by John R. Fischer
, Senior Reporter | April 28, 2020
If 80 percent of the U.S. population gets infected with the novel coronavirus, researchers at the City University of New York (CUNY) Graduate School of Public Health and Health Policy estimate that medical expenses will reach about $654 billion.
“Our study shows the direct medical costs that may result from allowing larger and larger percentages of the population to get infected and thus some of the major costs of ‘herd immunity’ strategies or premature opening of businesses, schools, and other locations that would allow more people to get infected,” Dr. Bruce Lee, professor of health policy and management at CUNY School of Public Health, told HCB News.
Using a computer simulation model of the entire U.S. to simulate different infection rates by population size, the authors tracked costs, resources and outcomes for each scenario, taking into account the different symptoms for each infected person over time, the number of patients that would require hospitalization, and resources such as healthcare personnel time, medication, hospital beds and ventilators depending on the health status of each patient.
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They found that an average 11.2 million hospitalizations and 1.6 ventilators would be used should 20% of the population become infected, costing an average of $164.4 billion in direct medical costs during the infection. Should 50% fall ill, the price would rise to $408.8 billion, with 27.9 hospitalizations, 4.1 million ventilators and 156.2 million hospital bed days acquired. In the scenario where 80% were infected, the average price would be $654 billion with 44.5 million hospitalizations, 6.5 million ventilators and 249.5 million hospital bed days in the general ward and ICU combined.
A single case of symptomatic COVID-19 costs an average of $3,045 in direct medical costs for the infection alone, four times that of a symptomatic influenza case and 5.5 times higher than a symptomatic case of pertussis. The cost rises to $3,994 when factoring in expenses for longer-lasting effects, such as damage to the lungs and other organs, and others after the pandemic ends.
Some experts suggest herd immunity strategies to quell the pandemic, in which people would be allowed to become infected until herd immunity thresholds are met and the spread of the virus ends. Such a tactic, however, is discouraged in the study due to the tremendous cost associated with it and the impact it would have on the economy.
Another concern is the insufficient amount of person-power, ventilators, and hospital beds necessary for the care of a surge of patients. Even when only 20% of the population comes down with the virus, the approximate 96,596 ICU beds and 62,000 full-featured mechanical ventilators in the U.S. is substantially lower than the number needed, according to the Society of Critical Care Medicine.
“In the absence of a vaccine or a specific treatment versus the COVID-19 coronavirus, as long as the virus is still circulating in the community, you really need to have a solid test-trace-isolate plan and program in place to catch and quickly contain any new infections,” said Lee. “This means widespread testing, much wider than what is currently available, contact tracing to quickly identify whom any contagious person may have come into contact with, and rapidly isolating/quarantining anyone who may be infected.”
The name of the study is "The Potential Health Care Costs and Resource Use Associated with COVID-19 Coronavirus in the United States" and it was conducted by the university's Public Health Informatics, Computational, and Operations Research (PHICOR) team, in collaboration with the Infectious Disease Clinical Outcomes Research Unit (ID-CORE) at the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center and Torrance Memorial Medical Center.
The findings were published in the journal, Health Affairs