Airlines face $100 billion-plus virus hit, discounts ‘wouldn’t do any good’

The coronavirus epidemic could rob passenger airlines of up to $113 billion in revenue this year, an industry body warned on Thursday, while the head of Southwest Airlines said a drastic drop-off in travel demand seemed fear-driven, similar to the feeling after Sept. 11, 2001.

“We could discount prices tomorrow and it wouldn’t do any good,” Southwest Airlines Co (LUV.N) Chief Executive Gary Kelly said at an aviation conference in Washington.
Earlier, Kelly told CNBC: “9/11 wasn’t an economically driven issue for travel, it was more fear, quite frankly, and I think that’s what’s manifested this time. I think there’s elements of both but it has a 9/11-type feel.
“Hopefully, we’ll get this behind us quickly.”

The Dow Jones U.S. Airlines Index [.DJUSAR] closed down 8.6%.
The estimated revenue hit to the sector was made by the International Air Transport Association (IATA), which said the impact could range between $63 billion and $113 billion this year, depending on the progression of the virus.
That was more than three times its forecast for a $29 billion impact made just two weeks ago.
The COVID-19 virus emerged in China late last year and has now spread to more than 80 countries, leading to travel and other restrictions. It has killed more than 3,300 people and infected tens of thousands more, raising fears of a pandemic that could plunge the global economy into recession.
Airlines across the globe are rushing to cut flights and costs, and warning of a hit to earnings.
“There are lots of airlines that have got relatively narrow profit margins and lots of debt, and a cash flow shock like this could certainly send some into a very difficult situation,” IATA Chief Economist Brian Pearce told a media event in Singapore.
British regional carrier Flybe became the first big casualty of the outbreak after the British government walked away from a rescue package agreed upon in January due to the scale of the hit to demand over the virus.
In a sign of the new difficulties for airlines, a Turkish Airlines jet (THYAO.IS) was flown back to Istanbul without any passengers on board on Thursday on orders from Singapore after a passenger who had arrived on the same plane on Tuesday tested positive for the virus.
South Korea, Italy and Iran have been particularly badly affected. Germany, Japan, France, Spain, the United States, Singapore and Hong Kong have all reported more than 100 cases.

IATA said its lower forecast was based on the virus being contained in current markets with over 100 cases as of March 2, while the higher estimate was based on a broader epidemic. Both scenarios assume there will be a recovery by late summer.
Meanwhile, Southwest warned that the epidemic could wipe up to $300 million from its first-quarter operating revenue and Norwegian Air (NWC.OL) became the latest airline to scrap its profit forecast for 2020.
Norwegian, a pioneer of low-cost transatlantic travel, has been struggling for years due to cutthroat competition and heavy debts built up during rapid expansion.
Its shares, which have lost nearly 60% of their value this year, ended 13% lower on Thursday.
Analysts say few airlines are likely to remain unscathed, as both business and tourist travel are being affected, with meetings and events being canceled and companies limiting travel to protect employees.

Data provider ForwardKeys said on Thursday new flight bookings to Europe from elsewhere in the world fell by 79% in the last week of February, as the virus took hold in popular tourist destinations such as Italy.
“The drop-off in bookings to Italy is even worse than we have observed in the past for some of the most disruptive events such as terror attacks,” ForwardKeys Vice President Insights Olivier Ponti said.
https://www.reuters.com/article/us-healthcare-coronavirus-airlines/airlines-face-100-billion-plus-virus-hit-discounts-wouldnt-do-any-good-idUSKBN20S11G

Insurer lobby urges coronavirus test coverage, but can’t mandate changes

• The nation’s health insurance lobby, which represents some of the biggest payers but not giant UnitedHealth Group, said it will cover testing for the coronavirus when ordered by a physician. It also said it will work to limit financial and administrative barriers to accessing the test, including prior authorization and network concerns.
• Experts noted the trade group can nudge but not mandate that insurers change their policies. America’s Health Insurance Plans represents dozens of entities, including Aetna, CVS, Anthem, nonprofit Blue Cross plans, UPMC and Geisinger among its members, according to AHIP’s website.
• Cigna issued its own statement, vowing to waive cost-sharing and co-payments for diagnostic tests for its fully insured plan members. Groups that use administrative services only plans “will also have the option to include coronavirus testing as a preventive benefit,” the payer said.

