Measuring The Cost of COVID: Lost Health And Lost Opportunity
People's experiences with COVID vary widely. Some contract the virus and get little more than a fever. Others spend months in the hospital—or worse, don't make it at all.
Dr. Rich Ginnetti, regional director of primary care for OSF HealthCare in Bloomington, said the strain on hospitals and health care systems also has been mixed.
“We've had (COVID patients hospitalized) three or four day to three or four weeks. It's very variable," Ginnetti said. "The people that end up on a ventilator in the ICU, they're in there for a long time. And some people are discharged on home oxygen."
Ginnetti said treatment for COVID improved rapidly over the course of the pandemic, allowing more people to be treated at home. But many still require medical attention.
“Probably over half of the people will see a doctor after they had their infection, and then maybe 20% of them may see a specialist," Ginnetti said. "People can go to rehab, see a cardiologist ... basically a lot of supportive care."
Ginnetti said treatment plans are more complicated for people with long COVID. That's when symptoms last more than four weeks after infection. Early research by the Centers for Disease Control and Prevention (CDC) suggests this occurs in about 10% of people who contract the virus.
Under normal circumstances, a lengthy hospital stay, ventilator use, and appointments with specialists could spell a hefty medical bill for patients.
But COVID patients typically don't see a bill at all, according to OSF HealthCare Chief Financial Officer Mike Allen.
"Whether you get the bill or not ... we have to pay the bill, as taxpayers or health plan members. It's a shared cost across the country."
Allen said hospitals that accepted CARES Act dollars agreed to certain things, like covering the cost of testing and vaccines for everyone. He said insurance companies largely covered COVID treatment and hospital stays, with big companies like Blue Cross Blue Shield waiving co-pays and deductibles for coronavirus patients through most of the pandemic. Insurance companies began reinstating those fees earlier this year.
Allen said the same is true for people on Medicare and Medicaid, and the uninsured were covered by COVID relief dollars.
"I'm sure there are exceptions that popped out. You could have somebody with insurance that has a large deductible. That happens. But those are going to be relatively few and far between," Allen said.
In those rare cases, he said, hospitals have financial assistance available to help people with out-of-pocket costs.
That doesn't mean COVID care is free. Allen said there might not be an individual cost, but there is a societal cost.
"Whether you get the bill or not ... we have to pay the bill, as taxpayers or health plan members. It's a shared cost across the country," Allen said. "We are collectively paying for it through our health insurance premiums, or we're paying collectively through it through taxation."
The federal CARES Act included more than $175 billion dollars for hospitals and health care providers to care for COVID patients. Allen said those reimbursements have helped immensely—especially during outbreak peaks. He said there was a time last fall when OSF was admitting more than 450 COVID patients a day—more than a quarter of all hospital beds.
But Allen said federal and state grants haven't covered everything. He said OSF has taken a loss caring for COVID patients, although they've been able to adjust.
Hospital bills aren't the only expense a COVID patient incurs—especially those with long-haul symptoms.
Sarah Welander, 20, of LeRoy contracted COVID last fall. She suffered what doctors think was a mini-stroke. About nine months later, she's still experiencing "brain fog." She has a hard time focusing. Her short term memory is impaired. Her energy levels remain low.
Sarah lost out on work and a year of college. She saw Mayo Clinic doctors after her initial diagnosis. She also met with an educational psychologist to craft a plan to return to college. Insurance did not cover those things, which cost the Welanders thousands of dollars.
Sarah's mother, Patti Welander, said that's nothing compared to the emotional toll.
“We're still at the point where I don't know what the final outcome will be," Patti Welander said. "If it's something that just delays her being able to achieve her goals for a few years, that's a lot different than if she is never going to be able to."
"If it's something that just delays her being able to achieve her goals for a few years, that's a lot different than if she is never going to be able to."
Sarah Welander said the most frustrating part is not being able to do the things she could before, like hang out with friends or audition for a play.
“In my head, I'm like, 'Oh, I want to do this, this, this. This would be so much fun.' But then I have to step back and be like, 'Can you realistically do that with the amount of energy you have and the amount of brain power that you're able to exert before you have nothing left?"
Before her COVID diagnosis, Sarah planned to move in with a friend and start an independent life as a college student. None of that can happen right now. She said it feels like her friends' lives are moving along around her.
“It's kind of frustrating because it's like, 'Well, my friends are going to graduate before me. They're going to be off before me like doing adult jobs. They're going to be moving on with their life faster than me.'”
Sarah said it's also frustrating to know she'll be trapped in minimum wage jobs longer. She recently started a new job in retail. She said it took a while to find a position where her managers would understand the challenges she might face—remembering how to use the cash register or clock in for her shift, for example.
Illinois State University psychology professor Dawn McBride said those cognitive challenges can be disheartening.
“Cognitive resources have a limit. We know that there's only so many things we can do at once. There's only so many tasks we can take on and try to remember," McBride said. "But as people start to make mistakes, as people start to forget things, it does tend to affect their self image."
Depression and anxiety are common symptoms of long COVID. McBride said not being to do the things you used to be able to is hard on people.
She said it also could be an adjustment for businesses that have expectations for "productivity" that don't always take into account individual circumstances—especially if they're not operating at "full capacity" for months.
“As people are sort of emerging from this, it's going to be a slow process, to get people back up to their level of productivity where they work," McBride. "Some people may have decided, for example, that their own well being is best served by slowing down a little bit."
Health care providers and long COVID patients agree the not knowing is the hardest part—when or whether symptoms will subside or when the pandemic will end.