, when the rapid spread of the virus in the U.S. overwhelmed the health system and lead to widespread shutdowns of schools, businesses and public venues.

Hospital admissions from the virus have also fallen to the lowest level since the U.S. started tracking the data in August 2020.

The end of the emergency will bring significant changes in how the U.S. responds to the virus. Hospitals will lose flexibility to rapidly add bed capacity if patient admissions surge, and the Centers for Disease Control and Prevention will scale back its efforts to track the virus.