In disappointing news, the FDA put a hold on blood plasma use for COVID-19

Plus, why insurance companies are turning down claims for coronavirus disruptions, why cruise lines are optimistic, and more.

August 20, 2020

Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

Wednesday was another of those two-steps-back kind of days for COVID-19 treatments. The nation’s largest study of blood plasma as a COVID-19 treatment produced results that Dr. Anthony Fauci said were too weak to be dependable.

Researchers had hoped blood plasma from people who have recovered from COVID-19 might be full of antibodies that would speed recovery in sick patients. Antibodies are proteins that the body uses to fight off infections. The blood from people who’ve recovered is called “convalescent plasma” (plasma is the liquid portion of the blood).

The study, run by the Mayo Clinic, involved about 35,000 critically ill patients. Just over half of those patients, 52.3%, were in the intensive care unit and 27.5% were receiving mechanical ventilation at the time of the plasma transfusion. A week after the infusion, 8.7% of the patients were dead.

The number of people infused with plasma to treat COVID-19 as part of the treatment protocol has risen to more than 66,000 at 2,700 locations involving close to 14,000 physicians.

Researchers are not giving up on blood plasma as a treatment, but they say they need more data to know more about whether and how to use it. The Food and Drug Administration could still approve plasma’s use as a COVID-19 therapy within the next few months if new data shows it is safe and effective, according to Dr. H. Clifford Lane, deputy director at the National Institute of Allergy and Infectious Diseases.

Mayo Clinic explained why everyone hopes plasma treatment will prove to be effective and why the FDA’s delay is such deflating news:

Convalescent plasma therapy may be helpful for people with COVID-19 who aren’t helped by other treatments.

Researchers hope that convalescent plasma can be given to people with severe COVID-19 to boost their ability to fight the virus. It also might help keep people who are moderately ill from becoming more ill and experiencing COVID-19 complications.

It could also help other people who may have a higher risk of serious illness, such as people with chronic medical conditions, for example, heart disease or diabetes, or those who have weakened immune systems. Convalescent plasma could help these people from getting sicker if they get COVID-19.

Convalescent plasma might also be considered for family members or health care workers who have been exposed to someone with COVID-19 to potentially prevent them from getting COVID-19.

In April, the FDA launched a campaign urging people who had been infected to donate plasma for research. Earlier this month, President Donald Trump added convalescent plasma treatment to the list of unproven treatments that he has publicly lauded.

The lesson in all of this is one we should have learned by now: Journalists should be cautious in how we describe the hopes for any medical treatment until there is long-term and deep data to back those hopes. Real breakthroughs are rare. Studies to prove safety and efficacy take a lot of time and sometimes, maybe even often, they prove inconclusive.

Thousands of lawsuits are coming as insurance companies turn down “business interruption” claims

This is a really big issue involving billions of dollars, thousands of lawsuits, the very survival of some businesses and the future of catastrophic insurance claims. In short, this story is worth your attention.

More than a thousand businesses have filed lawsuits against insurance companies that refuse to pay “business interruption” claims over COVID-19. Hundreds more lawsuits are on the way.

Businesses buy interruption coverage to protect against shutdowns that they did not cause themselves. But after dutifully paying their premiums for years, businesses are discovering that when their sales and services are interrupted by a virus, they are not covered. The insurance companies are claiming the interruption has to be caused by physical damage to a property, not a pandemic.

One insurance expert said the number of lawsuits is more than five times the suits filed after recent hurricanes.

Researchers at the University of Pennsylvania are tracking these lawsuits and keeping insightful charts on who is filing insurance lawsuits and what they are claiming. The tracking project is run by Tom Baker, the William Maul Measey Professor of Law at Penn Law, who said these lawsuits are way more important than you may realize.

“The COVID-19 pandemic has created the biggest insurance coverage event in our lifetimes — it’s bigger than any hurricane and bigger than 9/11 in terms of total dollar value of claims,” said Baker. “For the many small and medium sized businesses that have been severely impacted, these insurance claims may be a way for them to recover, depending on how courts answer the novel questions the cases present.

