• More than three quarters (76%) people in the UK are currently stressed
• More than half (51%) of Brits fear for their future
• Money worries driving surge in anxiety

New research from global health service company Cigna Europe has revealed that uncertainties about the future along with worries around personal finance are the leading causes of stress amongst UK workers.

As 2020 draws to a close and the pandemic continues on, Cigna’s COVID-19 Global Impact Study unveils more than three quarters (76%) of Brits are currently stressed, more than half say uncertainty about the future is the leading cause, followed by personal finances (32%) and the amount of news/information related to COVID-19 on the media (32%).

As news of a vaccine continues to dominate the headlines, the study also shows that Brits have concerns about returning to work when rules are relaxed, with 40% concerned about catching the virus during their commute, 37% are worried about an outbreak returning when mixing in the office whilst 36% have worries over restrictions they will face in the work environment. Many workers feel financial support from their employer for COVID testing would be a key incentive to returning to the workplace.

“The COVID-19 pandemic has impacted almost every part of life across the globe and continues to play a major part in fueling stress”, said Arjan Toor, CEO, Cigna Europe. “It’s evident from our research that people are weighed down by this stress, with anxiety around income and future prospects in our new world the leading causes. This is in stark contrast to our first Impact study in April which showed that 78% of UK workers felt they had good job stability. It’s been a tough year for many, and it is naturally worrying to see so many people stressed about their future.”

The ‘always on’ corporate culture has grown rapidly since lockdown began in March, with almost 7 in 10 (68%) of workers always-on, more than half (54%) are working after working hours, 50% before working hours, and more than 4 in 10 (43%) are working on weekends. Encouragingly however, employers are remaining more flexible as the pandemic continues. The most popular measures put in place by employers are flexible working location/hours (37%) and mental health support (29%).

Toor added: “The emotional toll the virus has had on so many people, not to mention the experiences of isolation, loneliness, financial hardships and mental health trauma cannot be underestimated. As the year draws to a close, we need to look ahead to 2021 and how we, as a whole health partner, can intuitively understand our customers in this increasingly complex world, and support them in each and every aspect of their lives.”

The Cigna COVID-19 Global Impact Study is an ongoing study that has been conducted by Cigna, in partnership with Kantar, between January and October 2020, and will continue into 2021. To date, more than 23,000 online interviews have been conducted across China, Hong Kong, Korea, New Zealand, Singapore, Spain, Taiwan, Thailand, United Arab Emirates, United Kingdom and United States.

The study was conducted using an online survey, with respondents recruited from online panels and undergo rigorous quality control. Age, gender and residing city quotas were set based on the population proportion of respective markets. The 20 to 25 minutes survey was completed anonymously.

Read the full report here.

By Dr. Lynn Gordon, Chief Medical Officer, Charles Taylor Assistance.

COVID-19 has had a major impact across the world; not just killing over a million people, but also disrupting the global economy, stalling global movement and forcing large swathes of the world’s population to work from home.

The 70 million+ cases of COVID-19 to date (confirmed by the European Centre for Disease Prevention and Control at time of writing) have inevitably strained global resources. And, although it’s too early to assess the full impact of the virus on the international accident and health sector, it looks set to leave its mark. But it's not all negative.

Disrupted healthcare

Undeniably, COVID-19 has created challenges to the accessibility and availability of global healthcare; not least by causing international borders to be closed at short notice, local medical facilities to become stretched and hospital beds to become limited. This has affected COVID-19 and non COVID-19 patients alike.

At the same time, the virus has highlighted shortcomings in resource-limited countries, for instance where oxygen supplies are low.  In countries that have created state-designated COVID-19 hospitals with limited services, there has been little, and often no, opportunity to transfer patients to private alternatives. 

Adding to this complexity has been the limited availability of commercial flights; impacting the transfer of patients requiring transport to superior medical facilities or repatriation home. For COVID-19 positive patients, the only transfer option has involved specialized isolation pods on air ambulances. Meanwhile, lengthy compliance measures, including virus testing, have often been mandatory for all patients needing transfers.                     

Rising claims costs

The global rise in medical costs has long outpaced inflation, but COVID-19 has added to the financial pain. The pandemic has, for example, necessitated longer hospital stays for patients whose transfers have been held up by restrictions. It has also created an increased reliance on - more expensive - air ambulances. Combined with the added expense of business interruption, factors like these are increasing the cost of international accident and health claims.

The 2021 Global Medical Trends Survey Report by Willis Towers Watson acknowledges that many insurers are reporting a decreasing trend in claims this year, as most non-urgent medical treatments and surgeries have been delayed. But these delayed treatments, combined with the long-term (largely unknown) effects of COVID-19 suggest that a rapid escalation in claims lies ahead.

It's also important to remember that the availability of a vaccine is positive news, but that it calls for global motivation and the cooperation of communities worldwide to be truly effective. So, we're not out of the COVID-19 woods yet.

Opportunities in a post-COVID 19 world

That's not to say that there are no opportunities in the current climate - and one of these lies in digital development.

US healthcare providers lead the field in their adoption of digital technology; with almost 90% of US employees offered a telehealth benefit last year. COVID-19 is accelerating the wider use of telehealth around the world, which could well help to counteract medical cost inflation, whilst also providing an efficient, user-friendly way for policyholders to access medical triage services. And this could ease the pressure on potentially overstretched healthcare providers.

Digital tools can play an important part in intelligent underwriting too; for instance, by identifying individuals at risk of developing severe symptoms of COVID-19, or of any other serious illness. We’ve had a lot of interest in our own digital tool, Venture, which can assess these risks via online questionnaires completed by globally mobile employees. It can also correlate risks with the availability and standard of healthcare in specific destinations.  