The administration is working to quickly expand testing by making the kits more readily available to state and local laboratories across the country as the case count increases, particularly among patients who did not travel to China — the origin of the outbreak — and have no direct link to travelers.
Initially, the government limited the testing to only those exhibiting symptoms of the virus who had also traveled to China. The tests were only being performed in a handful of laboratories in certain states at first.
Testing kits are becoming more readily available, but as the access to tests increases, it has raised questions about whether the nation’s insurers will cover the test and what limitations may exist.
AHIP attempted to ease concerns and said its members will cover the test and aim to limit other barriers for patients, including copay and other cost concerns.
Still, health policy experts cautioned that AHIP’s statement doesn’t create a mandate for its member insurance companies.
“They can’t require member companies to do anything,” Sabrina Corlette, a research professor at Georgetown University, told Healthcare Dive.
There are some legal obligations for insurers to cover laboratory testing, which would include coronavirus testing, but it depends on the type of plan, she said.
For instance, the Affordable Care Act requires individual health plans bought on the exchanges and small employer plans to cover essential health benefits, which includes laboratory testing. But for large and self-funded employers, there is no federal obligation to covering lab services or this specific test. However, Corlette noted “as a practical matter, I think most employer plans do cover lab, so it’s probably covered for most people in employer-based plans.”
Still, patients with high deductible plans, or those who are uninsured or have short-term limited duration plans, may be exposed to “cost sharing that they just can’t afford even if the test itself is covered,” she said.
AHIP only said it will take action to ease “and/or waive patient cost sharing.”
However, Washington state’s insurance commissioner issued an emergency order requiring insurers there to waive copay and deductibles for any consumer that requires testing for the coronavirus.
It also bars any prior authorization requirement for treating or testing for the virus and allows for a one-time early medication refill.
“Consumers are rightly concerned about prevention, testing and possible treatment,” Insurance Commissioner Mike Kreidler said in a statement on Thursday. “My emergency order provides guidance to health insurers and should help reassure the public that we will take all necessary steps to protect them.”
As testing expands to include commercial labs, patients will need to be on guard about whether their physician uses a lab that’s out-of-network, Corlette said. “Generally speaking, the insurer is only obligated to cover lab tests on an in-network lab and consumers could face full charge or higher out-of-pocket charges if the specimen is sent to an out-of-network lab.” Both LabCorp and Quest Diagnostics said they plan to make tests available next week.​
The illness has upended plans as large conferences dotted across the U.S. are canceled to avoid drawing thousands to gather in one area. United Airlines is cutting back flights domestically, the first major U.S. air carrier to do so and the major health tech conference HIMSS canceled its event.
https://www.healthcaredive.com/news/insurer-lobby-urges-coronavirus-test-coverage-but-cant-mandate-changes/573595/

Top insurers commit to easing cost barriers to coronavirus testing

Top insurers committed Thursday to mitigate the costs associated with testing for and treatment of the novel coronavirus that has begun spreading in the U.S.
The board of industry group America’s Health Insurance Plans (AHIP)—which includes the heads of top insurers like Humana, Anthem, CVS and Cigna—said in a statement they are committed to providing coverage for tests ordered by a physician. They also said they are working to ease network, referral and prior authorization requirements that could hinder access.
The group said their organizations would also potentially waive out-of-pocket costs for the tests.

“Health insurance providers will devote our resources, insights, and abilities to collaborate with key partners to confront and resolve this challenge,” AHIP said in a statement. “Working together with federal, state and community leaders; clinicians; pharmacies; drug makers; medical equipment providers; and other essential partners, we are confident that we can collectively overcome this challenge and keep the American people safe and healthy.”

The group said it would be teaming up with state and federal policymakers to allow for greater flexibility to change benefits or offer preventive services and treatments. Cigna was the first health plan to announce they would waive copayments or other cost-sharing on Thursday.
“During this time of heightened concern, Cigna’s role is clear. We will do everything we can to help contain this virus, remove barriers to testing and treatment, especially for seniors and people who are chronically ill, and give peace of mind to those we serve,” said David M. Cordani, Cigna CEO, in a statement. “This is another example of how, every day, we strive to stand by our customers through their life and health journeys.”
AHIP also reiterated its plan for providing crucial data to providers and directing members toward tech options that could avoid the spread of the virus, such as telehealth.
Health plans will also continue to use their platforms to ensure members have access to the most recent—and accurate—information from the Centers for Disease Control and Prevention or other sources to spot the symptoms or navigate these conversations with their doctors.
Centers for Medicare & Medicaid Services Administrator Seema Verma said in a statement that she spoke with AHIP CEO Matt Eyles on the matter and commended the group and its board members for the announced plan.
“The Trump Administration is utilizing a whole-of-America approach, including working with our private partners, so that our entire healthcare system and our communities are activated and coordinated in our efforts to protect the American people,” Verma said.
https://www.fiercehealthcare.com/payer/ahip-commits-to-easing-cost-barriers-to-coronavirus-testing

