Pandemic air travel just hit its biggest week, according to TSA data


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More than 500 people in the United Kingdom were put on “do not resuscitate” orders without their consent or their carers’ consent during the coronavirus pandemic, a study released by the country’s Care Quality Commission (CQC) reported Thursday.

“From the beginning of the COVID-19 pandemic, there were concerns that ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions were being made without involving people, or their families and/or carers if so wished, and were being applied to groups of people, rather than taking into account each person’s individual circumstances,” according to the study from the independent regulator of health and social care in England.

Out of 2,048 adult social care providers who responded to the CQC’s information request, 5.2% (508 out of 9,679) of DNACPR decisions put in place since March 17, 2020 “had not been agreed in discussion with the person, their relative or carer,” the study said.

The report includes at least one case study of a man whose death may have involved an involuntary order not to resuscitate. 

“Jim, who was in his 80s, was taken to hospital at the beginning of the pandemic after becoming unwell with a chest infection. Jim, who still worked, had normally been fit, well and active and went out most weeks in his car to visit friends or go to the cinema,” the report said.
“About 12 hours after being admitted to hospital Jim called [his daughter] Melanie. He was upset and confused, and told her he had signed away his life and was going to die. He told her that a doctor had put an order in place that they wouldn’t restart his heart if it stopped. He was upset that he had agreed to it because he didn’t want to die.”
The daughter told the commission she had tried to speak to medical and nursing staff about the decision. 
“Because Jim was able to make decisions about his care, no one had discussed the decision with her,” she said, according to the report. “However, she was concerned that her dad was vulnerable because he was ill, likely to be confused as he had a bad infection, and he was all alone. She felt he would have just gone with what they told him.”
“Jim died while in hospital,” the report said.

The report is a result of a request from the Department of Health and Social Care to the CQC to conduct a “rapid review of how DNACPR decisions were used during the coronavirus pandemic, building on concerns that they were being inappropriately applied to groups of people without their knowledge.”

“It is unacceptable for any DNACPR decisions to be made without proper conversations with the individual, or an appropriate representative, taking into account their wishes and needs,” the report said. 

An interim report from the CQC in November 2020 revealed “a combination of unprecedented pressure on care providers and rapidly developing guidance may have led to decisions concerning DNACPR being incorrectly conflated with other clinical assessments around critical care,” CQC said. 

Despite positive feedback from most care providers, CQC revealed some concerns regarding the use of “blanket” DNACPR decisions proposed at a local level. 

“Across the review process, whilst inspectors did find some examples of good practice, they also found a worrying picture of poor involvement of people using services, poor record keeping, and a lack of oversight and scrutiny of the decisions being made,” the study said.

The CQC called for government action to address a “worrying variation” in people’s experiences of DNACPR decisions and “to take responsibility for delivering improvements in this vital and sensitive area.”

The CQC’s goal with the plea to ministers is to have a bigger focus on “information, training and support,” as well as a “consistent national approach to advance care planning” and “improved oversight and assurance,” it said.

Correction: A previous version of this post incorrectly stated the date the CQC interim report was released.



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US air travel rises to highest levels yet since pandemic hit


The number of people flying in the United States has eclipsed the year-ago level for the first time in the pandemic period, although travel remains deeply depressed from 2019.

The Transportation Security Administration said 1.34 million people passed through U.S. airport checkpoints on Sunday, topping the 1.26 million people that TSA screened on the comparable Sunday a year ago.

It marked the fourth straight day that TSA saw more than 1 million people pass through its checkpoints. That has not happened since March 2020, when travel was collapsing as the number of COVID-19 cases in the U.S. grew rapidly and governments enacted more travel restrictions to curb the spread of the virus.

However, Sunday’s screenings were still 45% lower than on the comparable day in 2019, and screenings in March are running 53% lower than the same period two years ago.

Several airlines report that after dismal sales in January and February, more people have bought tickets to travel in spring or summer as infection rates decline and more people get vaccinated against COVID-19.


Delta Air Lines CEO Ed Bastian said Monday that bookings began picking up five or six weeks ago.