Digital risk assessment tools like this offer an opportunity to access aggregated and anonymised data on the health of employees overseas, which can inform underwriting decisions for international accident and health policies.

Meeting mental health needs

The World Health Organisation (WHO) estimates that close to 1 billion people worldwide are already living with a mental disorder. And COVID-19 is swelling the numbers. It's no secret that the virus has added to the global mental health load; exacerbating anxiety, loneliness and depression.

But this presents an opportunity to better-fill the void in the provision of mental health coverage and servicing, with drivers from possible regulatory changes and increased employee need. And it’s worth bearing in mind that this need may become more acute as the global economy shrinks and corporates look increasingly to minimise business disruption and retain or improve productivity.

It’s likely that improving mental health coverage could benefit all parties. After all, the WHO estimates that, for every US$ 1 invested in scaled-up treatment for common mental disorders such as depression and anxiety, there is a return of US$ 5 in improved health and ability to work.

COVID-19 may have impacted the world - but collective determination and global cooperation will see us through it.

In this exclusive iPMI Magazine interview, Christopher Knight, CEO, iPMI Magazine, met with Janette Hiscock, CEO of Global Solutions Europe, UnitedHealthcare Global. They discussed in detail the COVID-19 global pandemic and how UnitedHealthcare Global has managed the public healthcare crisis, internally and externally. 

COVID-19 has had a huge impact on the healthcare industry. How has your organisation managed?

As a leading global healthcare company, we have been impacted like everyone else. We’ve been able to help support our employees, our customers, and communities around the world to aid the global fight against this disease. 

Since the outbreak, we’ve had to work quickly to make sure that we’re doing everything possible to continue treating patients and supporting our members. In the U.S., UnitedHealth Group has worked to develop accurate tests which aren’t as invasive as those which have been used more widely. These tests were made available to patients with a doctor’s order at hospitals, clinics and testing facilities across the U.S. We’ve also completed a *study with the Yale School of Medicine that suggests older COVID-19 patients with hypertension, who were taking angiotensin-converting enzyme (ACE) inhibitors, may have a lower risk of COVID-19 hospitalisation. A clinical trial will follow as a next step.1 The study is still under peer review.2

At UnitedHealthcare Global specifically, we have waived member cost sharing, including copayments and deductibles, for COVID-19 diagnostic testing provided this is medically necessary and is carried out at an approved location and in accordance with applicable governmental or public health advice.

This was made available on top of existing access to Virtual Visits, our telehealth solution, our Optum Employee Assistance Programme (EAP) and our unique health management programme. All these features continue to be a source of significant support for our members during this unprecedented time..

More widely, we looked to help other businesses in need across the world. For example, in the UK, our Medical Services team has been globally supplying vital PPE to protect healthcare workers across other essential businesses around the world.

Not only have we supported the scientific and clinical aspect of COVID-19 but since April we’ve committed over $60 million, via the UnitedHealth Foundation, to support homelessness, food insecurities and the health and safety of the frontline workforce. This funding has been used across the U.S. and other regions including, Brazil, Chile, Columbia, India, Ireland, Peru, the Philippines and Portugal.  It’s been a real privilege to be part of an organisation working actively to address the virus and its effects and serve the needs of our members and customers. We are fortunate that as a global organisation we’re skilled at working seamlessly across countries, time zones and home offices. As the pandemic evolves, I’m confident that we’ll continue to adapt and support our customers effectively, with a focus on compassion, relationships and performance. 

How has your role changed during the pandemic and what are your priorities for your own people?

This year has been challenging in so many ways, both personal and professional. However, it has shown me the importance of understanding our markets and the people we serve. We must offer comprehensive, yet affordable solutions to meet their changing needs. I’ve been working closely with my team to navigate our response to the changing healthcare landscape, and I am confident we have delivered a high standard of support and care throughout this time. 

A crucial aspect of my role this year has been to find the best route to minimise the impact of the pandemic on the business, both in terms of our continued growth and, more importantly, on our employees. The safety and wellbeing of our employees is my absolute priority and I have been in close communication with all our teams to ensure we support each other. We’ve also made it a top priority to reinforce the importance of taking annual leave, using the EAP and supporting flexible working. We commissioned a 12 Steps to Personal Resilience programme for all our European-based teams and encouraged them to adopt the practical hints and tips on a weekly basis.

I am very proud to lead our team in Europe and whilst I have reverted to working at home full time, this has been the only real change for me in my role: We have maintained our strong engagement with our brokers and partners, supported our clients and their members at every step, and have ensured the health, safety and wellbeing of our people are protected at all times.

The pandemic has raised lots of questions about the world of work. How do you imagine the future of the workplace?

Prior to the COVID-19 outbreak, I would imagine that only a small portion of the population had experienced working from home. Some companies may have previously doubted the efficiency and productivity of working from home, preferring to keep their workforce in the office. Personally, I’ve been so impressed by the professionalism and productivity of my colleagues continuing to go above and beyond during this crisis, whilst working from home. Despite the upheaval of this year, we have remained collaborative across the organization, working with our colleagues around the globe.

It is likely that working from home will continue to be an ever-present feature of our working life for the foreseeable future. Homeworking is a new reality for all of us. This may be individual employee preference or simply continuing to ensure social/physical distancing. Whatever the reason, organisations will need to be able to foster a sense of community despite the increased physical distance between their staff. Leaders will need to trust their people and empower them to manage their working day in a way that suits them. This can be a difficult pivot to make as a leader, but I encourage any leader to make this transition sooner rather than later. It takes time to build new working patterns and nurture trust and self-management, but in my opinion, it is worth the investment.

What can organisations do to support employees working from home for long periods, and manage the eventual return to the office?

