A coronavirus lesson from China: don’t make patients pay for tests and treatment

[dufus]

People with lower incomes will be deterred from seeking treatment if they face healthcare costs, worsening the epidemic, specialist says

But ‘aggressive testing was not realistic in most countries’

 

 

As the coronavirus continues to spread around the world [1] China has one important lesson for other governments in fighting the disease – be prepared to pay so that patients won’t let costs deter them from getting tests and treatment.

 

The coronavirus – which causes a disease called Covid-19 – has spread to more than 100 countries, with Italy, Iran and South Korea [2] emerging as growing epicentres of the epidemic.

 

Italy has reported more than 10,00 cases of infection [3], overtaking South Korea as the worst affected country outside China. The United States has also begun to report more confirmed cases as health authorities cleared some restrictions that had limited the availability of testing for the contagion [4]

 

But in China, where the disease was first reported, the epidemic is waning, with just 19 new cases of infection on Tuesday.

 

A coronavirus test reportedly costs about 370 yuan (US$53) in China. And in the southern city of Shenzhen, the average cost of treating the disease ranged from 23,000 yuan for elderly patients to about 5,600 yuan for minors, Chinese Hospital Management journal reported on February 28.

 

Some of the country’s treatment methods such as extracorporeal membrane oxygenation – which artificially oxygenates a patient’s blood for a limited period of time – are expensive but they are all covered by the government, which has earmarked 110.48 billion yuan for treatment, subsidies for medical staff and medical equipment.

In the US, where there have been 26 deaths among 472 confirmed cases, public anxiety is growing over the cost of testing.

 

The US government does not charge for coronavirus confirmation tests at designated laboratories but a trip to the hospital will incur other hefty expenses, in one case over US$3,200. Insurance lobby group America’s Health Insurance Plans said individuals needed to check their insurance providers for coverage of costs related to Covid-19.

 

As of Monday, only 1,707 people had been tested by the US Centres for Disease Control and Prevention. More tests may have been conducted at lower level public health laboratories but the number of infections could also be bigger, according to a new Cedars-Sinai study, which estimated that between 1,043 and 9,484 people in the US may have been infected by March 1.

 

South Korea, with 7,513 Covid-19 patients by Tuesday, announced in January that the government and insurance companies would cover the expenses associated with examination, isolation and treatment for coronavirus patients. The country has greatly expanded testing stations to include drive-through services and tested about 15,000 people a day.

 

Japan designated Covid-19 as an infectious disease in February, making it the government’s responsibility to pay inpatient bills related to the coronavirus infection.

 

In Britain, about 18,000 people have received free testing since last month, and 319 have been confirmed as infected.

 

Professor Dirk Pfeiffer, chair professor of One Health at City University’s Jockey Club College of Veterinary Medicine and Life Sciences, said affordability would hinder the epidemic control efforts.

 

“Clearly, wherever you have to pay for health care, individuals with mild symptoms in the lower-income groups will hesitate to visit a healthcare facility, and that may also be the case in some individuals with severe disease. These behaviours will extend the epidemic,” Pfeiffer said.

 

But he said aggressive testing was not realistic in most countries and social distancing would continue to be the most important risk mitigation measure.

 

“I don’t think large-scale testing is realistic in most countries because of the sheer number of tests required. And even where it is feasible, it will not eradicate the virus from the population. Therefore, testing would have to remain risk-based, focusing, for example, on those in contact with known cases,” he said.

 

Pfeiffer said that in Western democratic societies, social distancing would be based mostly on voluntary compliance in contrast to China where tests were mandatory under the country’s infectious disease control regulations.

 

“The consequence of this difference will be that the epidemic will take longer in the countries where social distancing is voluntary,” he said.

 

Ni Feng, director of the Institute of American Studies under the Chinese Academy of Social Sciences, said China and the US had different conditions and it was understandable they used different strategies, but China’s success in bringing the epidemic under control could be a good opportunity for both countries to work together.

 

“This is the least-sensitive area. There are many fields where the two countries can cooperate. We saw some solid cooperation in the past with Sars, H5N1 and H7N9 aviation influenza outbreaks, but not this time,” Ni said.

