Tag Archives: WHO

Long-term complications of COVID-19 signals billions in healthcare costs ahead

By Caroline Humer, Nick Brown and Emilio Parodi

NEW YORK (Reuters) – Late in March, Laura Gross, 72, was recovering from gall bladder surgery in her Fort Lee, New Jersey, home when she became sick again.

Her throat, head and eyes hurt, her muscles and joints ached and she felt like she was in a fog. Her diagnosis was COVID-19. Four months later, these symptoms remain.

Gross sees a primary care doctor and specialists including a cardiologist, pulmonologist, endocrinologist, neurologist, and gastroenterologist.

“I’ve had a headache since April. I’ve never stopped running a low-grade temperature,” she said.

Studies of COVID-19 patients keep uncovering new complications associated with the disease.

With mounting evidence that some COVID-19 survivors face months, or possibly years, of debilitating complications, healthcare experts are beginning to study possible long-term costs.

Bruce Lee of the City University of New York (CUNY) Public School of Health estimated that if 20% of the U.S. population contracts the virus, the one-year post-hospitalization costs would be at least $50 billion, before factoring in longer-term care for lingering health problems. Without a vaccine, if 80% of the population became infected, that cost would balloon to $204 billion.

Some countries hit hard by the new coronavirus – including the United States, Britain and Italy – are considering whether these long-term effects can be considered a “post-COVID syndrome,” according to Reuters interviews with about a dozen doctors and health economists.

Some U.S. and Italian hospitals have created centers devoted to the care of these patients and are standardizing follow-up measures.

Britain’s Department of Health and the U.S. Centers for Disease Control and Prevention are each leading national studies of COVID-19’s long-term impacts. An international panel of doctors will suggest standards for mid- and long-term care of recovered patients to the World Health Organization (WHO) in August.

YEARS BEFORE THE COST IS KNOWN

More than 17 million people have been infected by the new coronavirus worldwide, about a quarter of them in the United States.

Healthcare experts say it will be years before the costs for those who have recovered can be fully calculated, not unlike the slow recognition of HIV, or the health impacts to first responders of the Sept. 11, 2001 attacks on the World Trade Center in New York.

They stem from COVID-19’s toll on multiple organs, including heart, lung and kidney damage that will likely require costly care, such as regular scans and ultrasounds, as well as neurological deficits that are not yet fully understood.

A JAMA Cardiology study found that in one group of COVID-19 patients in Germany aged 45 to 53, more than 75% suffered from heart inflammation, raising the possibility of future heart failure.

A Kidney International study found that over a third of COVID-19 patients in a New York medical system developed acute kidney injury, and nearly 15% required dialysis.

Dr. Marco Rizzi in Bergamo, Italy, an early epicenter of the pandemic, said the Giovanni XXIII Hospital has seen close to 600 COVID-19 patients for follow-up. About 30% have lung issues, 10% have neurological problems, 10% have heart issues and about 9% have lingering motor skill problems. He co-chairs the WHO panel that will recommend long-term follow-up for patients.

“On a global level, nobody knows how many will still need checks and treatment in three months, six months, a year,” Rizzi said, adding that even those with mild COVID-19 “may have consequences in the future.”

Milan’s San Raffaele Hospital has seen more than 1,000 COVID-19 patients for follow-up. While major cardiology problems there were few, about 30% to 40% of patients have neurological problems and at least half suffer from respiratory conditions, according to Dr. Moreno Tresoldi.

Some of these long-term effects have only recently emerged, too soon for health economists to study medical claims and make accurate estimates of costs.

In Britain and Italy, those costs would be borne by their respective governments, which have committed to funding COVID-19 treatments but have offered few details on how much may be needed.

In the United States, more than half of the population is covered by private health insurers, an industry that is just beginning to estimate the cost of COVID-19.

CUNY’s Lee estimated the average one-year cost of a U.S. COVID-19 patient after they have been discharged from the hospital at $4,000, largely due to the lingering issues from acute respiratory distress syndrome (ARDS), which affects some 40% of patients, and sepsis.

The estimate spans patients who had been hospitalized with moderate illness to the most severe cases, but does not include other potential complications, such as heart and kidney damage.

Even those who do not require hospitalization have average one-year costs after their initial illness of $1,000, Lee estimated.