Since the pandemic hit, air travel has picked up a few times — mostly around holidays — only to drop back down. This time, the recovery “seems like it’s real,” Bastian said on a J.P. Morgan investor conference.

Airline stocks rose in morning trading. American Airlines rose nearly 9%, United Airlines was up more than 6%, Delta gained more than 3% and Southwest Airlines added 1%.



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Newsroom – Travel Alert: Winter Storm To Hit Colorado Stations


American is closely monitoring the winter storm currently expected to bring heavy snow and strong winds through several Colorado cities. The safety of our customers and team members is the airline’s No. 1 priority, and the team will remain in contact with those impacted by this harsh winter storm.

Earlier this week, American issued a travel alert for nine stations in Colorado, allowing customers whose travel plans are impacted by this storm to rebook without change fees. Customers can reschedule their travel on aa.com or by contacting Reservations at 800-433-7300 in the U.S. or Canada. If a customer chooses not to fly to/from an airport covered by the current waiver, American will waive change fees for future travel. Customers are also encouraged to check the status of their flight on aa.com.

If an American flight has been canceled or excessively delayed, customers may cancel their itinerary and request a refund by visiting our website. Customers who booked through a travel agent should contact their travel agency directly.

About American Airlines Group
American’s purpose is to care for people on life’s journey. Shares of American Airlines Group Inc. trade on Nasdaq under the ticker symbol AAL and the company’s stock is included in the S&P 500. Learn more about what’s happening at American by visiting news.aa.com and connect with American on Twitter @AmericanAir and at Facebook.com/AmericanAirlines.





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In North America, Big Markets Presaged Covid’s Hit on Corporate Travel


US Column Charts

Though it wasn’t until mid-March 2020 that Covid-19 fully took hold in North America, corporate travel spending in the region’s major metro areas felt foreshocks of the pandemic earlier in the year, with pricing levels in key U.S. markets plummeting during the first quarter as businesses halted travel to those areas—even as the virus remained largely limited to Asia and Europe.

Canaries in the Coal Mine

Average hotel rates of were down sharply in the first quarter of 2020 in markets such as Boston, Chicago and Philadelphia, all of which saw prices drop by between 15 and 19 percent compared to the final quarter of 2019. New York’s hotel sector was even harder hit, experiencing a 35 percent pricing plummet over the same period. 

Given those cities’ status as major business travel destinations—as well as initial infection “hot zones” during the first stages of the virus’ arrival in North America—it’s little surprise they served as canaries in the proverbial coal mine, foreshadowing further pricing collapses throughout the region as the virus spread. 

Sure enough, additional North American markets were soon to follow as the true scale of the pandemic set in, with nearly every other significant U.S. and Canadian metro area seeing a double-digit hotel pricing decline during the second quarter of 2020. 

In particular, smaller markets that had escaped Q1 pricing pain suffered from devastating delayed effects in the second quarter. For example, Anaheim—which had actually seen hotel prices inch up 4 percent during the first quarter—came crashing back to earth with a 48 percent drop in Q2. A similar pattern took hold in Austin, Phoenix and several Florida markets—all of which were buoyed in Q1 by higher winter pricing rates—as well as Albany, Columbus, Ottawa and White Plains, among many others. Meanwhile, the major cities that had taken the brunt of the demand shock in the early phases of the pandemic were largely spared further significant damage in the second quarter. 

For the remainder of 2020, hotel pricing remained drastically depressed across North America as corporate travel remained at a standstill. 

On the other hand, car rental rates proved quite resilient despite the pandemic, with supply limitations and increased demand from leisure travelers wary of flying amid the pandemic among the factors shoring up price stability in that sector throughout 2020, observers noted. 

“Car rental volumes declined, but to a much smaller extent than air,” said David Reimer, executive vice president, global clients and general manager for the Americas, for American Express Global Business Travel. “Corporates and travelers alike view cars as a relatively safe transportation option that limits exposure and offers greater privacy than other modes.”

