nsurance advisors have become the go-to consultant for executives and HR departments throughout the benefits industry when it comes to the type of healthcare coverage they should provide for their employees. Normally, advisors can rely upon historical and actuarial tables for the normal range of healthcare in American society. We can all agree that these are extraordinary times and the usual calculations are unreliable.
Trusted advisors are navigating for their clients in a world of unknowns as businesses reopen amid a pandemic that has, to a lesser or greater extent, been faced by more than 7 million Americans to date. According to the CDC, only 4.6 per 100,000 people required hospitalization. As the individuals who recovered rejoin the workforce, what is emerging is a “Post – COVID Syndrome” that is alarming healthcare providers and researchers with its unpredictability and potential severity.
In article for Science magazine on July 31, 2020, Jennifer Couzin-Frankel wrote:
The likelihood of a patient developing persistent symptoms is hard to pin down because different studies track different outcomes and follow survivors for different lengths of time. […] But with the crisis just months old, no one knows how far into the future symptoms will endure, and whether COVID-19 will prompt the onset of chronic diseases.
Healthcare researchers are now facing diverse COVID-19 data and trying to make sense of an evolving illness. According to the Sciencemag.org article, “Distinct features of the virus, including its propensity of systemic inflammation and blood clotting, could play a role in the assortment of concerns now surfacing.”
The article further expresses the uncertainty of what was initially perceived to be a binary situation- you got a mild case of COVID-19 and quickly recovered, or you became extremely ill and wound up hospitalized, possibly in the ICU. However, post-recovery for both groups has been very unpredictable. Some individuals with mild cases do not quickly recover. This condition may present with persistent relapsing fatigue and is predicted to be twice as prevalent in women indicated a study at the Texas Health Presbyterian Hospital Dallas as reported in Healthline. Initially, a cytokine storm occurs followed by a newly discovered bradykinin storm.
The following bradykinin storm is what is perceived to cause long-term COVID-19 complications. According to preliminary studies published by the National Centers for Biotechnology Information (NCBI), The Lancet and UpToDate, the bradykinin storm is responsible for labile blood pressures, vascular resistance, renal failure, heart valve disorders, pulmonary dry-drowning, trans-ischemic attacks (TIAs), and general fatigue.
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Adding to the complexity of these physical sequelae is the negative mental health symptoms that both the post COVID-19 recovery patients and their healthy coworkers are experiencing. The national suicide rates are expected to be 200-300 times greater than in 2019. Not to forget homicide and domestic abuse.
I (Schlussel) am reminded of the impact that the 1929 Great Depression had on my father as proof of the lingering effects of the mental health impact of COVID-19. My dad graduated law school in 1929 and as the depression hit opportunities in his chosen profession disappeared. The effect this had on his DNA throughout his life was palpable. It reset his thinking about economic risk. Today, all of us, whether we recognize it or not, have a similar DNA reset about our physical and mental health security. We have been impacted in ways we are aware of such as isolation, solitude, social distancing, masking, and a myriad of other everyday changes in our lives. Yet, the long term mental health, stress and social interaction impacts of COVID-19 are just beginning to be identified. It will be a long and unpredictable road to a sense of confidence and security.
It is in this environment, the trusted benefits advisors have to provide their clients with a sense of direction about the future healthcare needs and costs to their employees. We at Curus believe that care navigation as well as care orchestration are going to be to critical components within the total healthcare spend. Claims reviews are going to be a key part of the process at the earliest stage possible to handle the Post-COVID care that is necessary. This should follow immediate engagement of the care process, whether the needs are physical or mental. Utilizing this process, the potential cost curve caused by unexpected healthcare needs can be controlled as much as possible.
As the healthcare profession gains more experience with the Post COVID-19 syndrome, better solutions will be available. Further, centers of excellence will also emerge that will be best equipped for the unique differing syndromes that are beginning to appear. Many of the long-term syndromes are neurological, vascular, renal, and/or gastrointestinal.
The challenges of Post-COVID Syndromes are going to be significant. The benefit advisors will need the backing of companies such as Curus who fully understand how navigation through this system is most effective. The need for sophisticated health care delivery at the most cost-effective manner is key. Decisions will need to be made between face-to-face healthcare visits and telehealth visits, depending upon the duration of the pandemic, the age of the patient, number of co-morbidities, and the effectiveness of telehealth within the patient needs. In addition, Curus can add high quality care during the successful transition from uncertainty to certainty for your clients and health care plans.