Boosting and maintaining morale will be critical for employee wellbeing during this extended period of working from home. Never has it been so important to have that virtual coffee with a colleague and to provide virtual events such as quizzes or team activities. In addition, employees should be encouraged to frame their day as if they were in the office and work within their agreed working hours. Although the traditional 9-5 ‘clock in clock out’ approach has been turned on its head, it’s key that employees maintain a balance and don’t fall into the trap of always being available. And yes, I need to take my own advice!

I encourage all employees to take frequent breaks for their physical and mental wellbeing. This is especially important as the days get shorter and its harder to get outside in the evening. Employees should also be encouraged to block an hour in their diary each day to ensure they are taking a lunch break, which will only serve to benefit their productivity for the remainder of the day. 

Depending on where you are in the world and how the pandemic changes, some companies have already started to head back to the office. Employers have a duty of care to make sure that workers feel safe. There are various ways to create a safe, clean, socially distanced environment, such as visible signs and instructions, one-way systems, and plenty of handwashing stations. Ensuring staff are aware of the measures in place to protect their wellbeing is a critical step in implementing social distancing and creating a safe working environment. Communication is key.

To help navigate our customers through these unfamiliar times, we’ve developed a new product, our ‘Return to Workplace Screening Tool.’ This is an online health screening service for clients to monitor the health and wellness of their global workforce. Using a simple online pre-deployment medical screening questionnaire, we can identify responses which may require further intervention and alert HR teams to decide whether further action is required. It has been designed to highlight COVID-19 exposure and any changes in their employees’ health and wellbeing that may have developed since last in their workplace.

We’re also pleased to offer an extension to our Global Medical Arrangement (GMA) service by now facilitating COVID-19 testing across our network of providers. All testing is conducted at vetted and approved facilities by certified and accredited healthcare professionals either through a nasal/throat swab or an antibody test. Our offering is unique in that it is managed in-house, creating a continuum of care for all our members.

Have you managed to keep building your business despite the challenges of COVID-19?

Despite the challenges we have faced from COVID-19, we’re still committed to growing our team. In April we added to our senior leadership team with the appointment of John Kaye as Market Development Director for the EMEA region. John’s hire further strengthens our commitment to this market, with his extensive experience in the international healthcare industry. We have also had new hires in sales support, policy enrolment and client management, all signs of an ever-growing business.

Looking ahead to 2021, we are very optimistic about UnitedHealthcare Global’s continued evolution across the European market. Despite the continued challenges from COVID-19, I feel positive about what lies ahead. We have exciting new plans lined up, including entering the Netherlands market, and I know that we have the people and resources to deal with whatever challenges COVID-19 has in store for us.

¹ https://news.yale.edu/2020/05/27/seniors-covid-19-taking-ace-inhibitors-have-lower-hospitalization-risk

² https://www.medrxiv.org/content/10.1101/2020.05.17.20104943v1

There’s no question that the landscape for international business travel has changed beyond recognition.

Recent research by the Institute of Travel Management found that 38% of corporate travel managers expect their firm’s travel plans and budgets for 2021 to be down by 25% to 50% compared to 2019. However, for many organisations that operate on an international footprint there is also an imperative to get employees moving again, and for expat workers to be located abroad. And with this requirement comes all the usual risks – as well as COVID-19.

In response, Healix International, the security and health risk management business has developed a new suite of tools to give risk managers vital control to meet their duty-of-care obligations. Healix Sentinel brings together five solutions to provide global organisations with vital tools to stay informed of the risks their employees and operations may face and take appropriate action wherever they are across the globe. 

“This year has been extraordinary and organisations around the world are adjusting to a new way of working to ensure business continuity and productivity,” explained Mike Webb, CEO of Healix International. “But remote working can only go so far, and it is critical for many businesses that travel resumes. While COVID-19 brings a new dynamic, all the other risks associated with working abroad, such as earthquakes, terrorist activities or staff experiencing other health related emergencies, remain.

“Whether it is risk associated with COVID-19, or a country’s political landscape, we understand the importance of balance. Excessive risk management programmes can be burdensome and costly, while inadequate cover leaves an organisation vulnerable to operational disruption, reputational damage and potential litigation.”

Developed by experts in crisis management and risk mitigation, the Healix Sentinel suite of services goes beyond the traditional travel risk space to focus instead on ‘people’ risk management, whether they are travelling or not. Another refreshing way the Sentinel platform stands out is the way the client risk manager – rather than the employee - is seen as the primary stakeholder. As Mike Webb adds; “Often the client only has a small team, or a single individual, responsible for risk mitigation. That’s a heavy burden. The Sentinel platform addresses that by making their lives easier and acting as a force multiplier.”

Risk managers can tailor Healix Sentinel to fit their own specific requirements, choosing the mix of services that will complement and support existing security resources. Alternatively, Healix International can provide a fully managed 24/7 ‘virtual’ security department, delivering timely, actionable intelligence using cutting-edge technology to provide location specific insights and monitoring of incidents. In doing so, it gives risk managers peace of mind that they are providing employees with the highest level of duty-of-care.

“Our holistic approach encompasses planning, preparing and taking appropriate action as and when required. By providing a solution scalable to specific needs, this new suite of offerings allows risk managers to capitalise on opportunities in challenging environments within their own risk parameters,” concluded Mike Webb.

“As well as helping tackle an organisation’s risk management concerns and giving peace of mind, Healix Sentinel helps an organisation maintain a competitive advantage and will enhance its reputation as a secure and compliant organisation.”

