Most travel insurers have retained the cover they began offering for Covid-related issues during the pandemic (although many now refer in more general terms to pandemics rather than specifically to Covid).
A comprehensive travel policy is likely to cover you for some or all of the following Covid scenarios:
However, terms and conditions around the cancellation element relating to Covid can vary between insurers so, as with any insurance, check the policy wording carefully to find out what is both included and excluded from cover.
Anna-Marie Duthie, travel insurance expert at financial data company Defaqto, explained: Medical costs will be covered in relation to Covid, as they would be in any other circumstance or illness.
However, when it comes to cover for cancellation that is specifically due to Covid, rules will vary by insurer. For example, cancellation may be covered only with a medical note from a medical practitioner advising you not to travel, for example, rather than just a positive Covid test being enough evidence for an insurance claim.
This is because Covid tests are no longer mandatory and while there may be a moral argument there are no legal restrictions regarding travelling with Covid.
Defaqto data shows that 99% of annual travel insurance policies cover medical expenses in relation to Covid-19, and 95% cover cancellation due to a positive Covid test.
If you are concerned about the cover you may have in relation to Covid, check with your insurer before you travel.
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LEIPZIG, GERMANY - NOVEMBER 18: Doctors and nurses work in the Covid-19 intensive care unit at ... [+] University Hospital Leipzig on November 18, 2021 in Leipzig, Germany. Hospitals are coping with a high influx of patients as the fourth wave of the coronavirus pandemic is sending infection rates to new record highs in Germany. Saxony is especially hard hit, with an average of over 750 new cases per 100,000 over a seven-day period, the highest for any state nationwide. Germany's vaccination rate, currently at about 67% of the population, is low compared to many other EU countries. The vast majority of people currently being admitted to hospital with Covid are unvaccinated. (Photo by Jens Schlueter/Getty Images)
While most researchers, policymakers, lawyers, and journalists have always advocated that doctors are obligated to treat patients with infectious diseases, the Covid-19 pandemic might have changed that long-held view. According to a new study that analyzed peoples tolerance for doctors withholding treatment to Covid-19 patients, researchers observed a steadily growing acceptance of the view that it could be ethically acceptable for doctors to refuse care.
All the papers throughout history have shown that physicians broadly believed they should treat infectious disease patients, lead author, Braylee Grisel, a student at Duke University School of Medicine, said in a press release.
We figured our study would show the same thing, so we were really surprised when we found that COVID-19 was so different than all these other outbreaks, Grisel added.
Grisel and colleagues assessed 187 published articles, which included legal briefings, news stories, academic papers, opinion pieces, and policy statements. The researchers selected those articles because they addressed the ethical dilemma that doctors have been facing over the last four decades while treating outbreaks of infectious diseases like HIV, influenza, SARS, and more recently the novel coronavirus.
Around 75% of the articles staunchly advocated for every doctors obligation to treat patients. However, Covid-19 had the highest number of articles (60%) stating that it is ethically acceptable for doctors to refuse treatment. Meanwhile, only 13.3% of the 187 articles said doctors refusing to treat patients with HIV was acceptable.
Until the Covid-19 pandemic started wreaking havoc globally five years ago, only 9% to 16% of published views from the 1980s to 2019 argued that it was okay for doctors to withhold treatment from patients.
Some of these results may be because we had the unique opportunity to evaluate changing ethics while the pandemic was actively ongoing, as COVID-19 was the first modern outbreak to put a significant number of frontline providers at personal risk in the United States due to its respiratory transmission, said senior author of the study, Krista Haines, an assistant professor at Duke University School of Medicine, in a press release.
The researchers found that the main reason views shifted so significantly was due to labor rights and worker protections, which were key issues that authors had highlighted in 40% of articles published after the Covid-19 pandemic began. Compared to that, labor rights were brought up in only 17% to 19% of articles for influenza and SARS and only 6.2% of the articles cited that issue for HIV.
The study, in the journal Clinical Infectious Diseases, brought out various factors that altered views on doctor's obligation to care for all Covid-19 patients. First, healthcare workers struggled through severe shortages of resources like hospital beds, ventilators, oxygen cylinders, and personal protective gear while being overwhelmed during multiple Covid-19 waves with different variants of the virus. Secondly, a growing number of health care workers faced mistreatment and aggression from patients and relatives and had to deal with patients refusing vaccinations and other forms of misinformation.
