Dr. Michael Kitchell guest column: The cost of COVID, in lives and in dollars, is staggering

It has been two years since the COVID-19 virus emerged from China to become a worldwide pandemic, and no one could predict at that time all the tragic illness, loss of life, and disruption of economic activity, making us all poorer and liable to be sicker — or dead.

In the US, we have now had over 800,000 deaths, and more deaths in 2021 than in 2020, despite very effective vaccinations. Though the over-65-year-old population has lost 1 out of 100 people to COVID-19, the latest variants of the virus, called delta and omicron, have been infecting and killing younger Americans. Since the omicron variant is even more infective, with 70 times the ability to multiply, it is predicted that every American who has not been vaccinated will get infected.

Predictions about the virus also didn’t anticipate the huge resistance of the public and politicians to simple prevention such as social distancing, masks, and vaccinations. The avalanche of false information, called “dis-information” (not just mis-information) has been stunning, with some politicians taking sides with conspiracy theorists, passing on false information that has kept many people from protecting themselves and others — and then getting sick and dying.

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The total cost of COVID-19 infections to the economy is still unclear, including the cost of absenteeism due to sickness, absence of full employment (layoffs and resignations), supply disruption, reduced spending, and now inflation.

The cost to the health care system is also hard to tally, as many health care workers were laid off during the pandemic’s peak, and many health care workers quit and have not returned. Virtually every hospital now has a shortage of nurses and many other workers. This shortage, along with full intensive care units in most cities, has restricted admissions not only for COVID patients, but even for those with other afflictions such as heart attacks and traumatic injuries.

From Thanksgiving to late December, COVID infections increased nationally by over 35%. Hospitalizations increased 20% in just two weeks.

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Emergency departments in Iowa also have been overwhelmed, with waiting times as long as six hours in some Des Moines hospitals. At Mary Greeley Medical Center in Ames, the total number of emergency department patients seen has risen by 30%. Many patients all over Iowa are housed in emergency departments until a bed opens up two or three days later. Many Iowa hospitals turn down patients from numerous hospitals in other states who have no open beds, because like those other states, there are no available beds here.

There has been an underreported “burnout” crisis too, in COVID-19 units and intensive care units with front-line nurses and physicians who see so many tragic deaths, including young patients who did not get vaccinated. The much-smaller numbers of vaccinated patients who have died (like Colin Powell) have usually had pre-existing conditions that made them immune-suppressed, or more susceptible to pneumonia.

Many nurses have seen more deaths in one month on a COVID unit than in their entire career before COVID-19. Daily stress and “burnout” while caring for all the sick and dying patients is a widespread crisis with no end in sight. A recent nationwide survey found that 40% of nurses reported they plan to quit their current jobs in two years.

Every hospital administrator in the US is complaining they can’t find enough nurses. Some for-profit “traveling nurse” companies take advantage of the shortage, and are charging three times the current nursing salaries for their traveling nurses to work temporarily.

The pandemic’s effect on the front-line health care workers has a high emotional toll, but the financial toll has also been great. The total cost to the federal government, and for businesses who pay most of the cost of coverage of their employees with private insurance for treatments and hospital stays in 2020, has now been reported.

In the journal Health Affairs, using 2020 data, it was reported that the United States’ total cost of health care in 2020 went up to $4.124 trillion, from $3.759 trillion in 2019. That is, for every man, woman, and child, the US now spends $12,530 per person per year, up from $11,462 in 2019. That is an increase of 9.7%, the largest increase in many years, with the average increase per year running about half that number. The percentage of national spending on health care in 2020, compared with the entire economy (GDP), was 19.7% — which is much higher than in 2019, when health care consumed 17.6% of our entire economic output.

Most Americans don’t realize how much we spend on health care, as most employers pay 70% to 90% of the health care costs for their employees and families, and the rest of the population is mostly covered by Medicare and or Medicaid. The average yearly cost of health care insurance premiums for businesses (according to the Kaiser Family Foundation) is $22,264 for a family policy in 2021, and 73% was paid by employers. Businesses pay 83% of the cost for individual employees, at $7,759 per year.

Over half of all dollars spent on US health care are spent by the government, at $2.068 trillion, either state or federal. In 2020, in large part due to COVID-19 infections and hospital stays, the federal share (Medicare, Tricare for veterans, and most of Medicaid’s costs) of the total spending increased at an alarming rate of 36%, with smaller increases for states and private businesses. Businesses laid off many employees, so their costs would have gone up more if they retained more employees.

Fair Health, a nonprofit organization, has state-by-state data on the cost of an average hospital stay for a non-complex admission for COVID-19 infection, which is $51,641 per patient in Iowa. For a complex admission, meaning a stay in the intensive care unit and on a ventilator, the average cost for that one patient’s total stay is $278,396.

Many larger employers are self-insured, so they are responsible for most of that $51,000 or $278,000 bill — not the insurance company. Most self-insured employers therefore want their employees to observe social distancing, masking, and to get fully vaccinated to avoid those huge COVID-19 costs.

There are some politicians who say they don’t like the government and taxpayers paying so much for health care, and, like their supporters, say everyone should be free to avoid masks and vaccinations — but are they willing to pay more for those who get sick because they avoided scientific advice to protect themselves and their immune-suppressed neighbors? Over 80% of hospitalizations for COVID-19 are unvaccinated patients, and except for those patients who are immune-suppressed (about 4% of our population), fully vaccinated patients rarely have a serious infection.

Immune-suppressed patients and children too young for vaccinations want “freedom” from getting infected from an unvaccinated person. Too many unnecessary deaths (over 170,000 Americans) have occurred since vaccines were widely available, in people who often believed false information that kept them from protecting themselves and others.

Dr. Michael Kitchell is a neurologist at McFarland Clinic in Ames, Iowa.

This article originally appeared on Ames Tribune: Opinion: The cost of COVID-19, in lives and in dollars, is staggering