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April 28, 2020
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COVID-19 could cost US health care system $654B, model shows

Eighty percent of the United States population becoming infected with COVID-19 may result in approximately $654 billion in direct costs over the course of the pandemic, according to a Monte Carlo simulation model published in Health Affairs.

The same percentage of infected patients could result in a median of 44.6 million hospitalizations, 10.7 million ICU admissions, 6.5 million ventilators used and 249.5 million hospital bed days.

In other scenarios, the model showed that:

  • One single symptomatic COVID-19 infection in the U.S. could lead to a median of $3,045 in direct medical costs during the course of the infection, which is four times higher than a symptomatic influenza case and more than five times higher than a symptomatic pertussis case.
  • One-fifth of the U.S. population becoming infected could result in a median of 11.2 million hospitalizations, 62.3 million hospital bed days and 1.6 million ventilators used, costing $163.4 billion. The Society of Critical Care Medicine estimates that the U.S. does not have enough beds and ventilators to meet that demand.
  • Half of the U.S. population becoming infected could lead to a median of $408.8 billion in direct medical costs during the course of the infection.

The model also showed that COVID-19 costs start to drop in patients aged older than 65 years, and patients aged 85 years and older also have a lower probability of ICU admission and lower ICU hospitalization costs than those aged 45 to 64 years. Researchers wrote that in these scenarios, this was likely due to older patients historically having shorter hospital stays and therefore, lower hospitalization costs. However, they also pointed out that they used existing data for hospitalization costs that may not be applicable to COVID-19 cases.

Referene: Bartsch SM, et al. Health Aff. 2020;doi:10.1377/hlthaff.2020.00426.

Some have suggested that if enough people become infected and herd immunity thresholds are met, the virus can no longer spread. However, one of the researchers — Sarah Bartsch, MPH, project director at the Public Health Informatics, Computational and Operations Research (PHICOR) team at the City University of New York Graduate School of Public Health and Health Policy — said in a press release that the model’s findings show that herd immunity strategies to mitigate COVID-19 could have a “tremendous cost.”

Bruce Y. Lee, MD, MBA, executive director of PHICOR, said the findings show what can happen if social distancing measures were relaxed and the country was to reopen too early.

"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. “Such costs will affect the economy as well because someone will have to pay for them. Any economic argument for reopening the country needs to factor in health care costs." – by Janel Miller

Disclosures: Healio Primary Care could not confirm relevant financial disclosures at the time of publication.