‘HARD JUST TO GET UP’

Extra costs from lingering effects of COVID-19 could mean higher health insurance premiums in the United States. Some health plans have already raised 2021 premiums on comprehensive coverage by up to 8% due to COVID-19, according to the Kaiser Family Foundation.

Anne McKee, 61, a retired psychologist who lives in Knoxville, Tennessee and Atlanta, had multiple sclerosis and asthma when she became infected nearly five months ago. She is still struggling to catch her breath.

“On good days, I can do a couple loads of laundry, but the last several days, it’s been hard just to get up and get a drink from the kitchen,” she said.

She has spent more than $5,000 on appointments, tests and prescription drugs during that time. Her insurance has paid more than $15,000 including $240 for a telehealth appointment and $455 for a lung scan.

“Many of the issues that arise from having a severe contraction of a disease could be 3, 5, 20 years down the road,” said Dale Hall, Managing Director of Research with the Society of Actuaries.

To understand the costs, U.S. actuaries compare insurance records of coronavirus patients against people with a similar health profile but no COVID-19, and follow them for years.

The United Kingdom aims to track the health of 10,000 hospitalized COVID-19 patients over the first 12 months after being discharged and potentially as long as 25 years. Scientists running the study see the potential for defining a long-term COVID-19 syndrome, as they found with Ebola survivors in Africa.

“Many people, we believe will have scarring in the lungs and fatigue … and perhaps vascular damage to the brain, perhaps, psychological distress as well,” said Professor Calum Semple from the University of Liverpool.

Margaret O’Hara, 50, who works at a Birmingham hospital is one of many COVID-19 patients who will not be included in the study because she had mild symptoms and was not hospitalized. But recurring health issues, including extreme shortness of breath, has kept her out of work.

O’Hara worries patients like her are not going to be included in the country’s long-term cost planning.

“We’re going to need … expensive follow-up for quite a long time,” she said.

(Reporting by Caroline Humer and Nick Brown in New York; Emilio Parodi in Milan and Alistair Smout in London; editing by Michele Gershberg and Bill Berkrot)

Anxious WHO implores world to ‘do it all’ in long war on COVID-19

By Michael Shields and Emma Farge

GENEVA (Reuters) – The World Health Organization warned on Monday that there might never be a “silver bullet” for COVID-19 in the form of a perfect vaccine and that the road to normality would be long, with some countries requiring a reset of strategy.

More than 18.14 million people around the world are reported to have been infected with the disease and 688,080​ have died, according to a Reuters tally, with some nations that thought they were over the worst experiencing a resurgence.

WHO Director-General Tedros Adhanom Ghebreyesus and WHO emergencies head Mike Ryan exhorted nations to rigorously enforce health measures such as mask-wearing, social distancing, hand-washing and testing.

“The message to people and governments is clear: ‘Do it all’,” Tedros told a virtual news briefing from the U.N. body’s headquarters in Geneva. He said face masks should become a symbol of solidarity round the world.

“A number of vaccines are now in phase three clinical trials and we all hope to have a number of effective vaccines that can help prevent people from infection. However, there’s no silver bullet at the moment – and there might never be.”

The WHO head said that, while the coronavirus was the biggest health emergency since the early 20th century, the international scramble for a vaccine was also “unprecedented”.

But he underscored uncertainties. “There are concerns that we may not have a vaccine that may work, or its protection could be for just a few months, not more. But until we finish the clinical trials, we will not know.”

“THE WAY OUT IS LONG”

Ryan said countries with high transmission rates, including Brazil and India, needed to brace for a big battle: “The way out is long and requires a sustained commitment,” he said, calling for a “reset” of approach in some places.

“Some countries are really going to have to take a step back now and really take a look at how they are addressing the pandemic within their national borders,” he added.

Asked about the U.S. outbreak, which White House coronavirus experts say is entering a “new phase,” he said officials seemed to have set out the “right path” and it was not the WHO’s job to do so.

The WHO officials said an advance investigation team had concluded its China mission and laid out the groundwork for further efforts to identify the origins of the virus.

The study is one of the demands made by top donor the United States which plans to leave the body next year, accusing it of being too acquiescent to China.

A larger, WHO-led team of Chinese and international experts is planned next, including in the city of Wuhan, although the timing and composition of that was unclear. Ryan said China had already given some information but knowledge gaps remained.

