Welcome to Pandemic Stories, a living history about the deadliest pandemic outbreak of the last century.
In today’s edition, we talk with a writer in West Virginia struggling with illness and health insurance as well as a guy in Germany working in an empty international airport (which does come with its perks).
If you have a story you want to share, email me at JordanZakarin@gmail.com.
The Health Insurance Loophole
The Person: Anna Davis Abel
The Place: Frankfurt, Germany
Anna Davis Abel was incredibly frustrated, and it was hard to blame her.
A writer and English instructor in West Virginia, Anna has the autoimmune disease lupus. She treats the illness with immunosuppressants, and before the coronavirus outbreak, she switched to Plaquenil, a brand name drug that is now better known by its generic name: hydroxychloroquine.
Until last month, it was never particularly hard to get hydroxychloroquine — it’s largely used to treat malaria — but then President Trump created a sudden stampede for the drug with a single tweet. There are now shortages nationwide, as doctors, dentists, and anyone with access to a prescription pad have been hoarding the stuff, and while Anna is safe for now thanks to a 90-day supply, any long-term supply chain issues could be devastating.
But that’s not even why she was frustrated. Here’s that story:
About a month ago, at the beginning of March, Anna went to a conference in San Antonio, a trip blessed by her rheumatologist given her recent good health and the effectiveness of her now-endangered medication.
Long story short, Anna got sick on that trip to San Antonio. Very sick, with a fever that ultimately peaked at 103. Early on, the COVID-19 hotline told her not to get tested, which her doctor eventually overruled given her condition.
“She expressed that my symptoms could fit any number of illnesses including COVID-19 and that despite what the nurse on the hotline had said, I could reasonably have started showing symptoms within three days of traveling,” Anna told me over email early this afternoon. “She wanted to test me for COVID but unfortunately, the hospital she worked at (the only research hospital in the state) had been given no COVID-19 tests. In order for me to receive one, my doctor would have to call the state capital and request one. In order to request one, she had to first show she had ruled out all other viral possibilities. So, she ordered the BioFire panel.”
A BioFire panel tests for all kinds of infectious diseases, which is where things really went awry. Basically, the test was the first part of a process of elimination that she was required to run through given the very limited supply of COVID-19 tests. Remember this part: Because her doctor had to use the BioFire panel in order to get the COVID-19 test, they couldn’t use COVID-19 as a specific diagnosis code on the lab work.
As Anna puts it, “it would be like submitting a diagnosis of ‘broken foot’ for a flu swab.” Her doctor instead wrote down “respiratory infection” and performed the test.
The test results diagnosed Anna with Influenza B, even though she’d received a flu shot. Given how long it took to get the test, Anna had to sweat it out for over a week, with a fever peaking at 103. Even more frustrating? Her insurer, Aetna, refused to pay for the test itself, despite the fact that it very publicly promised to cover COVID-19-related tests.
Instead, Aetna stuck her with a bill for $537.
“Aetna argues that it will only cover the cost of diagnostic testing ‘coded’ for COVID-19, but again, you cannot ‘code’ for COVID-19 on the BioFire test,” she says. “My doctor wrote this in red on my progress note from the visit, but Aetna claims it cannot take written notes into account and must abide by the diagnosis codes.”
She fought with them for weeks, to no avail.
“Aetna, if you’ll excuse the French, were being fucking assholes,” Anna says.
“They invited me to print a 24-page document explaining my argument for why it should be covered and mail it to their appeals office, who would then respond via the mail in 30-60 days with their decision,” she explains. “When I asked if I could complete it online, they said no. They are also not required by law to tell me when they’ve received the appeal so I won’t even know if it makes it to them until I call again or until they send me their response.”
This isn’t some isolated incident or fluke in an otherwise functioning system. Anna knows that very intimately. The $537 owed to Aetna was in addition to the $3000 in medical debt still on the books from a surgery she underwent last June; half of her annual income last year, Anna says, went to medical bills.
There is a slightly happy ending, though: After explaining what was going on on Twitter, two people reached out to Anna and offered to help her with her bills. There’s still plenty of debt, and the fight with Aetna goes on, but it’s a start.
Grounded in Frankfurt
Joseph Knitt is an American who has been living in Germany for the last decade. For the past year and a half, he’s had a job at Frankfurt am Main Airport, one of the busiest air hubs in Europe, where he works as an assistant at various information desks scattered throughout the massive building.
Like nearly every other airport in Europe and North America, Frankfurt has seen a dramatic decline in plane traffic, owing to canceled flights and global quarantines. On March 23rd, his department shut down each of its information desks and began working from back offices, interfacing with dwindling numbers of customers via video conference kiosks located in international transit areas beyond border control.
Instead of 15 work stations, there are just six in rotation, and his department’s 60 employees are each scheduled to work just six days in April.
The place, he says, has become a ghost town.
“March 1st had about 750 inbound flights and April 1st had about 125,” he says. “Current daily passenger counts are between 10,000 and 20,000 inbound and outbound passengers combined. It should be like 150,000 to 2000,000. In fact, they've shut down one of the four runways and are using it as a parking lot for airplanes not in service.
Some flights that do land offer little to do; the data on one Air China plane landing from Beijing had zero passengers aboard and was instead loaded with freight.
Because video requires more effort, the passengers that do contact him usually have more pressing questions… and far less embarrassing ones.
“It also means I don't have to interact with my least favorite guests,” Joseph says, “the middle-aged white guys trying to figure out why their ‘girlfriend’ hasn't come out of baggage claim from her flight from Bangkok or Moscow or Belgrade.”