The Healix Sentinel range includes:

Healix Sentinel Protect

The flagship service gives risk/security managers 24/7 access to a team of crisis and risk management experts. From travel security briefings and situation updates to incident and crisis response and evacuations, it is a virtual 24/7 Global Security Operations Centre (GSOC). Risk managers benefit from tailored analysis, second opinions and bespoke risk assessments to proactively mitigate risks before they become problematic, and expert assistance when incidents do occur. Furthermore, the service can be tailored to be, or support, an organisation’s in-house resources.

Healix Sentinel Tracker

This tool allows risk/security managers to seamlessly monitor and account for their globally mobile workforce via integration with the Healix Sentinel Travel Oracle mobile app. Security alerts and notifications are issued in a timely manner and managers can quickly locate and communicate with employees during a critical incident to ensure their safety.  With ‘Location Services’ activated by employees on their app, risk managers are provided with an accurate, real-time global view of their employees on an interactive map.

Healix Sentinel Critical Watch

Providing a cost-effective solution to extend a security team’s capabilities, Healix Sentinel Critical Watch is ideal for organisations lacking the in-house resources to monitor employees’ safety around-the-clock. The Healix International team provides 24/7 monitoring of global incidents. And in the immediate aftermath of a critical incident, the team reaches out to employees in the vicinity who could be impacted. Their safety is ascertained, and appropriate action can be taken according to the situation.

Healix Sentinel Travel Oracle App

Available on Android and iOS, the Healix Sentinel Travel Oracle app is an invaluable travel safety companion for a global workforce. Through alerts and comprehensive background travel and security briefings on over 200 countries, it provides instant access to critical insight and support before and during overseas assignments. As well as providing current travel safety information, advice and real-time alerts on breaking news, the app has a tracking function and enables travellers to share live location data or manually ‘check-in’ at pre-agreed milestones with a direct feed into the Healix Sentinel Tracker platform.

Healix Sentinel Intelligence Portal

This portal is designed to provide risk managers with up-to-date intelligence on global risks that could impact their operations. The dashboard displays a concise summary of information relating to ongoing incidents, risk levels and trends. Alerts are updated to the platform in real-time by our risk analysts who monitor, verify and assess the impact of incidents as they happen.

The Intelligence Portal also has detailed intelligence summaries on every country worldwide, providing risk managers with in-depth contextual information. A number of different reports can be accessed such as a weekly forecast, evacuation watch and threat report.

Healix International is a global provider of travel risk management and international medical, security and travel assistance services. Working on behalf of multinationals, governments, NGOs and insurers they look after the welfare of expatriates, travellers, offshore workers and local nationals in every country of the world. Healix provide a comprehensive, integrated range of solutions to help safeguard the health and security of their clients’ employees, providing a single point of contact to access the expertise and help they may need, wherever they are in the world, 24/7.

For more information about Healix Sentinel please visit: www.healix.com

As Brits desperately try to make plans for Christmas and winter breaks, against the backdrop of on-going Covid-19 restrictions, the prospect of a no-deal Brexit could bring more disruption if the European Health Insurance Card (EHIC) is scrapped.

So far, the Government has stated its intention to stick to its timeline to leave the European Union on 31 December 2020. At present, it is unclear, even if a deal is struck, that from 1 January 2021 an EHIC or something similar will be available to UK travellers so purchasing the correct travel insurance will become even more important.

Fiona Macrae, head of consumer awareness initiative travelinsuranceexplained.co.uk explains the potential consequences of travelling to Europe without an EHIC and how this might affect your plans.

What will it mean for British travellers if we no longer have access to the EHIC?

Provided free of charge, an EHIC is a medical card that can be used in certain European countries – EU member states, EEA countries, Iceland, Liechtenstein, Norway, as well as Switzerland. It allows British holidaymakers to have free, or heavily discounted, treatment in public hospitals should they fall ill and need emergency medical attention while on holiday. The reciprocal agreement has meant that British tourists would pay the same price for treatment at a hospital as residents would, and vice versa.

If the UK leaves the EU on 31 December 2020, without a reciprocal EHIC deal or agreement in place, then UK tourists will have to cover any medical costs incurred while on holiday themselves, if they don’t have the correct travel insurance in place. However, it is thought that students, pensioners, ‘frontier workers’, and EU nationals living in the UK will still be able access healthcare through the EHIC after 1 January 2021.

UK holidaymakers will need to make sure they have appropriate travel insurance in place as, without an agreement, they will no longer be able to rely on the EHIC for medical treatment while abroad. This means it’s more important than ever that holidaymakers declare any medical conditions to their insurer before they travel to make sure they are fully covered.

How much can British tourists expect to pay for common injuries/illnesses in EU countries?

In 2019 the average medical claim was around £1,368, according to the Association of British Insurers. This means that if a British tourist needed medical attention abroad, they could be left paying, on average, a sum of £1,368 upfront, without the use of the EHIC or appropriate travel insurance.

Here’s a list of the common injuries and illnesses that UK holidaymakers claim for, and a rough estimate of exactly how much they could expect to pay to be treated for these conditions, should they no longer have access to the EHIC or have an appropriate travel insurance policy in place:

• Diarrhoea and vomiting. An upset stomach is a common cause for visiting the hospital while abroad. Falling ill with a tummy bug could set you back around £4,000- £5,000 should you become dehydrated and need medical attention.
• Broken leg. An innocent fall could leave you paying up to £15,000 should you break a bone and need surgery.
• Ear infection. It’s not uncommon to contract an ear infection while on holiday. Costing around £300 to treat should you require treatment or medication; this minor infection does not come cheap!
• And for more serious conditions, you be could seriously set back. For example, treatment after a heart attack can cost up to £30,000 if surgery is required. A neck or spinal fracture can cost even more, hitting around the £40,000 if surgery is needed.

What would happen if the British tourist arrived at a hospital needing emergency medical treatment, but did not have travel insurance or access to the EHIC? Would they still be treated?