There was a great deal of discussion among frontline providers and ethicists on how best to allocate scarce resources, the authors wrote. Patients who refused vaccination were at a higher risk of complications while also putting other patients and providers at risk. Arguments were made based on reciprocity, medical triage, and personal responsibility to exclude patients who refused vaccines from consideration when ventilators and other resources were limited.
More than 1 million people keep Oregon Health Plan benefits due to efforts to expand coverage options
SALEM, Ore. (KTVZ) With more than 90 percent of the states 1.5 million renewals complete, more than 4 out of 5 Oregonians are keeping their Oregon Health Plan or other Medicaid benefits.
During the COVID-19 Public Health Emergency (PHE), which ended one year ago in April 2023, the federal government allowed states to keep people on Medicaid benefits. This ended when the pandemic emergency ended, so over the last year Oregon has been making sure everyone on OHP is still eligible.
At this point in the PHE unwinding process:
Oregons 81.8 percent renewal rate continues to be thethird highest in a national comparison of state renewal rates by KFF, a nonpartisan health policy organization. Oregons high renewal rates are due to proactive efforts by the state to keep people covered, including extended response timelines, and adding theupcoming OHP Bridge programfor adults with higher incomes.
Members who have not received a renewal yet should:
Although most people are keeping coverage, approximately 240,000 people will lose or have reduced medical benefits and need to consider other coverage options.
On Feb. 13, 2024, the federal government approved a revised plan for Oregons remaining 126,000 post-pandemic renewals.
Many of these renewals were affected by a federal request for more than 30 states to review automated renewal processes or restorations of someOregon Supplemental Income Program Medical (OSIPM)benefits. A May 2024 technical update to Oregons ONE Eligibility systemwill enable Oregon to use the new automatedprocess for the remaining renewals.
Renewal letters will be sent to members in four waves between June and September. Members will still have 90 days to respond, and 60 days advance notice before any termination or reduction in benefits. This means the final responses would be due in December 2024, and the final closures will happen in February 2025.
Data about pandemic unwinding renewals appears in theMedical Redeterminations Dashboard. The dashboard data and these press releases will not include renewals for OHP members who have already renewed early in the unwinding process, who are coming up for renewal again. Over time, Oregon is switching to renewing most OHP members every two years instead of annually.
As of March 19, 2024, 1,317,810 people have completed the renewal process. This represents 90.6 percent of all OHP and Medicaid members.
If you need to sign up for Medicare for the first time, contact the Social Security Administration (SSA) at 800-772-1213 to enroll by phone or find a local office. You can also enroll in Medicare online atssa.gov/medicare/sign-up.
The Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) are committed to transparency and will continue to send monthly information about medical coverage among Oregonians as the agencies continue to track theprograms. Check ourONE Eligibility Operations Dashboardsfor more frequent updates on medical renewal data and wait times for callers to the ONE Customer Service Center.
Media Advisory
Thursday, April 25, 2024
Deidentified data from thousands of adults with long COVID are now available to researchers.
Secure data from more than 14,000 adults who participate in National Institutes of Health observational research on long COVID are now available to authorized researchers through BioData Catalyst (BDC). BDC is a cloud-based ecosystem developed by the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, to accelerate research on heart, lung, blood, and sleep disorders. The research on long COVID broadly defined as signs, symptoms, or conditions that persist or develop for at least four weeks after an infection from the virus that causes COVID-19 is provided through the NIH Researching COVID to Enhance Recovery (NIH RECOVER) Initiative.
By giving researchers access to secure data, analysis tools, and resources, the BDC ecosystem aims to spur scientific innovation, collaboration, and discovery, while providing a platform for sharing data and validating results. The addition of RECOVER data to BDC can help investigators identify and explore long COVID connections that may benefit from or inform future studies.
Authorized researchers can now request access to a subset of data from adults in the observational RECOVER cohort. These data include information from more than 92,000 study visits collected between Oct. 29, 2021-Sept. 15, 2023 at 79 locations throughout the United States. New RECOVER data, including data from other studies, will be added to BDC at regular intervals.
As investigators seek to better understand, diagnose, and treat long COVID, many critical questions remain. By making RECOVER data more accessible by adding it to a central ecosystem, experts aim to find answers sooner.
