Claims Development for COVID (Part 2) - Insurance Thought Leadership

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March 1, 2021

Claims Development for COVID (Part 2)

Summary:

One study found that 50% of those infected were unable to work full-time six months after recovering.

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The latest Out Front Ideas with Kimberly and Mark webinar brought together a panel of industry experts to explore trends being seen in COVID-19 claims, as well as long-term medical complications and what risk managers should monitor in the future.

Our guests were:

  • Teresa Bartlett, MD – senior medical officer, Sedgwick
  • Max Koonce – chief claims officer, Sedgwick
  • Tim Stanger – vice president, partner relations, Safety National
  • Alex Swedlow – president, California Workers’ Compensation Institute

Long-Term Effects of COVID-19

There may not be a crystal ball to determine the impact COVID-19 has on a patient years from now, but current trends in symptoms can provide a better picture. These trends in long-term side effects range from fatigue and brain fog to more severe symptoms like blood clots and pneumonia. 

One study performed by the National Institutes of Health (NIH) followed over 4,000 people who tested positive for COVID-19 in the U.S. 50% of those people were unable to work full-time six months after recovering. With only 8% hospitalized, most cases were mild but resulted in long-term side effects, regardless. In another study, over 80% of the COVID-19 patients developed at least one long-term side effect. 

COVID-19 Variants

There have been over seven unique variants of COVID-19 found in the U.S. alone in recent days. While variants are common in viruses, much like with the flu, there is a difference in these mutations. However, understanding the difference between shift and drift is important. 

The U.K., South Africa and Brazil variants are drifts, meaning that the virus’s protein structure has warped, but that testing still recognizes this variant, and that the vaccine works against these strains. However, these variants are still more contagious, and there is uncertainty regarding how long the vaccine will work on these.

The medical community is watching closely for a shift in the virus. When a shift occurs, testing will not recognize the virus, and the vaccine will likely not work. 

Vaccine Developments

The Moderna and Pfizer vaccines are both taken in two doses, with Pfizer’s doses administered 21 days apart and Moderna’s administered 28 days apart. Pfizer’s option allows for anyone age 16 and above to receive the vaccine, while Moderna’s is a higher dosage and allows for anyone age 18 and above to receive it. Only those with an allergy to polyethylene glycol or those who have experienced severe reaction to vaccines are advised against receiving either vaccine.

Johnson & Johnson’s viral vector vaccine, which was just approved for use, varies considerably from the mRNA vaccines currently being administered by Pfizer and Moderna. Like the flu vaccine, Johnson & Johnson’s vaccine uses the cells in a body to target the virus’s spike protein, triggering an immune response. The Johnson & Johnson option is only one dose but is currently only citing 66% efficacy. However, because Moderna and Pfizer’s trials ended before the variants were spreading, all three may have similar efficacy.

See also: Pressure to Innovate Shifts Priorities

Vaccine Myths

There are plenty of myths surrounding the COVID-19 vaccines. One of the common myths states that they could alter your DNA, but they cannot. The vaccine instead penetrates the virus’ genetic code and provides a map to break up the virus and kill it. 

Another common myth concerns sterility in those of child-bearing age. The vaccine contains syncytin-1, a spike protein that is also found in the body and that is used to grow and attach a placenta during pregnancy. However, these two spike proteins are completely different. The syncytin-1 used in the vaccine is only used to penetrate the virus and does not live on inside the body. Therefore, it cannot affect pregnancy. 

There is also a general fear surrounding the potential side effects of the vaccine. While side effects are possible, most are mild and short-lived, occurring for one to three days after the vaccine is administered. These side effects are inconsequential compared with the potential impacts of the virus itself.

To listen to the archive of our complete COVID Claims Development: Workers’ Compensation & Beyond webinar and view a full list of FAQs from this session, please visit https://www.outfrontideas.com/.Follow @outfrontideas on Twitter and Out Front Ideas with Kimberly and Mark on LinkedIn for more information about coming events and webinars.

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About the Author

Mark Walls is the vice president, communications and strategic analysis, at Safety National. Mark is also the founder of the Work Comp Analysis Group on LinkedIn, which is the largest discussion community dedicated to workers’ compensation issues.

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About the Author

Kimberly George is a senior vice president, senior healthcare adviser at Sedgwick. She will explore and work to improve Sedgwick’s understanding of how healthcare reform affects its business models and product and service offerings.

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