It is illegal for a hospital to refuse to treat someone who arrives in a life-threatening condition. However, once treated, patients could be required to pay for any treatment received before leaving the hospital, if there is no reciprocal agreement in place, or there is no travel insurance policy to rely on.

Those who arrive at a hospital abroad with a non-life-threatening injury or illness could be required to pay upfront before receiving treatment, or show that they have travel insurance in place to cover any costs. For those that cannot afford it, and do not have travel insurance to depend on, it may become more difficult to obtain medical treatment for non-life-threatening issues.

While it is almost inconceivable that a public hospital would refuse access to treatment on the grounds of inability to pay, some public hospitals in parts of Europe have been under huge financials pressure and these have only worsened as a result of the Covid-19 crisis.

We would recommend that UK travellers fully understand the implications of travelling without an appropriate travel insurance policy, should the UK no longer have access to free or discounted treatment after December 31.

Around the world, consumers’ use of digital health is rapidly rising, with more people expecting the convenience of accessing all kinds of services, including healthcare, on their smartphones.

Since the beginning of the Covid-19 pandemic though, consumer awareness and use of telemedicine in particular has jumped. The status quo has shifted. As people have been forced to adopt social distancing measures, it’s not only become more important to have convenient access to quality medical advice, but for this primary care to be delivered remotely. 

As a result, the use of telemedicine services has accelerated, becoming more widely recognised in just a short space of time as both a worthwhile complement to face-to-face services and a credible solution in its own right. Our own online doctor consultation service, Virtual Doctor from AXA, has facilitated consultations in more than 115 countries since it was first launched in 2018, covering more than 27 medical specialities and providing a doctor who can guide members through their local healthcare system in their own language. Since the beginning of the Covid-19 pandemic though, it has seen an increase of up to 240% in registered users.  

With many countries still in various states of lockdown, it seems that services such as this are becoming increasingly relevant to people’s lives. 

Covid-19 

There’s no doubt that Covid-19 has been the catalyst for the acceleration in the use of telemedicine. As we all take measures to minimise the spread of the virus, there will be patients seeking help for other ailments and conditions, but not wanting to visit a medical centre in person. After all, life doesn’t simply stop because we’re living in an era of lockdowns. 

Telemedicine connects patients with a doctor remotely – whether online or on the phone – allowing them to share their medical concern and receive a prescription, treatment plan and if needed a specialist referral, all without the need to visit a clinic in person. This kind of flexibility will, I’m sure, continue to be hugely valuable for those of us who need medical support. 

Reassurance 

Getting to grips with an unfamiliar healthcare system can be challenging at the best of times, especially so when you’re also dealing with the stress of a potential medical emergency. Throw in the prospect of a global pandemic, and the situation becomes even more daunting. However, an online doctor service can go a long way towards providing some much-needed reassurance. Being able to speak with a medical professional, who can not only advise you on how to navigate the system, but can do so in your own native language, is likely to come as a huge source of relief for many worried expats. 

Convenience 

Even without the influence of Covid-19, one of the most significant benefits to using a telemedicine service is the convenience factor. Typically, telemedicine services allow members to speak – or video conference – with a GP, no matter where they are and at a time that is convenient for them. There’s no need to travel to a surgery or try to squeeze an appointment into often restrictive practice hours. Medical advice from a fully qualified professional is simply available whenever the patient needs it. 

Quality 

One of the most significant barriers to patients embracing telemedicine, from our own research, is that many think it’s delivered by AI. ‘Chatbot doctors’ is a term that we come across much more often than we would like. When they experience our Virtual Doctor service from AXA though, patients are typically very impressed by the quality of the consultation, the amount of time the doctor gives them, the depth of questioning and richness of advice given. And, many compare it favourably with their face to face appointments. It’s important, as these kinds of services become more mainstream, that we raise awareness of how technology merely enables the consultation – it does not deliver it. 

Variety 

While the most common use for an online doctor might be to remotely consult a GP, there is actually a wide – and growing – range of different services that can be accessed remotely. Many counsellors and even physiotherapists, for example, are now offering remote sessions. Here at AXA – Global Healthcare, we are piloting a remote mental health service and, in the UK market, specialist consultations. These kinds of services offer a wide range of different benefits, from cutting down waiting times to opening up new forms of treatment to those who might otherwise struggle to access them. Our intention at AXA – Global Healthcare is certainly that, in the near future, we will be able to roll these kinds of additional options out much more broadly.  

Why not? 

The increasing availability of virtual doctor services means that, in many cases, it doesn’t make sense not to use them. Our own research* has found that it’s already being offered to a great many expats, particularly as a source of support for mental health. 80% of the HR decision makers that we spoke with in April this year told us that virtual support is an essential aspect of their organisation’s mental health support package, while a further 79% went so far as to say that they believe it is actually the future of mind-health support. Telemedicine, it seems, is here to stay. 

This has already been a trying time for healthcare services around the world, and there’s no doubt in my mind that, over the coming months, it will continue to be so. But this period has also been a fascinating test for online doctors. For some time now, the technology has been in place for patients to meet a wide range of their healthcare needs digitally, but necessity is only just prompting many of us to embrace it. The true test will be how many continue to use it after we have returned to ‘normal’, and the option is once again available to freely visit medical centres in person. 

Depending on how warmly these services continue to be received in the current climate, we might soon find that a digital approach to healthcare does, itself, become the new “normal.”  

iPMI Magazine's CEO, Christopher Knight, speaks with Mary-Jo McDonald, Managing Director for Europe at Global Excel Management. They discuss in detail how COVID-19 has affected the industry, life after lockdown and the impact on the travel industry for leisure, business and student travel markets.