David C. Goff, M.D., Ph.D., a senior scientific program director for the RECOVER Observational Consortium Steering Committee and director of the Division of Cardiovascular Sciences at NHLBI, is available to discuss BDC and new directions in long COVID research.
About RECOVER: The National Institutes of Health Researching COVID to Enhance Recovery (NIH RECOVER) Initiative is a $1.15 billion effort, which is supported in part through the American Rescue Plan Act of 2021. It seeks to identify how people recuperate from COVID-19 and who is at risk for developing post-acute sequelae of SARS-CoV-2 (PASC). Researchers are also working with patients, clinicians, and communities across the United States to identify strategies to prevent and treat the long-term effects of COVID, including long COVID. For more information, please visit recovercovid.org.
About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit https://www.nhlbi.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIHTurning Discovery Into Health
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Astudy in JAMA Network Open finds that while US adults with long COVID have a higher rate of psychiatric conditions such as depression and anxiety and are just as likely to receive treatment, many cite cost as a reason for not seeking care.
A team led by University of British Columbia researchers parsed data on 25,122 US adults with and without long COVID (or post-COVID condition [PCC]) from the2022 National Health Interview Survey, a nationally representative interview-based survey, from October 2023 to February 2024.
The researchers used the Patient Health Questionnaire-8 to gauge depression symptoms and the General Anxiety Disorder-7 instrument to assess anxiety. Participants were considered treated if they received counseling or psychiatric medications for their symptoms. The median participant age was 46 years, half were women, and 3.4% were experiencing long COVID.
"The experiences of individuals who were unable to access care due to costs, stigma, or other reasons are important to consider when developing PCC-focused mental health supports," the researchers wrote. "Adults with mental illness frequently experience barriers to care and may be underserveda problem that was exacerbated during the COVID-19 pandemic."
Relative to participants without long COVID, those who had the condition were about twice as likely to experience depression (weighted prevalence [wPr], 16.8% vs 7.1%; adjusted odds ratio [aOR], 1.96), anxiety (wPr, 16.7% vs 6.3%; aOR, 2.21), sleep difficulties (wPr, 41.5% vs 22.7%; aOR 1.95), cognitive problems (wPr, 35.0% vs 19.5%; aOR, 2.04), and disabling fatigue (wPr, 4.0% vs 1.6%; aOR, 1.85).
People with PCC may have more difficulty paying for counseling or therapy due to lost employment wages and greater costs of managing complications from COVID-19, or they may experience challenges obtaining health plan authorization for these supports.
Having current long COVID was tied to female sex, White race, having multiple chronic conditions, and not having received a COVID-19 vaccine.
Of adults with depression or anxiety, those with long COVID (wPr, 28.2% vs 34.9%; aOR, 1.02) were similarly likely as those without the condition to not receive treatment in the previous year(wPr, 37.2% vs 23.3%; AOR, 2.05). But participants currently experiencing long COVID were twice as likely to report cost as a barrier to getting counseling (aOR, 2.12).
"People with PCC may have more difficulty paying for counseling or therapy due to lost employment wages and greater costs of managing complications from COVID-19, or they may experience challenges obtaining health plan authorization for these supports," the researchers wrote.
The authors said that theUS Department of Health and Human Services is helping healthcare systems create care pathways specific tolong COVID.
"These pathways can integrate mental health services by, for example, incorporating routine mental health screening in follow-up for individuals recovering from COVID-19 and including mental health professionals in multidisciplinary PCC clinics," they wrote. "In contexts in which mental health services are sparse, telehealth and group-based programs could be leveraged."
But these programs should recognize that long-COVID patients with or without psychiatric conditions may hesitate to seek care.
"These individuals have described experiencing stigma and medical gaslighting from clinicians, sometimes being told that their physical symptoms are psychosomatic," they wrote. "Standardized screening strategies for psychiatric symptoms in PCC clinics may help normalize mental health assessments for this population."
A comparative analysis yesterday inBMJ Global Health shows that national clinical guidelines for treating COVID-19 vary significantly around the world, and nearly every national guideline (NG) recommends at least one COVID-19 treatment proven not to work.
The authors considered the gold standard for clinical guidelines to be the World Health Organization's (WHO's) 2022 updated guidelinesthe 11th version of the WHO guideline.
They looked at NGs for 109 of the 194 WHO member states after the summer of 2022. Of the 85 countries not included in the final analysis, 9 did not have any NGs.