(Reporting by Michael Shields, Emma Farge and Francesco Guarascio; Writing by Andrew Cawthorne; Editing by Kevin Liffey)

WHO reports record daily increase in global coronavirus cases, up over 292,000

(Reuters) – The World Health Organization reported a record increase in global coronavirus cases on Friday, with the total rising by 292,527.

The biggest increases were from the United States, Brazil, India and South Africa, according to a daily report. Deaths rose by 6,812. The four countries have dominated global headlines with large outbreaks.

The previous WHO record for new cases was 284,196 on July 24. Deaths rose by 9,753 on July 24, the second largest one-day increase ever. Deaths have been averaging 5,200 a day in July, up from an average of 4,600 a day in June.

Nearly 40 countries have reported record single-day increases in coronavirus infections over the last week, around double the number that did so the previous week, according to a Reuters tally showing a pick-up in the pandemic in every region of the world.

Cases have been on the rise also in Australia, Japan, Hong Kong, Bolivia, Sudan, Ethiopia, Bulgaria, Belgium, Uzbekistan and Israel, among others.

Last week, cases in Latin America for the first time surpassed the combined infections in the United States and Canada, a Reuters tally showed. Infections are surging in Brazil, which is second in the world behind the United States in cases and deaths.

Globally there are over 17.4 million infections and nearly 675,000 deaths, according to a Reuters tally.

(Reporting by Lisa Shumaker; Editing by Howard Goller)

There is no ‘zero risk’ in easing travel restrictions, WHO says

By Bhargav Acharya and Kanishka Singh

(Reuters) – There is no “zero risk” strategy for countries easing international travel restrictions during the COVID-19 pandemic, and essential travel for emergencies should remain the priority, the World Health Organization (WHO) said.

In a long-awaited update to its guidance on travel, the United Nations global health agency said cross-border trips for emergencies, humanitarian work, the transfer of essential personnel and repatriation would constitute essential travel.

“There is no ‘zero risk’ when considering the potential importation or exportation of cases in the context of international travel,” it said in the updated guidance posted on its website on Thursday.

A surge of new infections in many parts of the world has prompted some countries to reintroduce some travel restrictions, including testing and quarantining incoming passengers.

The WHO had said in June it would update its travel guidelines before the northern hemisphere summer holidays.

The WHO’s guidance can be used by governments and industries to help shape policies, but is not enforceable.

The updated travel advice is little changed from previous guidance, which also included infection control advice applicable to other settings such as social distancing, wearing masks, washing hands and avoiding touching the face.

The WHO urged each country to conduct its own risk-benefit analysis before lifting any or all travel restrictions. Authorities should take into account local epidemiology and transmission patterns, it said, as well as national health and social distancing measures already in place.

Countries that choose to quarantine all travelers on arrival should do so after assessing the risks and consider local circumstances, the WHO said.

“Countries should continuously plan for and assess their surge capacities for testing, tracking, isolating and managing imported cases and quarantine of contacts,” it said.

The WHO said this week that international travel bans cannot stay in place indefinitely, and countries will have to do more to reduce the spread of the novel coronavirus within their borders.

(Reporting by Bhargav Acharya and Kanishka Singh in Bengaluru; Writing by Kate Kelland, editing by Diane Craft, Marguerita Choy, Grant McCool and Timothy Heritage))

WHO says COVID-19 pandemic is ‘one big wave’, not seasonal

By Emma Farge

GENEVA (Reuters) – A World Health Organization official on Tuesday described the COVID-19 pandemic as “one big wave” and warned against complacency in the northern hemisphere summer since the infection does not share influenza’s tendency to follow seasons.

WHO officials have been at pains to avoid describing a resurgence of COVID-19 cases like those in Hong Kong as “waves” as this suggests the virus is behaving in ways beyond human control, when in fact concerted action can slow its spread.

Margaret Harris repeated that message in a virtual briefing in Geneva. “We are in the first wave. It’s going to be one big wave. It’s going to go up and down a bit. The best thing is to flatten it and turn it into just something lapping at your feet,” she said.

Pointing to high case numbers at the height of the U.S. summer, she urged vigilance in applying measures and warned against mass gatherings.

