Research from the City University of New York (CUNY) School of Public Health (SPH) has found that if the majority of Americans were diagnosed with the coronavirus disease 2019 (COVID-19), the total cost of hospitalizations, ventilators, and other resources could cost $654 billion.

Although the economic costs have been a major concern since the beginning of the pandemic, the new research found that direct medical expenses alone could cost hundreds of billions of dollars while requiring resources beyond what is currently available.

Using a computer simulation model of the entire US population, the investigators simulated the outcomes if different proportions of the population ended up getting infected with COVID-19. In the model, every infected person would develop various symptoms over time and would visit clinics, emergency departments, or hospitals depending on the severity of those symptoms. The health status of the patients would also affect which resources they would require, including health care personnel time, medication, hospital beds, and ventilators. After playing out each model, the system then tracks the resources involved, the associated costs, and the outcomes for each patient.

In one model, if 20% of the US population were diagnosed, it was found that there would be a median of 11.2 million hospitalizations and 1.6 million ventilators used, costing a median of $163.4 billion in direct medical costs. Furthermore, including direct medical costs for a year after hospital discharge increased the median cost to $214.5 billion.

If 50% of the population were to become infected, there would be 27.9 million hospitalizations, 4.1 million ventilators used, and 156.2 million hospital bed days accrued, costing a median of $408.8 billion in direct medical costs, according to the model.

If 80% of the US population were infected with COVID-19, there would be 44.6 million hospitalizations, 6.5 million ventilators used, and 249.5 million hospital bed days accrued. In total, it would cost a median of $654 billion during the course of the infection., according to the model.

The significant differences in total costs emphasize the importance of various strategies to reduce infections, according to the study authors. Conversely, they added that the data also point to the potential cost of letting the virus run its course.

“This also shows what may occur if social distancing measures were relaxed and the country were to be ‘re-opened’ too early,” said Bruce Y. Lee, MD, MBA, senior author of the study, in a statement. “If the virus is still circulating and the infection rates surge as a result, we have to consider the resulting health care costs. Such costs will affect the economy as well because someone will have to pay for them. Any economic argument for re-opening the country needs to factor in health care costs.”

The investigators also compared the cost of the COVID-19 virus with other common infectious diseases. A single symptomatic COVID-19 infection costs a median of $3045 in direct medical costs, which is 4 times higher than a symptomatic influenza case and 5.5 times higher than a symptomatic pertussis case.

“Factoring in the costs incurred after the infection is over also adds to the costs. It is important to remember that for a proportion of the people who get infected, health care costs don’t end when the active infection ends,” Lee said. “This pandemic will have its lasting effects and taking care of those who will suffer continuing problems is one of them.”

REFERENCE
The COVID-19 coronavirus could cost the US billions in medical expenses [news release]. City University of New York School of Public Health; April 23, 2020. https://sph.cuny.edu/2020/04/23/covid-19-model/. Accessed April 29, 2020.