 

sauce

[dMog]

well, in the USA, IF YOU DON'T PAY..you die. anything else is un-american.... people should gladly die before embracing socialism.... 

[Jogs]

And in my country even if you pay there's no guarantee that you will get good treatment.

[dMog]

A virus is a strange beast, Sometimes it kills you right away sometimes it hardly makes you sick, sometimes you get really sick and need urgent critical care  and sometimes the doctors can do nothing for you.

[ghost]

9 hours ago, Jogs said:

And in my country even if you pay there's no guarantee that you will get good treatment.

You can literally place any country name to what you said and your statement would still be true.

[funkyy]

I think I've got it...I keep singing Bing Crosby and Dean Martin songs...I think I've got Crooner Virus!!

[dMog]

I was just away for 4 weeks, a woman i know got Dengue fever while i was visiting, she spent 5 days in hospital and almost died, she was hemorrhaging internally and from her gums when we took to the hospital. So, yea a virus is not something to take lightly. The flu virus mortality rate is 0.2 percent and kills on average 600 thousand world wide every year. Corona19 virus rate is 2.0 percent that is 10 times MORE DEADLY, do the math on that, it is freaking scary, and politician tweeting that it is not a big deal can change the goddamn truth. TAKE THIS SHIT SERIOUSLY PLEASE

[Karlston]

30 minutes ago, dMog said:

Corona19 virus rate is 2.0 percent that is 10 times MORE DEADLY

 

Yep, that's not good. It's 3.6% for my age group, even scarier.

 

It's being increasingly suggested that the true mortality rate is probably much lower, because the official stats ignore mild undetected cases. In other words, many that have caught it and experienced mild symptoms and recovered, haven't sought treatment or testing so aren't included in the official stats.

[dMog]

it is also increasingly known that healthy fare very well and do not die form Corona. BUT, they also easily pass on the virus to people at risk who WILL die.  An estimated 6 out of 10 people in the USA  and Canada fall into that AT RISK  percentage of the population, the elderly, those fighting any other disease at the moment, those with compromised immune systems, those with respiratory illness, heart problems , the list goes on. This in NOT a mild flu, or a common cold, it is dangerous, and the sooner people understand that the sooner things will start to get better. Do you actually think China shut down cities with countless millions upon millions of people , not to mention Italy now just doing the same thing just for shits and giggles? or is there dire reason to do so.

[ghost]

1 hour ago, dMog said:

it is also increasingly known that healthy fare very well and do not die form Corona. BUT, they also easily pass on the virus to people at risk who WILL die.  An estimated 6 out of 10 people in the USA  and Canada fall into that AT RISK  percentage of the population, the elderly, those fighting any other disease at the moment, those with compromised immune systems, those with respiratory illness, heart problems , the list goes on. This in NOT a mild flu, or a common cold, it is dangerous, and the sooner people understand that the sooner things will start to get better. Do you actually think China shut down cities with countless millions upon millions of people , not to mention Italy now just doing the same thing just for shits and giggles? or is there dire reason to do so.

Agreed. Personally, i'm not scared of getting it. But i am scared of inadvertently giving it to someone else and consequently killing them.

 

 

[funkyy]

I know it's serious, but apart from each of us taking the advice that we are hearing every day we can't do much else except wait and hope.

Panic and worrying yourself to death isn't going to help. We have to hope that with all the medical bodies and brains in the world working on a way to

stop this virus, a  vaccine will be created.

I just refuse to go around with doom and gloom all over my face crying "We're doomed, we're doomed".

[dMog]

One of the BEST things   anyone can do, and i might add the easiest way to help stop the spread of ANY HUMAN VIRUS is to STOP COUGHING AND SNEEZING INTO  YOUR HANDS. the fastest way to transmit a virus like is when people sneeze or cough into their hands.Then shake hands with other people, touch a hand tail door nob key pad, pen, cup glass,the list goes on and on how easily  ir is to pass on a virus and infect others

 

When you see others doing this please tell them to stop, AND MAKE THE GO WASH THEIR HANDS..the world population thanks you in advance.

[dMog]

there basically is no testing in the USA  at this time, and it looks like 6 weeks before they can even scratch the surface of the requirements are to get a handle on this virus...DESPITE  what your president keeps claiming, he seems to love to lie?