“People are still thinking about seasons. What we all need to get our heads around is this is a new virus and…this one is behaving differently,” she said.

“Summer is a problem. This virus likes all weather.”

However, she expressed concern about COVID-19 cases coinciding with normal seasonal influenza cases during the southern hemisphere’s winter, and said the Geneva-based body was monitoring this closely.

So far, she said, laboratory samples are not showing high numbers of flu cases, suggesting a later-than-normal start to the season.

“If you have an increase in a respiratory illness when you already have a very high burden of respiratory illness, that puts even more pressure on the health system,” she said, urging people to be vaccinated against flu.

(Reporting by Emma Farge; Editing by Michael Shields, William Maclean)

Travel bans cannot be indefinite, countries must fight virus at home: WHO

By Michael Shields and Stephanie Nebehay

GENEVA (Reuters) – Bans on international travel cannot stay in place indefinitely, and countries are going to have to do more to reduce the spread of the novel coronavirus within their borders, the World Health Organization said on Monday.

A surge of infections has prompted countries to reimpose some travel restrictions in recent days, with Britain throwing the reopening of Europe’s tourism industry into disarray by ordering a quarantine on travelers returning from Spain.

Only with strict adherence to health measures, from wearing masks to avoiding crowds, would the world manage to beat the COVID-19 pandemic, the World Health Organization’s director-general, Tedros Adhanom Ghebreyesus, said at a virtual news briefing.

“Where these measures are followed, cases go down. Where they are not, cases go up,” he said, praising Canada, China, Germany and South Korea for controlling outbreaks.

WHO emergencies program head Mike Ryan said it was impossible for countries to keep borders shut for the foreseeable future.

“…It is going to be almost impossible for individual countries to keep their borders shut for the foreseeable future. Economies have to open up, people have to work, trade has to resume,” he said.

“What is clear is pressure on the virus pushes the numbers down. Release that pressure and cases creep back up.”

Ryan praised Japan and Australia for having had “good success in containing the disease” but said that it was to be expected that the virus would re-surge in areas with active transmission if restrictions are lifted and mobility increased.

“And that is what has essentially occurred in many countries is that in nightclubs, other situations, dormitories, other environments in which people are close together can act as amplification points for the disease and then it can spread back into the community. We need to be hyper-alert on those.”

Measures must be consistent and kept in place long enough to ensure their effectiveness and public acceptance, Ryan said, adding that governments investigating clusters should be praised not criticized.

“What we need to worry about is situations where the problems aren’t being surfaced, where the problems are being glossed over, where everything looks good.”

Ryan said Spain’s current situation was nowhere near as bad as it had been at the pandemic’s peak there, and he expected clusters to be brought under control, though it would take days or weeks to discern the disease’s future pattern.

“The more we understand the disease, the more we have a microscope on the virus, the more precise we can be in surgically removing it from our communities,” he added.

(Reporting by Stephanie Nebehay, Emma Farge, Michael Shields; Writing by Andrew Cawthorne; Editing by Peter Graff)

Global coronavirus cases exceed 15 million: Reuters tally

By Jane Wardell and Gayle Issa

SYDNEY/LONDON (Reuters) – Global coronavirus infections surged past 15 million on Wednesday, according to a Reuters tally, with the pandemic gathering pace even as countries remain divided in their response to the crisis.

In the United States, which has the highest number of cases in the world with 3.91 million infections, President Donald Trump warned: “It will probably, unfortunately, get worse before it gets better.”

The top five countries with the most cases is rounded out by Brazil, India, Russia and South Africa. But, the Reuters tally shows the disease is accelerating the fastest in the Americas, which account for more than half the world’s infections and half its deaths.

Globally, the rate of new infections shows no sign of slowing, according to the Reuters tally, based on official reports.

After the first COVID-19 case was reported in Wuhan, China, in early January, it took about 15 weeks to reach 2 million cases. By contrast, it took just eight days to climb above 15 million from the 13 million reached on July 13.

Health experts stress that official data almost certainly under-reports both infections and deaths, particularly in countries with limited testing capacity.

The official number of coronavirus cases at 15,009,213 is at least triple the number of severe influenza illnesses recorded annually, according to World Health Organization data, while the death toll of more than 616,000 in seven months is close to the upper range of yearly influenza deaths.