But overall, the downward effect of Covid-19 on business travel spending in North America was massive. In its 2021 BTI Outlook report, the Global Business Travel Association calculated a 60 percent year-over-year decline in North American corporate travel spend in 2020—the biggest drop of any region, outpacing Western Europe’s 58 percent downturn. The figures are even more startling when considering only the final three quarters of the year; from April 1 through year’s end, corporate travel spending in North America plummeted by nearly 80 percent, according to the GBTA.

Data from the American Hotel & Lodging Association offers a more granular view of the degree to which the pandemic halted corporate travel. In a January 2021 survey commissioned by the hospitality industry group, 62 percent of U.S. business travelers polled reported taking an average of more than four business trips per year pre-Covid. In 2020, that number dropped sharply, to 27 percent. Further, 73 percent reported taking fewer than three business trips—and 26 percent took no trips at all—in 2020, even when including the first quarter, before the outbreak officially had reached North America. 

As the AH&LA’s recent State of the Hotel Industry report starkly put it, U.S. business travel “essentially ceased” in 2020.

Cost(ly) Consistency 

Amid the unprecedented industry upheaval, there was at least one area of normalcy in corporate travel for 2020: perennially expensive markets remained that way. Of the 15 cities with the highest per diem cost of combined hotel, rental car and meal expenses in 2019, nine ranked in the Top 15, according to 2020 data as well. 

Despite the steep first-quarter hotel pricing drop-off in New York, the Big Apple ranked as the most expensive city in North America for the year—albeit at a per diem $120 lower than in 2019, when it ranked third. San Francisco, which occupied 2019’s top spot, fell to third in 2020, due largely to a nearly $165 year-over-year plummet in average nightly hotel cost—a decline even steeper than New York’s. 

Meanwhile, Santa Barbara moved up from eighth in 2019 to rank second on 2020’s list, propelled by resilient hotel pricing, along with upticks in car rental and meal prices which combined to actually increase the city’s per diem average by about $14. The only other markets in 2020’s Top 15 where the average per diem rose last year were Phoenix, Sacramento and Providence. 

Uneven Recovery

While the year 2020 drew to a close amid resurgent infection rates and troubling news of more contagious viral variants, there was plenty of cause for optimism as well—most notably, the rollout of long-awaited Covid-19 vaccines. 

But corporate travel’s recovery is projected to be a slow process, and the vaccine is just one of the key steps necessary for the industry to get back to full health, observers note. Border entry restrictions, changing supply dynamics and—perhaps most critically—corporate and traveler confidence remain among the critical challenges still to be navigated. 

“In alignment with the current travel restrictions landscape, the trend for corporate demand in North America is predominantly domestic with very little international travel,” said American Express GBT’s Reimer. “We see most clients continue to have a business-critical-only travel policy and with senior-level management approval required,” he added.

Among corporate verticals leading way in getting back onto the roads and skies are healthcare, education, natural resources and transportation, with the SME segment “recovering a little faster” than large corporates, according to Reimer—and that uneven recovery has led to a change in demand patterns, he said. 

“For domestic flights, airlines have trimmed capacity significantly on traditional heavy corporate markets like New York, Chicago and Boston, which have struggled with the slow recovery of financial services and professional services,” Reimer said. “By comparison, airlines are shifting aircraft and seats to non-traditional corporate markets.”

Carriers have shrunk capacity on traditional mainstay routes like Boston to New York and Chicago to New York by as much as 90 percent year-over-year during the first quarter of 2021, with routes to and from secondary markets gaining share, Reimer noted. 

“Who would have imagined that Chicago to Louisville and Louisville to Philadelphia would be among the Top 15 corporate markets right now, as certain industry verticals like transportation, education and health are recovering faster than others?” said Reimer. 

In the face of demand shifts, hotel suppliers are taking a wait-and-see approach to pricing strategies, Reimer noted. The increased demand from corporate travel buyers for dual-rate-load models, with a fixed and dynamic pricing in place for each property—has resulted in significant reduction in booked rates, he noted.