Broadly speaking, can you tell us what steps Europe is taking towards life after lockdown?

We know that European countries’ response to this pandemic has varied in intensity – from closed borders to domestic travel restrictions. Overall, Europe is pulling together, and many countries are moving towards opening internal borders before the end of June. This first step will have a refreshing impact on travel, hospitality and education – a variety of industries will be operational. There will be limitations though, in this “new normal”, which we are gradually settling in to. Social distancing, protective face coverings and hand washing are already accepted at large in European society. Travel corridors or air-bridges are being considered, ground transportation will be permitted, and non-essential travel will be allowed.

We’re optimistic, as many clients and partners are preparing for this first step – continental Europe will be open for business very shortly. We remain realistic, knowing COVID-19 won’t disappear overnight. What we expect is that many Europeans will be asking questions and looking for reassurance, especially concerning their health as they travel, first within Europe and then abroad.

Has Global Excel seen a significant increase in assistance requests during this pandemic? What changed and how did you adapt to this unprecedented situation?

We have seen an increase in assistance requests, from business travellers having to modify schedules, expatriates worried about being able to keep their appointment with a physician, students needing to quickly access care and many wanting to speak with a practitioner in a “virtual” environment rather than face to face. One key concern was being able to respond within a reasonable amount of time. To do so, we quickly shifted to providing information, support and guidance online either via chat, text or email. This significantly reduced call wait-times while responding to requests. We prioritized different request-types – medical emergencies remain our top priorities. We also deployed a COVID-19-specific version of our digital health solution, StandbyMD. This is a self-serve virtual assistant which enables travellers to quickly self-assess their symptoms, then select the best care option. Responding with minimal down time, in several languages, across several time zones was a big challenge, but our team made it work, to the satisfaction of our clients and their members.

How has Global Excel Europe weathered this pandemic?

Early in February this year, we started reaching out to our clients with regular updates on measures we were taking as a response to developing situations. At that time, many countries reactions and directives were varied.

Our concern was two-fold: to ensure we could quickly respond to members returning to their homes – business travellers, tourists and students – but also to respond to medical emergencies and answer concerns while directing them to the best care available in their area. Our second priority was our own employee health, with over 95% of them working safely from home. Transferring our staff and ensuring our systems were up and running within only a few hours is a testament to our leadership’s agile planning and to the commitment of our team members. We were even able to outsource our services to other companies struggling with the sudden increase in volume and complexity.

As the gradual exit from lockdown is being coordinated, what should business and leisure travellers expect and how can they best prepare themselves?

As travel restrictions are loosening up across Europe, we expect that travellers in general will have to focus on low risk areas, seeking information from governments and using “travel bubbles/corridors”. This means additional wait times at airports for screenings and decontamination processes, with physical distancing and face coverings which will likely remain a requirement. Many vacation areas, educational institutions, restaurants and airports have already adapted to these new directives, as well as places of worship, offices and government buildings.

More than ever, we believe that travellers’ best protection is research – being aware of government advisories and looking closely at their travel and health policies, knowing and understanding the limitations, but also reaching out to travel experts to discuss options. An ounce of prevention is worth a pound of cure.

Has access to healthcare for students, travellers and others changed? If so, what are some must-haves going forward?

Polls across different countries indicate that many students and travellers have accessed healthcare using some form of digital solution. In some countries, telemedicine was used, and in other countries a mix of video, text and email communication to engage with physicians has been preferred.

We’ve seen a greater demand for our own digital health tool. Many members appreciate that they can self-serve and choose the type of care they prefer, wherever and whenever. Digital healthcare and choice will be key to responding to needs during a pandemic, but also during any cautious recovery period. These solutions ensure that physical distancing directives are met, minimizing infection risks while reducing wait times. The future is digital, and having a great solution that combines flexibility, personalized care and cashless billing options with worldwide coverage will be the new norm.

How can Global Excel help insurance and assistance companies and their members (business travellers, expats, students, etc)?

Global Excel combines four elements to ensure our clients and their members consistently benefit from the best available care options, no matter where they are: flexible, comprehensive healthcare solutions; world class costavoidance and cost-containment services; FastTrack, our cashless out-patient solution; fully customisable networks across Europe.

As a global enterprise, we can easily assist travellers, expats, international students and those seeking major medical treatment anywhere in the world: a unique, reliable and proven offering from your trusted partner – Global Excel.

Allianz Care reports up to 235% year-on-year increase in applications for international health insurance policies, and significant increases in demand for health and wellbeing advice and digital services-

Allianz Care has reported a significant increase in demand for international health insurance services since the beginning of the COVID-19 pandemic, with year-on-year sales of private individual/family policies up 235% in Germany, 100% in Singapore and 65% in the UAE. Allianz Care is the international health brand of Allianz Partners.

Some of the key uplifts in demand for health and wellbeing advice and digital health services include:

• 48% increase in web traffic to AllianzCare.com in March, with a further increase of 83% in April, with visitors keen to keep up to date with the latest information on the pandemic.
• 6,000 subscriptions to the Allianz Care channel on the BrightTALK platform, which has been used to broadcast webinars on COVID-19. This is up from an average of 380 subscribers before the pandemic. Almost 3,000 insured members attended one webinar alone with Dr. Ulrike Sucher, the company’s Chief Medical Officer for International Health, in which she outlined recommendations on steps they could take to protect themselves.
• Significant increase in demand for Allianz Care’s Employee Assistance Programme (EAP), with users looking for further information on financial advice, as well as seeking counselling services and advice on stress management.
• 257% increase in calls made to Allianz Care’s 24/7 medical advice line. The medical advice line is staffed by an experienced medical team that can address queries in real-time, including general medical advice and information regarding self-care. To provide further support, a COVID-19 digital symptom checker was added to the service, which has already been used by more than 46,000 customers to date.
• Year-on-year increase in sales of individual policies across almost all markets, most notably 235% in Germany, 100% in Singapore, 65% in the UAE, 62% in Italy, 57% in France and 48% in Spain.