RELAX OR TIGHTEN

With the first wave of the virus still to peak in several countries and a resurgence of case numbers in others, some countries are reintroducing strict social distancing measures while others relax restrictions.

Stung by low approval ratings for his handling of the epidemic and downplaying the risks during the early stages, Trump made a significant shift in rhetoric on Tuesday, encouraging Americans to wear a face mask.

While the epidemic worsened in the United States, Trump’s focus ahead of a presidential election in November has been on reopening the economy, and governors in the hard-hit states of Texas, Florida and Georgia continue to push back hard against calls for stricter restrictions.

In Brazil, more than 2.15 million people have tested positive including President Jair Bolsonaro, and more than 81,000 people have died. While Bolsonaro has played down the outbreak, its scale has made Brazil a prime testing ground for potential vaccines.

India, the only other country with more than 1 million cases, reported almost 40,000 new cases on Wednesday. Having been keen to reopen its economy, India is now facing the twin challenge of combating the pandemic and massive flooding in the country’s northeast.

Two ministers in South Africa’s cabinet were admitted to hospital with COVID-19, as Africa’s most-industrialized country counted a total 372,628 confirmed cases and 5,173 deaths.

Other countries are reintroducing restrictions in response to fresh outbreaks.

In Spain, the number of people allowed on Barcelona’s beaches was limited after crowds flocked to the seaside over the weekend despite advice to stay home.

In Australia, residents of Melbourne, the country’s second biggest city, were ordered to wear masks in public from Wednesday after the country reported a record 501 new cases.

Officials in Canada were closely watching a spike in cases as the economy reopens, attributing the rise in part to large numbers of young people gathering in bars.

China, meanwhile, announced that passengers on inbound flights must provide negative COVID-19 test results before boarding, as authorities seek to reduce the risk of imported cases amid increased international travel.

(Reporting By Jane Wardell and Gayle Issa; Editing by Simon Cameron-Moore)

U.S. companies fear workplace coronavirus precautions do not address airborne risk

By Caroline Humer

NEW YORK (Reuters) – U.S. companies are raising new questions about how they can make workplaces safe after the world’s top public health agency acknowledged the risk that tiny airborne droplets of the novel coronavirus may contribute to its spread, industry healthcare consultants said.

About two weeks ago, the World Health Organization called for more scientific study into airborne transmission of COVID-19. The move raised awareness of an issue excluded from U.S. government back-to-work guidelines, adding to the challenge of keeping people safe in offices, stores and work sites, these consultants said.

Many companies devised strategies based on WHO guidance that large respiratory droplets of the virus could infect people when first emitted and after they landed on surfaces. Now the concern over infection is focused on the idea that tiny droplets could linger in the air for hours.

Companies are reviewing if they have gone far enough with policies on mask-wearing, sealing off conference rooms and upgrading ventilation systems. Some, like retailers who have installed plexiglass barriers in their stores between cashiers and customers, are wondering what else they can do if the larger droplets those barriers aim to contain are just one piece of respiratory transmission, consultants said.

Neal Mills, chief medical officer at healthcare benefits group Aon, began fielding questions last week about the WHO’s decision to investigate aerosol transmission, and said employers were slowing the return of remote workers back to their offices.

“They are doing due diligence around how are you going to reduce the transmission of the virus in light of the proposed aerosol nature of COVID-19,” Mills said.

The slowdown comes as some employers, such as Texas energy companies Halliburton Co and Chevron Corp, had already begun delaying plans to bring back office workers due to rising coronavirus cases.

Employers are asking whether public health recommendations that individuals remain 6 feet apart and wear masks to limit transmission through large droplets are enough.

They also wonder about air conditioning systems that do not have filtration systems and the effectiveness of plexiglass partitions against a virus floating in the air, said David Zieg, a lead consultant on clinical services at Mercer, another healthcare services companies.

Consultants are advising employers to go beyond their existing plans, which may also include temperature checks, health questionnaires and frequent restroom cleanings.

“The concept here is risk reduction. It’s not 100%. You add in all the little things you can to reduce the risk,” Zieg said.

Months after U.S. companies sent all but essential workers home due to the global new coronavirus pandemic, many are still struggling to bring their workforce back.

For some employers, the cost of not putting in effective precautions goes beyond that of workers missing days while they are sick. There are concerns about legal liability and healthcare costs, many of which are paid for by large employers.