“Nearly 90 percent of GBT customers employed the dual-rate-load model for the 2021 contract year, Reimer said. “And given the process efficiencies of this new approach coupled with the continuing uncertainty in corporate travel demand, we expect customers to demand the same or similar approach in 2021 for the 2022 contract year.”

And it’s not just pricing models. Corporates are re-evaluating nearly every other aspect of travel spending as well—including overall budgets. In a fall 2020 study by Flight Centre Travel Management, T&E was the most commonly cited area of planned cost reduction for 2021.

Meanwhile, the drastically increased emphasis on corporate duty-of-care responsibilities post-Covid will lead to further scrutiny on the cost-benefit analysis of any given trip, many observers predict—thereby putting further downward pressure on travel spending. 

Long Term Prognosis

With significant progress on vaccine rollouts across North America and globally, sentiment is on the rise that travel will begin to resume in earnest in 2021. Among frequent U.S.-based business travelers polled in the AH&LA study, 29 percent expected their first business conference in the first half of 2021, while 36 percent anticipated that the second half of the year. 

But a full recovery to pre-Covid corporate travel level remains years away—and may never return at all in North America. GBTA projects the region to feel the lingering effects of the pandemic on business travel spending longer than any other, with a projected 5.7 percent decline in North American spending through 2024, outpacing Western Europe’s 4.3 percent drop over the same period. 

Along with continued vaccine progress, public and economic policy decisions made by the newly installed Biden administration will play a critical role in spurring corporate travel’s recovery in North America and beyond. 

The GBTA report cited the liberal trade and immigration policies expected to be pursued under Biden as key drivers of increased business travel activity. The industry group also stressed the importance of implementing a cohesive public strategy to instill in businesses and their employees the confidence necessary to resume travel. 

GBT’s Reimer echoed the importance of concerted, cooperative private-public sector action. 

“The Biden administration and governments around the world must work with each other, airlines, airports and TMCs to find solutions to safely open up the international trade routes that are so critical to global recovery.”



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CDC Announces Travel Restrictions For Countries Hit By Ebola


Passengers to the U.S. arriving from Guinea and the Democratic Republic of Congo will be sent to six airports so the CDC can track them. News is also from Canada, China and elsewhere.


The Hill:
CDC To Impose Travel Measures For Ebola-Hit Countries 


The Centers for Disease Control and Prevention (CDC) on Friday announced new travel measures for those coming to the United States from countries that have been hit with an Ebola outbreak. Starting next week, passengers traveling from Guinea and the Democratic Republic of the Congo will be redirected to six U.S. airports so the CDC can track and follow up with them.“ Airlines will collect and transmit passenger information to CDC for public health follow-up and intervention for all passengers boarding a flight to the U.S. who were in DRC or Guinea within the previous 21 days,” the announcement states. (Lonas, 2/27)

In other global developments —


AP:
Canadian Regulator Authorizes AstraZeneca Vaccine


Canadian regulators on Friday authorized AstraZeneca’s coronavirus vaccine for all adults. It is the third COVID-19 vaccine given the green light by Canada, following those from Pfizer and Moderna. “This is very encouraging news. It means more people vaccinated, and sooner,” Prime Minister Justin Trudeau said, adding that the nation of 38 million people will now get 6.5 million vaccines in total before the end of March, 500,000 more now with the new approval. (Gillies, 2/26)


Reuters:
China To Provide Afghanistan With 400,000 Doses Of COVID-19 Vaccine 


China has pledged to deliver 400,000 doses of Sinopharm’s COVID-19 vaccine to Afghanistan, Afghan officials said on Monday, in a boost for an immunisation campaign begun last week. “China’s ambassador to Kabul said in a meeting with health officials that his country would provide Afghanistan with 400,000 doses of COVID-19 vaccine,” Ghulam Dastagir Nazari, the health ministry’s head of the immunisation programme, told Reuters. (Sediqi, 3/1)


CIDRAP:
Zika Roadmap Outlines Steps Toward Diagnostics, Treatment, Vaccines 


Currently, there is no treatment or preventive vaccine for Zika virus infection, but as the disease’s prevalence has faded, so has global concern. To spur the development of Zika medical countermeasures (MCMs), the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), the University of Texas Medical Branch (UTMB), a task force of experts, and the World Health Organization (WHO) have created the “Zika Virus (ZIKV) Research and Development (R&D) Roadmap,” a 10-year framework for optimizing research, diagnostics, therapeutics, and vaccines. In the roadmap, experts outline 14 strategic goals, such as ensuring research tools are available, identifying funding sources, supporting novel therapies, and promoting vaccine development. (mClERNON, 2/26)


This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.