Allianz Care has provided ongoing support to members throughout the COVID-19 emergency, confirming that customers contracting the virus are covered by their healthcare policies. It has also made temporary changes to its cover such as extending the period of cover for emergency medical treatment for those trapped outside their normal region of cover, from 6 weeks to 21 weeks.

Speaking about the surge in demand for support services and the action being taken to address it, Paula Covey, Chief Marketing Officer for International Health said: “The global emergency being experienced as a result of the COVID-19 pandemic is unprecedented in its impact on people and businesses. People are understandably worried, not only about their own health, but also about that of their families and loved ones. As well as the general uncertainty, there’s also increased concern stemming from the emotional and financial impact. It wasn’t a surprise that there’d be an increase in demand for support services and advice – whether through our EAP, 24/7 helpline, webinars or the website. However the scale of the demand did take us somewhat by surprise. We were particularly pleased with the strong levels of participation and engagement in the webinars.

 “The reaction to our COVID-19 digital symptom tracker also demonstrated just how much people want to address concerns from the safety of their own home, while some hospitals and clinical settings are either experiencing overcrowding or trying to mitigate it. While our medical advice line gives customers access to more than 120 health professional who can support them regardless of their location.

 “In response to the situations our customers are finding themselves in, through no fault of their own, we’ve temporarily changed some of the terms of our policies. We want to support people who are stuck outside their normal region of cover due to global travel restrictions. So our cover for medical emergencies outside the normal region of cover has been temporarily extended from 6 weeks to 21 weeks. When we say we care about our customers, emergency situations like this are where we really get a chance to prove that. It’s not an empty promise. We have to be there for our customers and from a business continuity point of view, we were already set-up for staff to work from home. So this has been a seamless transition and it’s very much business as usual.”

For more information about Allianz Care, visit: www.allianzcare.com and for the latest news about COVID-19, go to: https://www.allianzcare.com/en/about-us/news/2020/01/coronaviruses.html.

Global passenger traffic data for February 2020 showing that demand (measured in total revenue passenger kilometers or RPKs) fell 14.1% compared to February 2019.

This was the steepest decline in traffic since 9.11 and reflected collapsing domestic travel in China and sharply falling international demand to/from and within the Asia-Pacific region, owing to the spreading COVID-19 virus and government-imposed travel restrictions. February capacity (available seat kilometers or ASKs) fell 8.7% as airlines scrambled to trim capacity in line with plunging traffic, and load factor fell 4.8 percentage points to 75.9%.

“Airlines were hit by a sledgehammer called COVID-19 in February. Borders were closed in an effort to stop the spread of the virus. And the impact on aviation has left airlines with little to do except cut costs and take emergency measures in an attempt to survive in these extraordinary circumstances. The 14.1% global fall in demand is severe, but for carriers in Asia-Pacific the drop was 41%. And it has only grown worse. Without a doubt this is the biggest crisis that the industry has ever faced,” said Alexandre de Juniac, IATA’s Director General and CEO.

1-% of Industry RPKs in 2019 2-Year-on-year chnage in load factor 3-Load factor level

International Passenger Markets

February international passenger demand fell 10.1% compared to February 2019, the worst outcome since the 2003 SARS outbreak and a reversal from the 2.6% traffic increase recorded in January. Europe and Middle East were the only regions to see a year-over-year traffic rise. Capacity fell 5.0%, and load factor plunged 4.2 percentage points to 75.3%.

Asia-Pacific airlines’ February traffic plummeted 30.4% compared to the year-ago period, steeply reversing a 3.0% gain recorded in January. Capacity fell 16.9% and load factor collapsed to 67.9%, a 13.2-percentage point drop compared to February 2019.

European carriers’ February demand was virtually flat compared to a year ago (+0.2%), the region’s weakest performance in a decade. The slowdown was driven by routes to/from Asia, where the growth rate slowed by 25 percentage points in February, versus January. Demand  in markets within Europe performed solidly despite some initial flight suspensions on the routes to/from Italy. However, March data will reflect the impact of the spread of the virus across Europe and the related disruptions to travel. February capacity rose 0.7%, and load factor slipped 0.4 percentage point to 82.0%, which was the highest among regions.

Middle Eastern airlines posted a 1.6% traffic increase in February, a slowdown from the 5.3% year-over-year growth reported in January largely owing to a slowdown on Middle East-Asia-Pacific routes. Capacity increased by 1.3%, and load factor edged up 0.2 percentage point to 72.6%. 

North American carriers had a 2.8% traffic decline in February, reversing a 2.9% gain in January, as international entry restrictions hit home and volumes on Asia-North America routes plunged 30%. Capacity fell 1.5%, and load factor dropped 1.0 percentage point to 77.7%.

Latin American airlines experienced a 0.4% demand drop in February compared to the same month last year. This actually was an improvement over the 3.5% decline recorded in January. However, the spread of the virus and resulting travel restrictions will be reflected in March results. Capacity also fell 0.4% and load factor was flat compared to February 2019 at 81.3%.

African airlines’ traffic slipped 1.1% in February, versus a 5.6% traffic increase recorded in January and the weakest outcome since 2015. The decline was driven by around a 35% year-on-year traffic fall in the Africa-Asia market. Capacity rose 4.8%, however, and load factor sagged 3.9 percentage points to 65.7%, lowest among regions.

Domestic Passenger Markets

Demand for domestic travel dropped 20.9% in February compared to February 2019, as Chinese domestic market collapsed in the face of the government lockdown. Domestic capacity fell 15.1% and load factor dropped 5.6 percentage points to 77.0%.