Some corporations moved early and began integrating the possibility of airborne transmission of COVID-19 into their plans as evidence began emerging of transmission at indoor bars and restaurants.

General Motors Co, Ford Motor Co and Fiat Chrysler Automobiles NV maximized ventilation in their manufacturing facilities before restarting production on May 18 because of the potential for aerosol transmission, the companies said.

But others are more than halving the number of workers they bring back to the office to 10 percent of staff and rethinking how many people can safely ride in an elevator or attend an in-person meeting, Willis Towers Watson health practice co-leader Jeff Levin-Scherz said.

“Once you start limiting how many people can be in a conference room, the imperative to bring some types of workers back to the office, if they have to attend meetings virtually anyway, is much lower,” Towers Watson’s Levin-Scherz said.

(Reporting by Caroline Humer in New York, additional reporting by Ben Klayman in Detroit; Editing by Cynthia Osterman)

Germany urges WHO to hasten review of its handling of pandemic

BRUSSELS/BERLIN (Reuters) – Germany’s health minister urged the World Health Organisation (WHO) to speed up its review of how it handled the pandemic, apparently signalling Europe’s tougher line on the United Nations body.

Berlin, which holds the rotating presidency of the European Union, has so far largely shielded the organization from the most intense criticism by Washington, which wants to leave the WHO because of its alleged excessive closeness to China.

But now Germany seems to be taking a more assertive position.

Spahn told reporters he had discussed the review of the WHO’s management of the crisis with its chief Tedros Adhanom Ghebreyesus twice over the last 20 days.

“In both conversations I encouraged him very clearly to launch this independent commission of experts and to expedite its launch,” Spahn said.

The WHO said last week it was setting up an independent panel to review its handling of the COVID-19 pandemic and the response by governments.

U.S. President Donald Trump has accused the WHO of being too close to China and not doing enough to question Beijing’s actions at the start of the crisis. Tedros has dismissed the suggestions and said his agency kept the world informed.

Tedros has said the panel will provide an interim report to an annual meeting of health ministers in November and present a “substantive report” next May.

Spahn said the review was important now, even if the pandemic is still raging across the world, because “we can already draw conclusions.”

This could lead to quick actions over the body’s governance and to improve “cooperation between the political and the scientific level” of the organisation, Spahn added.

EU governments have said the review should be followed by a reform of the organisation, a possibility already being discussed with the United States and other members of the G7 group of rich countries, officials told Reuters.

One official had said the aim was to ensure WHO’s independence.

(Reporting by Francesco Guarascio @fraguarascio in Brussles, Joseph Nasr and Andeas Rinke in Berlin, Editing by William Maclean)

Pompeo expects ‘completely whitewashed’ WHO China investigation

WASHINGTON (Reuters) – U.S. Secretary of State Mike Pompeo said on Wednesday he expected a World Health Organization (WHO) investigation into the origins of the novel coronavirus in China to be “completely whitewashed.”

Nearly 580,000 people globally have died from COVID-19, the disease caused by the coronavirus, and more than 13 million have been infected following an outbreak that started in Wuhan, China, last year.

The Geneva-based WHO said it was sending an team to China in early July to investigate how the outbreak started.

“This is a regime that failed to disclose the information they had about a virus that has now killed over 100,000 Americans … and now it is allowing the World Health Organization to go in to conduct what I am confident will be a completely, completely whitewashed investigation,” Pompeo told reporters.

The United States is the WHO’s most prominent critic, and has said it is leaving the U.N. agency.

President Donald Trump, who has been harshly criticized for his response to the outbreak in the United States, which has the world’s highest death toll at more than 136,000 people, has sought to blame China.

“I hope I am wrong. I hope it’s a thorough investigation that gets fully to the bottom, but I have watched the Chinese Communist Party’s behavior with respect to the virus that emanated from Wuhan and they have simply refused,” Pompeo said.

“They have destroyed samples. They have taken journalists and doctors who were prepared to talk about this and not permitted them to do what nations that want to play on a truly global scale and global stage ought to do: be transparent, and open, and communicate and cooperate,” he said.

(Reporting By Arshad Mohammed and Humeyra Pamuk; Editing by Sonya Hepinstall)