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CDC announces travel restrictions for countries hit by Ebola


Next week, the US government will start directing travelers from Guinea and the Democratic Republic of Congo to six US airports, according to the CDC. Airlines will collect information from all passengers boarding flights to the US who were in either country within the previous 21 days, and share the data with the CDC and local health departments for monitoring purposes.

Countries in West Africa on high alert after Ebola outbreak in Guinea

The measures come as the US and other nations grapple with the Covid-19 pandemic, with increasing concern that variants could send rates spiking once again. It also follows two previous outbreaks of Ebola in Africa that began in 2014 and 2018, resulting in the deaths of thousands.

During the 2014 outbreak, similar travel precautions were applied. Passengers arriving at designated airports to the US from Guinea, Liberia and Sierra Leone — the hardest-hit nations during the outbreak — had their temperature taken and were asked questions about whether they had been exposed to anyone with Ebola.

The CDC noted that this year’s outbreaks are in remote areas and the risk to the US is extremely low. The agency said the travel restrictions are being implemented out of an abundance of caution.

As of Thursday, the World Health Organization said there were nine Ebola cases and five deaths reported in Guinea, and eight cases and four deaths reported in the Democratic Republic of Congo.

Guinea declared an Ebola outbreak in one of its regions earlier this month, days after the Democratic Republic of Congo declared its 12th outbreak in its history.

The Red Cross said in a statement that a network of more than 700 trained volunteers has been “activated as part of a first wave of response and the government has called on people to respect hygiene and prevention measures and to report signs of the disease to health authorities.” The World Health Organization has helped control the recent outbreak in the Democratic Republic of Congo with vaccines and is helping to procure doses for Guinea.



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CDC announces travel restrictions for countries hit by Ebola


Travel precautions will be imposed for individuals coming to the US from Guinea and the Democratic Republic of Congo — two countries fighting recent outbreaks of the Ebola virus, the US Centers for Disease Control and Prevention announced Friday.

Next week, the US government will start directing travelers from Guinea and the Democratic Republic of Congo to six US airports, according to the CDC. Airlines will collect information from all passengers boarding flights to the US who were in either country within the previous 21 days, and share the data with the CDC and local health departments for monitoring purposes.

The measures come as the US and other nations grapple with the Covid-19 pandemic, with increasing concern that variants could send rates spiking once again. It also follows two previous outbreaks of Ebola in Africa that began in 2014 and 2018, resulting in the deaths of thousands.

During the 2014 outbreak, similar travel precautions were applied. Passengers arriving at designated airports to the US from Guinea, Liberia and Sierra Leone — the hardest-hit nations during the outbreak — had their temperature taken and were asked questions about whether they had been exposed to anyone with Ebola.

The CDC noted that this year’s outbreaks are in remote areas and the risk to the US is extremely low. The agency said the travel restrictions are being implemented out of an abundance of caution.

As of Thursday, the World Health Organization said there were nine Ebola cases and five deaths reported in Guinea, and eight cases and four deaths reported in the Democratic Republic of Congo.

Guinea declared an Ebola outbreak in one of its regions earlier this month, days after the Democratic Republic of Congo declared its 12th outbreak in its history.

The Red Cross said in a statement that a network of more than 700 trained volunteers has been “activated as part of a first wave of response and the government has called on people to respect hygiene and prevention measures and to report signs of the disease to health authorities.” The World Health Organization has helped control the recent outbreak in the Democratic Republic of Congo with vaccines and is helping to procure doses for Guinea.



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