Article
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A Cost-Analysis of the 2014/15 Ebola Virus Disease in the United States
Version 1
: Received: 12 May 2023 / Approved: 19 May 2023 / Online: 19 May 2023 (09:40:54 CEST)
How to cite: Berthe, P. A Cost-Analysis of the 2014/15 Ebola Virus Disease in the United States. Preprints 2023, 2023051417. https://doi.org/10.20944/preprints202305.1417.v1 Berthe, P. A Cost-Analysis of the 2014/15 Ebola Virus Disease in the United States. Preprints 2023, 2023051417. https://doi.org/10.20944/preprints202305.1417.v1
Abstract
Background: Significant national and global costs were incurred from recent emerging infectious disease outbreaks, notably H1N1 highly pathogenic influenza, Zika and Severe Acute Respiratory Disease (SARS), both in the medical sphere and within the socioeconomic context around it. With forecasts expecting an increase in direct and indirect burden of novel infectious disease events, costs of future outbreak events are likely to be exacerbated. In this scope, it is critical for countries to identify this trend and work towards minimizing costs while continuing to improve prevention, treatment and mitigation. Objectives: The impacts of the West Africa Ebola crisis have largely focused on the response to the outbreak abroad. The aim of this paper was to determine the direct and indirect domestic costs of the Ebola Virus Disease (EVD) introduction into the United States (U.S.), compare the economic consequences of the epidemic with other disease outbreaks and identify the primary drivers of such costs to leverage more global health preparation to prevent, prepare for, and respond to disease threats more effectively. Methods: I conducted a literature review of 1) EVD cases documented by the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), 2) scientific articles identifying the costs of Ebola for the U.S. and countries around the world and 3) grey literature on treatments and public reactions. Extrapolating data from these sources, I then performed a cost-analysis of direct costs (preparation, treatment and contact tracing) and indirect costs (loss of productivity owing to disease, death, and risk avoidance behaviors) of the disease. Findings: The country spent between $300-$700 million in direct costs. Additionally, roughly $200-$340 million were forgone as results of loss of productivity from to disease, death or social risk avoidance behaviors. The cost-per-case for the United States was vastly higher than for any other country. Conclusions: High direct costs suggest that either the United States took disproportionate preparative measures to mitigate a potential American outbreak or were unprepared for a potential outbreak of this magnitude. The significant risk avoidance behavior estimates hint that forces having the ability to shape social attitudes and norms – namely traditional and online media – played a significant role in driving social behavior towards fear of exposure to others. The findings reinforce that outbreaks occurring in a single part of the world can have dramatic economic effects globally, even in areas with existing public health capacity and other preventive measures, highlighting the need for change in global health systems to shift from a passive responder and incorporate other societal actors to effectively reduce the ever-increasing costs of disease threats.
Keywords
Ebola; EVD; cost-analysis; cost-benefit analysis;
Subject
Business, Economics and Management, Economics
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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