Study: Health Care Costs Could Soar if COVID-19 Infections Grow

Bruce Y. Lee, MD, MBA

Most of the discussion of the economic impact of coronavirus disease 2019 (COVID-19) has centered on the impacts of shutting down large portions of the economy, but a new study shows the disease itself will have tremendous direct costs to the United States’ health care system.

The report, published in Health Affairs, finds that hundreds of billions of dollars will need to be spent on health care, therapies, and medical equipment for people who contract SARS-CoV-2. However, the precise amount of money spent could triple depending on how many people end up getting the disease. The economic modeling was conducted by the City University of New York’s School of Public Health and Health Policy, along with the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center and Torrance Memorial Medical Center.

The study shows that if 20% of Americans eventually become infected, the cost of health care for those patients would total upwards of $214.5 billion. Those costs would include 13.4 million hospitalizations and the use of 2.3 million ventilators. However, if half of Americans became infected, the costs could soar to $408.8 billion, with nearly 28 million hospitalizations and 4.1 million ventilators in use.

At the highest end of the spectrum—if 80% of Americans got the virus—the US health care system would face costs of around $654 billion, the study found, including 44.6 million hospitalizations, 6.5 ventilators used, and 249.5 million hospital bed days.

Bruce Y. Lee, MD, MBA, the study’s senior author and the executive director of CUNY’s Public Health Informatics, Computational, and Operations Research (PHICOR) team, said the numbers offer a stark warning of the importance of careful planning as states and localities begin to relax mitigation efforts.

“If the virus is still circulating and the infection rates surge as a result, we have to consider the resulting health care costs,” he said, in a press release. “Such costs will affect the economy as well, because someone will have to pay for them. Any economic argument for opening the country needs to factor in health care costs.”

Lead author Sarah M. Bartsch, MPH, project director at PHICOR, said the study also casts doubt on notions that it might be helpful to allow people to get infected until a “herd immunity” threshold is reached.

“[O]ur study shows that such strategies could come at a tremendous cost,” she said, in the press release.

Accordinging to the Society of Critical Care Medicine, the US has 62,000 full-featured mechanical ventilators. Bartsch said the extent to which those and other resources are sufficient will depend on the number and severity of cases at any single point in time.

“But showing that there are orders of magnitude differences between what is currently available and what may be needed is concerning,” she said.

Lee said public health officials also must think about the long-term impacts of the virus, since he said it is likely that many people who fall ill during the pandemic will continue to have lingering effects from the disease.

“This pandemic will have its lasting effects and taking care of those who will suffer continuing problems is one of them,” he said.