Coronavirus in NY: 9 new cases confirmed, with 1st in Nassau County

An additional nine New Yorkers have tested positive for coronavirus, Gov. Andrew Cuomo said Thursday, ballooning the total number of cases to 22 statewide.
Eight of the new cases are in Westchester, connected to a single New Rochelle lawyer, identified by sources as 50-year-old Lawrence Garbuz, while the ninth is on Long Island, Cuomo said.
The afflicted attorney’s wife, son and daughter have also tested positive, as have a friend, his wife and three of their four kids, Cuomo has said.
A neighbor who drove Garbuz to the hospital has additionally been confirmed to have the potentially deadly disease.
Because he also has an underlying respiratory infection, Garbuz is currently hospitalized in Upper Manhattan, while the others are self-isolating in their homes.

Two students at Yeshiva University’s Washington Heights campus — where Garbuz’s son attends classes — are being evaluated, as are seven co-workers and an intern from Garbuz’s law office near Grand Central, authorities have previously said.
Additionally, approximately 1,000 people connected to that web have been asked to self-isolate, according to officials.
Cuomo nevertheless urged calm.
“Here the facts do not merit the level of anxiety that we are seeing,” he said in an afternoon press briefing. “I believe it’s being generated because … people don’t know the truth, they don’t know the facts.
“I’m a little bit perturbed about the daily angst,” he continued.
The announcement of the additional patients came hours after Mayor Bill de Blasio announced two new cases in the five boroughs: A man in his 40s, and a woman in her 80s, both of whom are hospitalized in intensive care.
The Long Island patient is a 42-year-old Nassau County man currently hospitalized in an undisclosed county hospital, according to Cuomo.
“That individual has underlying medical conditions, which is one of the populations that is at greater risk for this virus,” said Cuomo, noting that the man’s condition is “improving.”
His close relatives have been advised to self-isolate, while disease detectives are re-tracing his steps in an attempt to track down anyone he may have come in contact with.
Officials are also working to ascertain exactly how the man caught the disease.
“We don’t know yet, but it’s community spread,” said Dr. Howard Zucker, the commissioner of the state Department of Health, noting that the man had not recently traveled to any countries affected by the outbreak.
https://nypost.com/2020/03/05/coronavirus-in-ny-9-new-cases-confirmed-including-first-in-nassau-county/

Blood plasma from recovered patients could help treat the new coronavirus

When it comes to creating treatments for Covid-19, the disease caused by the novel coronavirus, the first line of defense may be a century-old technology: purified blood plasma.
Medical literature published during the Spanish flu pandemic of 1918 includes case reports describing how transfusions of blood products obtained from survivors may have contributed to a 50% reduction in death among severely ill patients. In 1934, a measles outbreak at a Pennsylvania boarding school was halted when serum harvested from the first infected student was used to treat 62 fellow students. Only three of the 62 students developed measles — all mild cases.
More recently, plasma-derived therapy was used to treat patients during outbreaks of Ebola and avian flu. And on Wednesday the Japanese drugmaker Takeda Pharmaceutical Co. said it was developing a new coronavirus drug derived from the blood plasma of people who have recovered from Covid-19. Its approach is based on the idea that antibodies developed by recovered patients might strengthen the immune system of new patients.

Here’s what you need to know about how this old technology might help slow the coronavirus outbreak.

How is blood plasma turned into an infection-fighting drug?

Patients who have recovered from a disease have permanent antibodies generated by the immune system floating in their blood plasma, the liquid component of blood. To turn that into a drug, the plasma is harvested, tested for safety, and purified to isolate those protective antibodies. When injected into a new patient, the “plasma-derived therapy” — also known as convalescent plasma — provides “passive immunity” until the patient’s immune system can generate its own antibodies.
Mike Ryan, the head of the WHO’s emergencies program, has said convalescent plasma is a “very important area to pursue” as a potential treatment for patients with Covid-19. “It must be given at the right time because it mops up the virus in the system and it just gives the new patient’s immune system a vital push at the time it needs it — but it has to be carefully time and it’s not always successful.”

Is this approach already being used in this outbreak?

In February, doctors in Shanghai set up a special clinical to administer convalescent plasma to select patients who were newly infected with coronavirus.
“In China, we’ve only heard anecdotal reports of encouraging results. Nothing has been published yet,” said Greg Poland, a physician and infectious disease expert at the Mayo Clinic in Rochester, Minn. “But this approach is definitely worth trying.”

How is what Takeda is doing different?

Takeda already makes a medicine called intravenous immunoglobin, or IVIG, for treating patients who have immune disorders. It consists of antibodies of all types purified from the blood plasma of healthy people. Giving antibodies in this purified form is easier, because it requires a much lower volume of treatment; it’s safer, because there is no chance of transmitting other viruses; and it’s more efficient.