Regionally, Europe had the most countries with easily identifiable guidelines (69.8%), followed by Africa (53.2%). A country's ministry of health published 73.4% of guidelines, while 12.8% of the guidelines were published by a national disease organization.
The 11th WHO guidelines recommend that clinicians categorize disease severity as non-severe, severe, and critical. However, 84.4% of reviewed NGs defined COVID-19 severity differently from the WHO, and 6.4% of the guidelines did not define severity at all.
Just 10 countries (9.2%) had NGs that published severity definitions comparable to the WHO.
The WHO guidelines recommend 10 therapeutics or medications, but NGs recommended 1 to 22 therapeutics. The therapies recommended in NGs were graded in 25 (23.8%) of the guidelines assessed. Most (77%; 84) guidelines did not include an assessment of the strength of the therapeutic recommendation.
"The most commonly recommended drugs were corticosteroids; 92% (100/109) of the NGs featured corticosteroids, and 80% (88/109) recommended corticosteroids for the same disease severity as did the WHO," the authors wrote.
Corticosteroids were not recommended in severe disease in nearly 10% of guidelines, however, despite strong evidence of their benefit.
Several countries, especially those in poorer regions, in 2022 continued to recommend treatments that had been disproven and were not recommended by the WHO, including chloroquine, lopinavirritonavir, azithromycin, vitamins, and zinc.
Why do NGs differ so much in their treatment guidance for such a widespread and potentially serious infection when all have access to the same information?
"Why do NGs differ so much in their treatment guidance for such a widespread and potentially serious infection when all have access to the same information?" the authors wrote. "Apart from the prohibitive cost of some medications for low-resource settings, we do not have a satisfactory explanation."
Two new studies highlight the impact that the COVID-19 pandemic has had on antibiotic use and resistance.
In one study, data gathered by researchers from the World Health Organization (WHO) confirms what previous research has shownglobally high rates of antibiotic use in COVID-19 patients despite low rates of suspected bacterial infections. In the other, a team led by researchers from the National Institutes of Health (NIH) found that rates of hospital-acquired, multidrug-resistant infections at US hospitals remain well above pre-pandemic levels.
Both studies are being presented at the upcoming European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Barcelona, Spain.
The WHO data, collected through the WHO Global Clinical Platform, shows that, among 592,898 COVID-19 patients hospitalized in 65 countries from January 2020 through March 2023, antibiotic use ranged from 83% in the WHO Eastern Mediterranean Region to 32.8% in the Western Pacific Region. Overall, three of four COVID-19 patients received antibiotics, despite the fact that antibiotics provide no benefit for the viral illness.
The highest rate of antibiotic use was seen among patients with severe or critical COVID-19, 81% of whom received antibiotics. But even in patients with mild or moderate COVID, antibiotics were commonly used, with rates as high 79% in the African Region. Empiric treatment was common, ranging from 55% in patients with mild/moderate COVID-19 to 69% in severe critical cases.
While antibiotic prescribing rates for COVID-19 declined over time in Europe and the Americas from the beginning of the pandemic through 2022, they increased in Africa.
Although frequent use of antibiotics in the early months of the pandemicwhen hospitals were overwhelmed and few treatment options were availablehas been well documented, the continued use of antibiotics for COVID well into the pandemic is concerning. The WHO says they're concerned that this extensive overuse of antibiotics is contributing to the "silent spread" of antimicrobial resistance (AMR).
In another concerning finding, the data also show that antibiotics with an increased risk of promoting resistanceknown as "Watch" antibiotics under the WHO's AWaRE (Access, Watch, and Reserve) classification systemwere frequently prescribed for COVID-19 patients in the Eastern Mediterranean Region (93.8%), the Region of the Americas (90.8%), and the African Region (91.1%).
But, as has been found in previous studies, there is little reason to prescribe antibiotics for patients with COVID-19. Suspected bacterial co-infectionswhich might justify use of antibiotics in some caseswere reported in only a fraction (8%) of COVID-19 patients. Higher rates of bacterial co-infections were reported in the Region of the Americas (14.1%) and the Eastern Mediterranean Region (8.8%).
