OBJECTIVES: Coronavirus (SARS-CoV-2) infections lead to high societal burdens in terms of health, healthcare resource usage, costs of care, and worker productivity losses. The Covid-19 outbreak has had a significant impact on daily life of populations and also a significant budget impact for health care systems. Germany has been seen at the forefront of the Covid-19 control and outcomes until July 2020. The question remains on the potential budget impact of these control measures for the health care system.

METHODS: For modeling the spread of SARS-CoV-2 infections, a standard SEIR-based simulation (Susceptible [S], Exposed [E], Infected [I], and Recovered/removed [R]) model was applied (http://covidsim.eu) using Germany-relevant data. CovidSIM outcomes were then combined with cost-input data in an Excel economic model. Using CovidSIM, epidemiologic outcomes were calculated. As general assumption an R(0) of 2.0 was taken as well as a contact reduction starting in March 2020.

RESULTS: With the assumptions taken from German sources, the CovidSIM model was validated and able to reproduce the real infection and hospitalization numbers in Germany. Cost items were added for each outcome where relevant including payments to hospitals to increase ICU capacities. The overall cost for the health care system for the first 3 months during the pandemic in Germany (March–May) was at least 16 billion € not considering social welfare spending. Key cost drivers were incentives to free hospital beds as well as actual non-ICU and ICU hospitalizations of patients.

CONCLUSIONS: The Covid-19 outbreak will have a significant impact on health care budgets – also in the long-run. Cost for the first 3 months for the medical/clinical system in Germany was already around 16 billion € (5% of overall HC budget). Social and economic support programs might overrule these budgets significantly with an estimated budget of at least 1.2 trillion €.