With its new treatment, TAK-888, Takeda hopes to create an IVIG from the blood of people who have been infected with the coronavirus and who have recovered. That could create a treatment or prophylactic relatively quickly. It might not need to go through phase I studies to demonstrate basic safety, or larger phase III studies to demonstrate efficacy. That means the treatment could be available sooner.
The other advantage of this approach is that researchers don’t need to figure out which antibodies work best at fighting off the novel coronavirus. They basically import the entire disease-fighting army of antibodies from patients whose bodies have already won. The antibodies in TAK-888 will be more narrowly selected to target coronavirus than those in garden variety IVIG.

How much of this new drug can Takeda make?

“We are not looking at this as a therapy that everyone should go on,” Julie Kim, the president of Takeda’s blood plasma unit, told STAT. “This will be targeted to patients who have severe disease.”
Kim said the hope is that a single donor might provide enough IVIG for a single patient. But it’s also possible that IVIG derived from several people would be needed to treat each patient. Takeda won’t know until it has taken steps to learn how many antibodies are present in patients who have recovered, and what dose of TAK-888 appears necessary to be effective. Those measures, Takeda said, could be discovered without large-scale trials.
Kim said that she could not comment on precise timelines until Takeda has had discussions with regulators like the Food and Drug Administration.

Are there others working with antibody treatments?

Yes. Among them is Regeneron, which is working on a mix of manufactured antibodies to attack the coronavirus. Vir Biotechnology, another biotech firm, has said it will have a similar approach.
The IVIG approach Takeda is using is known as “polyclonal antibodies,” which means, simply, that there are a lot of different types of antibodies in the mix. But many biotech drugs are what are known as monoclonal antibodies, single antibodies that can be originally generated in mice and then manufactured in huge tanks of cells.
One reason to be optimistic is that Regeneron has pulled it off before, manufacturing a treatment composed of three different monoclonal antibodies that appears to have some effectiveness against the Ebola virus.
Geoffrey Porges, an analyst at the investment bank SVB Leerink, said in an interview he was “very impressed” with the speed at which Regeneron developed an Ebola treatment. He said that the novel coronavirus might be harder, because it is not clear what parts of the rapidly mutating virus antibodies should target. “But if anyone can figure this out, it’s Regeneron,” he said.

Don’t vaccines also work by creating antibodies?

Vaccines work by teaching the body to make its own antibodies to an infectious agent without a person ever becoming infected. This is why they are among the most powerful weapons in public health.
But Porges, who worked at Merck’s vaccine division in the 1990s, said he thinks that creating a vaccine might be harder than companies expect, because this new virus is just not well enough understood. “You kind of need to have some fundamental understanding of the immunology and the virus before you can develop a vaccine,” he said. “It’s not clear to me that we have that.”
Many companies, including the biotechnology firm Moderna and the large pharmaceutical companies Johnson & Johnson and Sanofi, are working hard to develop vaccines quickly.

So which of these approaches is better? 

That’s not the right question. Convalescent plasma, and then IVIG, could provide our first-line defense for people with Covid-19, especially those who are older and at much higher risk for complications. A monoclonal antibody drug could reach a greater number of patients. We also need antiviral drugs, such as remdesivir, being tested by Gilead Sciences. And a vaccine could do the most to slow or stop transmission.
“We need them all,” said Poland of the Mayo Clinic.

How blood plasma from recovered patients could help treat the new coronavirus

Cooper Companies FQ1 earning down 12%

Cooper Companies (NYSE:COO) fiscal Q1 results:

Revenue: $646.2M (+3%); CVI: $485.2M (+3%); CSI: $161.0M (+2%).

Net income: $90.5M (-12%); EPS: $1.82 (-12%); non-GAAP EPS: $2.69 (-7%).

2020 guidance: Revenue: $2,767M – 2,817M; CVI revenue: $2,070M – 2,100M; CSI revenue: $697M – 717M; non-GAAP EPS: $12.80 – 13.20. Consensus: non-GAAP EPS of $12.82 on revenue of $2.8B.

The Cooper Companies EPS misses by $0.03, misses on revenue

https://seekingalpha.com/news/3549239-cooper-companies-fq1-earning-down-12

Cigna to waive member fees for coronavirus testing

Cigna (NYSE:CI) announces that it will waive all copays and cost-share fees for members who are tested for COVID-19 infection per their doctor’s instruction. It says it considers the medical test a preventative benefit vis a vis fully-insured plans thereby warranting no out-of-pocket costs for patients.
https://seekingalpha.com/news/3549271-cigna-to-waive-member-fees-for-coronavirus-testing