1-% of Industry RPKs in 2019 2-Year-on-year chnage in load factor 3-Load factor level

Chinese airlines’ domestic traffic fell 83.6% in February, the worst outcome since IATA began tracking the market in 2000. With the easing of some restrictions on internal travel in March, domestic demand is showing some tentative signs of improvement.

US airlines enjoyed one of their strongest months in February, as domestic traffic jumped 10.1%. Demand fell  toward the end of the month, however, with the full impact of COVID-19 expected to show in March results.

The Bottom Line

“This is aviation’s darkest hour and it is difficult to see a sunrise ahead unless governments do more to support the industry through this unprecedented global crisis. We are grateful to those that have stepped up with relief measures, but many more need to do so. Our most recent analysis shows that airlines may burn through $61 billion of their cash reserves during the second quarter ending 30 June 2020. This includes $35 billion in sold-but-unused tickets as a result of massive flight cancellations owing to government-imposed travel restrictions. We welcome the actions of those regulators who have relaxed rules so as to permit airlines to issue travel vouchers in lieu of refunds for unused tickets; and we urge others to do the same. Air transport will play a much-needed role in supporting the inevitable recovery. But without additional government action today, the industry will not be in a position to help when skies are brighter tomorrow,” said de Juniac.

Governments in Africa and the Middle East need to provide financial relief to airlines as the latest IATA scenario for potential revenue loss by carriers in Africa and the Middle East reached US$23 billion (US$19 billion in the Middle East and US$4 billion in Africa).  This translates into a drop of industry revenues of 32% for Africa and 39% for the Middle East for 2020 as compared to 2019.

Some of the impacts at national level include:

Saudi Arabia

• 26.7 million fewer passengers resulting in a US$5.61billion revenue loss, risking 217,570 jobs and US$13.6 billion in contribution to Saudi Arabia’s economy

UAE

• 23.8 million fewer passengers resulting in a US$5.36 billion revenue loss, risking 287,863 jobs and US$17.7 billion in contribution to the UAE’s economy

Egypt

• 9.5 million fewer passengers resulting in a US$1.6 billion revenue loss, risking almost 205,560 jobs and around US$2.4 billion in contribution to the Egyptian economy

Qatar

• 3.6 million fewer passengers resulting in a US$1.32 billion revenue loss, risking 53,640 jobs and US$2.1billion in contribution to Qatar’s economy

Jordan

• 2.8 million fewer passengers resulting in a US$0.5 billion revenue loss, risking 26,400 jobs and US$0.8 billion in contribution to Jordan’s economy

South Africa

• 10.7 million fewer passengers resulting in a US$2.29 billion revenue loss, risking 186,850 jobs and US$3.8 billion in contribution to South Africa’s economy

Nigeria

• 3.5 million fewer passengers resulting in a US$ 0.76 billion revenue loss, risking 91,380 jobs and US$0.65 billion in contribution to Nigeria’s economy

Ethiopia

• 1.6 million fewer passengers resulting in a US$0.3billion revenue loss, risking 327,062 jobs and US$1.2 billion in contribution to Ethiopia’s economy

Kenya

• 2.5 million fewer passengers resulting in a US$ 0.54 billion revenue loss, risking 137,965 jobs and US$1.1 billion in contribution to Kenya’s economy

To minimize the broad damage that these losses would have across the African and Middle East economies, it is vital that governments step up their efforts to aid the industry. Many governments in the region have committed to provide relief from the effect of COVID-19. And some have already taken direct action to support aviation including the United Arab Emirates. But more help is needed. IATA is calling for a mixture of:

• direct financial support
• loans, loan guarantees and support for the corporate bond market
• tax relief

We are also starting to see several governments in the region providing some financial and tax reliefs, including deferral of aircraft lease payments by the government of Cabo Verde, extension of VAT refund payment dates in Saudi Arabia and positive considerations for financial relief from governments across the region including Jordan, Rwanda, Angola and the UAE.

“The air transport industry is an economic engine, supporting up to 8.6 million jobs across Africa and the Middle East and $186 billion in GDP. Every job created in the aviation industry supports another 24 jobs in the wider economy. Governments must recognize the vital importance of the air transport industry, and that support is urgently needed. Airlines are fighting for survival in every corner of the world. Travel restrictions and evaporating demand mean that, aside from cargo, there is almost no passenger business. Failure by Governments to act now will make this crisis longer and more painful. Airlines have demonstrated their value in economic and social development in Africa and the Middle East and governments need to prioritize them in rescue packages. Healthy airlines will be essential to jump-start the Middle East and global economies post-crisis,” said Muhammad Al Bakri, IATA’s Regional Vice President for Africa and the Middle East.

In addition to financial support, IATA called for regulators to support the industry. Key priorities in Africa and the Middle East include:

• Providing a package of measures to ensure air cargo operations, including fast track procedures to obtain overflight and landing permits, exempting flight crew members from 14-day quarantine, and removing economic impediments (overflight charges, parking fees, and slot restrictions).
• Providing financial relief on Airport and Air Traffic Control (ATC) Charges and Taxes
• Ensuring aeronautical information is published, timely, accurately, and without ambiguity, ensuring the airlines can plan and execute their flights

“Some regulators are taking positive action. We are grateful to the Ghana, Morocco, the UAE, Saudi Arabic and South Africa for agreeing a full-season waiver to the slot use rule. This will enable airlines and airports greater flexibility for this season and greater certainty for summer.  But there is more to do on the regulatory front. Governments need to recognize that we are in a crisis,” said Al Bakri.

Latest impact estimates, selected Africa, Middle East countries