Unsurprisingly, antibiotics did not improve clinical outcomes for COVID-19 patients. In fact, an analysis of patients without suspected or confirmed bacterial infections found that patients with mild/moderate COVID-19 who received empiric antibiotic therapy had an 80% increased mortality risk (adjusted hazard ratio [aHR], 1.80; 95% confidence interval [CI], 1.36 to 2.38) compared with those didn't receive antibiotics.
Patients with severe/critical COVID-19 who received antibiotics had a 16% increased risk of death (aHR, 1.16; 95% CI, 1.08 to 2.84).
"When a patient requires antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance. However, when they are unnecessary, they offer no benefit while posing risks, and their use contributes to the emergence and spread of antimicrobial resistance," Silvia Bertagnolio, MD, WHO unit head for surveillance, evidence, and laboratory strengthening in the Division for AMR, said in a WHOpress release.
"These data call for improvements in the rational use of antibiotics to minimize unnecessary negative consequences for patients and populations," she added.
Meanwhile, data collected from 120 US hospitals from January 2018 through December 2022 illustrate how AMR surged during the pandemic, driven largely by dramatic increases in hospital-acquired infections.
In the study, researchers examined all adult hospitalizations over the period for culture-confirmed infection by six pathogens: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus(VRE), extended-spectrum cephalosporin-resistant Enterobacterales (ECR), carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CR-PA). Hospital-acquired infections were defined as those that occurred after 3 days of hospitalization.
These data call for improvements in the rational use of antibiotics to minimize unnecessary negative consequences for patients and populations.
The researchers wanted to provide an update to a previous report by the Centers for Disease Control and Prevention (CDC). The report, published in 2022, showed alarming increases in the six pathogens at US hospitals during first year of the pandemic, resulting in a 15% overall increase in drug-resistant infections and deaths from 2019 through 2020.
The NIH-led study found the overall prevalence of AMR infections increased by 6.3% during the pandemic, driven mainly by hospital-acquired infections, which rose 32.4%, compared with a 1.4% increase in community-acquired infections. Among the hospital-acquired infections, the largest increases were seen for CRAB (a 160.0% increase), CRE (63.6%), CR-PA (54.5%), and ECR (50%). Conversely, community-acquired MRSA infections fell 10% during the pandemic, a result the researchers believe is linked to reduced social interactions.
As with the CDC report, the researchers believe the surge in multidrug-resistant, hospital-acquired infections is likely the result of a combination of pandemic-related factors.
"It is likely that surges in severely ill COVID-19 patients during the pandemic corresponded with significant surges in antibiotic use and challenges following infection and prevention control protocols in strained hospitals," lead author Christina Yek, MBBCh, of the National Institute of Allergy and Infectious Diseases, said in an ESCMIDpress release. "In addition, hospitals may have experienced shortages of personal protective equipment, while treating sicker patients who were more likely to require the use of medical devices like ventilators, which would have added to the spread of antimicrobial-resistant infections."
Yek and her colleagues also found that the hospitals that saw the largest surges in severely ill COVID-19 patients had the largest increases in hospital-acquired AMR infections.
And while the overall prevalence of AMR infections in US hospitals returned to pre-pandemic levels (a 0.2% increase) by the end of 2022, hospital-acquired AMR infections remained 13% above baseline, largely because of continued increases in carbapenem-resistant gram-negative pathogens. From March to December 2022, CRE, CRAB, and CR-PA infections were 81%, 43%, and 38% above pre-pandemic levels.
Yek said the persistence of these infections is concerning.
"More action is needed to protect people, especially from difficult-to-treat hospital-acquired gram-negative infections that remain concerningly high," she said.
** Shares of vaccine makers Pfizer PFE and BioNTech BNTX fall between 2% to 3%
** Drugmaker GlaxoSmithKline GSK sues BNTX and PFE accusing them of infringing its patents related to messenger RNA (mRNA) technology in the companies' blockbuster COVID-19 vaccines
** GSK says that PFE and BNTX's Comirnaty vaccines violate its patent rights in mRNA-vaccine innovations developed "more than a decade before" the outbreak of the COVID-19 pandemic
** GSK also asked the Delaware federal court for an unspecified amount of monetary damages from both companies that includes an ongoing patent-licensing fee
** A Pfizer spokesperson said in a statement that the company is "confident in our IP position around Comirnaty" and intends to "vigorously defend" against GSK's claims, while a BioNTech spokesperson declined to comment
** Including session moves, PFE down 11.3% and BNTX down 18.1% YTD