Look at this chart, which starts before the COVID-19 shutdown to provide a baseline of how many business interruption lawsuits are usually filed per week, versus the weekly count now.

(Data and chart from the Covid Coverage Litigation Chart, University of Pennsylvania)

As you might expect, restaurants have filed the most business interruption lawsuits so far. But health care services like doctors’ offices and laundry services are high on the list, too.

PropertyCasualty360, which tracks the insurance industry, dove into details of some of the claims to give you an idea of what is at stake:

  • In a federal suit filed in Chicago, Big Onion Tavern Group — a group of Chicago-based restaurants and movie theaters — sued their insurer seeking coverage for lost revenue due to forced closures following Illinois Gov. J.B. Pritzker’s COVID-19 shutdown order. The plaintiffs also sought damages for statutory bad faith.
  • Seven shuttered San Antonio, Texas, barbershops filed claims with their insurer, State Farm, asking them to cover loss of business income. The claims were denied, so the shops responded by suing State Farm for breach of contract for wrongfully denying coverage and other claims.
  • Mudpie Inc. — a San Francisco-based children’s clothing boutique — filed a class-action lawsuit on behalf of California-based retail stores against Travelers, alleging the small businesses were wrongfully denied coverage for losses resulting from government-mandated public health shutdowns related to COVID-19 — despite having paid premiums for business interruption policies.

Travelers Insurance, which is the plaintiff in the Mudpie Inc. lawsuit, said:

“We recognize that the spread of COVID-19 has affected many of us in ways we never could have expected, and we are taking many steps to support our customers, agents, brokers and communities during this difficult time.”

The statement continued:

“In our standard commercial property policies that include business interruption coverage, we have very specific exclusions stating that losses resulting from a virus or bacteria are not covered.”

The most common claim from the lawsuits is for interruption of “business income.”

(Data and chart from the Covid Coverage Litigation Chart, University of Pennsylvania)

When lawsuits claim “bad faith,” it means the plaintiff is accusing the insurance company of failing to be fair in responding to claims. States have various requirements about what it means to show “good faith” in responding to insurance claims, but generally they require an insurance company to at least investigate a claim and explain how it made its decision to cover or deny it.

So far, the insurance companies have been denying coverage because COVID-19 did not cause “direct physical damage” to property, which is a key to business interruption insurance.

But is there coverage when local authorities require bars, restaurants, gyms and other establishments to close because of their chances of spreading the virus? As you can see in the above chart, more than 750 lawsuits, so far, are claiming that the civil authority (cities, counties, states) closing the businesses caused a business interruption that should be covered. The insurers disagree.

The insurance companies got wise to their potential exposure to virus-related claims after the SARS outbreak and built exclusions into their policies. Insurance companies also built in exclusions for when police or health officials shut down businesses for interruptions caused by viruses or bacteria.

PropertyCasualty360 dug into a typical insurance “endorsement,” which is an add-on that you might buy for your property insurance. Generally, business interruption insurance requires:

…a civil authority prohibiting access to the insured property because of damage to other property, but two conditions must apply. That other property must be within one mile of the insured property, and the action of the civil authority is taken in response to dangerous physical conditions resulting from the loss, continuation of the covered cause of loss that caused the damage, or to allow the authority unimpeded access to the property.

The insurance companies say a virus pandemic does not fit that description.

The Insurance Journal said the University of Pennsylvania’s data reveals:

  • 69% of COVID insurance coverage lawsuits have been filed in just nine states.
  • Big states known for high litigation rates generally, like California and Illinois, are among them.
  • Another factor is the correlation between COVID-19 infection rates and the number of insurance coverage lawsuits filed.
  • Pennsylvania has produced 10.5% of the coverage lawsuits as of mid-July. Florida produced 8.3%, and New York 7%.
  • The plaintiff law firms may be consolidating claims from various states.
  • There is about a one-month lag between the high water mark of COVID-19 cases and lawsuits being filed.

A third chart lists the plaintiffs most often mentioned in the lawsuits, which could be especially important for journalists who have company headquarters nearby.

(Data and chart from the Covid Coverage Litigation Chart, University of Pennsylvania)

These kinds of cases will take a long time to settle, partly because they involve so many cases, so much money and such deep implications. Even if the courts rule in favor of restaurant owners, for example, it might be too late to rescue their businesses.

And then there is the possibility that legislatures and Congress could step in and require business interruption insurance to cover pandemics, which the insurers would inevitably claim would raise rates.

Insurance Journal pointed out:

The American Property Casualty Insurance Association, the largest trade group representing such insurers, has argued if insurers are forced to pay for losses that are not covered under existing insurance policies, “the stability of the sector could be impacted and that could affect the ability of consumers to address everyday risks that are covered by the property casualty industry.”

Why cruise lines are so optimistic

Carnival Cruise ships docked at the Port of Tampa in Tampa, Florida. (AP Photo/Chris O’Meara, File)

In the midst of a pandemic, why are companies like Royal Caribbean, Carnival and Norwegian Cruise Lines watching their stock prices leap around 5% this week? While people are not sailing out of the U.S. this year, they are booking cruises for 2021.

Keep in mind, only a week ago, the big cruise lines were watching their stocks dive.

While its ships sit at the docks, Royal Caribbean said it is burning through $200 million a month. The entire cruise industry is losing a mind-boggling $250 billion a month. And no matter how optimistic people are about 2021, the future may be governed more by how the Centers for Disease Control and Prevention sees the future and whether it will extend the no-sail order currently in effect until the end of September.

Travel Pulse said even the heads of the cruise companies are surprised by travelers’ optimism:

In business updates in recent weeks, both Royal Caribbean Group and Norwegian Cruise Line Holdings Ltd. said 2021 bookings are “within historical ranges.” In fact, NCLH President and CEO Frank Del Rio said he was “astonished” by the booking strength.

“Given the current global situation and uncertainty, we’ve been both encouraged and humbled by the volume of bookings we’ve been receiving for 2021,” Royal Caribbean CFO Jason Liberty said in the call. “Since our last earnings call, bookings have averaged more than double the levels seen during the first eight weeks of the global cruise suspension.”

A survey that quizzed people who had completed a recent cruise asked about their plans to sail again. Cruise Industry News reported:

The vast majority of survey respondents plan to cruise again before the end of 2021 (86.6% at least somewhat likely, with 62.3% definitely or very likely).

Top destinations (respondents were encouraged to select all that apply) are Caribbean/Mexico (57.2%), Europe (43.5%) and Alaska (13.7%). Other destinations of interest include Hawaiian Islands and South Pacific, Canada / New England, World, Transatlantic, Antarctica, Galapagos Islands, Panama Canal and Asia. Respondents also expressed a “write-in” interest in river cruises and small ships.

That insight about river cruises and smaller ships may prove to be important, the survey said.

Cruise companies have slowly restarting sailing in Europe and the Middle East.

People who cruise say they will be vigilant in reading about how a ship handles health protocols.

That people are booking for 2021 says to me that we just need to put something on our calendars to convince ourselves that one day we will get back to normalcy. And maybe we are taking the money we planned to spend on vacations this year and, rather than letting it evaporate, we are putting that money down on 2021 adventures.

Talk about hitting a company when it is down: This week, Carnival said it was attacked by ransomware that may have given up some customers’ data.

The times in which we live

Axios was so clever this week. It looked at how retailers are pitching back-to-college sales. The big retailers have had to change their pitches and some have been great.

(Screenshot, Axios)

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Al Tompkins is senior faculty at Poynter. He can be reached at atompkins@poynter.org or on Twitter, @atompkins.