Key Economic Findings About COVID-19
As people and economies around the world reel from the impact of the novel coronavirus (COVID-19), one thing is clear: facts are at a premium. The value of trusted data has never been more in evidence than in the months since the onset of COVID-19 in China at the end of 2019, and its rapid spread around the world.
I have been struck time and time again by how much my colleagues want to contribute to finding solutions to the COVID-19 crisis. Yet, we are not qualified to develop a vaccine or to treat those who are suffering. However, economists at the University of Chicago, with their grounding in rigorous research and commitment to public policy, are uniquely positioned to offer insights into the ongoing economic challenges occasioned by this historic health crisis.
So, we decided that what BFI could contribute is a set of findings about COVID-19 that we believe can help people better understand its consequences and potential policy responses. Specifically, we aim to deliver key economic insights that are often missing from policy discussions. The economic implications of COVID-19 are significant and varied, and we address a range of questions: What is the economic benefit of social distancing? What would the impacts of universal testing for COVID-19 be for mortality rates and economic outcomes? Which sectors will be hardest hit? What do the latest stock market gyrations tell us about the expectations for growth? What can China teach us about the economic implications of widescale lockdowns? The answers to these and other important questions are addressed in the following selected facts.
This is a dynamic effort. And in this signal social and economic period, BFI will continue to develop, update, and communicate findings as part of our contribution to minimizing COVID-19’s harm to people and society.
Please visit this page regularly for updates.
Michael Greenstone
Director of the Becker Friedman Institute for Economics
Milton Friedman Distinguished Service Professor of Economics
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The COVID-19 pandemic has led to a surge in demand for medical care, and healthcare systems across the United States have faced the risk of being overwhelmed. This creates an opportunity to study the labor markets that hospitals use to manage temporary staffing shortages. How effective are short-term labor markets at re-allocating workers to where they’re needed most?
Using data from a healthcare staffing firm, the authors study flexibility of nurse supply across the United States. At different points throughout the spring and summer, hospitals in affected regions needed more nurses to deal with pandemic-related surges. The authors find that job postings for temporary nurse positions tripled from their usual rate at the height of the pandemic’s first wave, and increased even faster in places facing extreme pandemic conditions. In New York state, job postings increased eightfold, while the compensation almost doubled.
The differences across states and across nursing specialties allow the authors to study workers’ flexibility in this market. For example, there was little-to-no increase in wages for nurses working in labor and delivery units, as the first wave of the pandemic did not change the number of women who were already pregnant.In contrast, demand skyrocketed for for nurses in intensive care units (ICU) and emergency rooms (ER). For these specialties, the number of job openings and compensation rates are positively associated with state-level COVID-19 case counts. In other words, more acutely ill COVID-19 patients implies increased need for traveling nurses, and higher payments required to recruit them. Based on one estimate, ICU jobs increased by 239 percent during the first wave of the pandemic, while compensation increased 50 percent. ER jobs increased by 89 percent while compensation increased by 27 percent.
The large size of the United States, and nurses’ ability to work in different states, appears to be an important part of how this market adapted to the first waves of demand for COVID-19 nursing. An analysis by the authors demonstrates that the increases in quantity may understate the willingness of ICU and ER nurses to travel, given relatively higher compensation. In economic terms, they find nursing supply to be highly elastic, which suggests that price signals are an effective way of reallocating nurses to the parts of the country with increased staffing needs. Likewise, they find that workers who accept such postings travel longer distances from their homes to job locations when pay is higher.
This work suggests that a national staffing market may offer timely flexibility to accommodate demand shocks. When demand increases in specific geographic areas, nurses’ ability to move can help mitigate a local shortage. That said, adjusting to a simultaneous national demand shock is harder. If numerous different regions experience simultaneous COVID-19 surges, meeting demand may require more than mobility across regions. Even though some nurses can travel, there is still a limited national supply of those with skills in demand.
- Physicians & Surgeons — Surge Clinician-Shifts (Per Week Per 100k)
Epidemiological models predict that COVID-19 will generate extraordinary demand for medical care, raising questions about whether the US healthcare system has sufficient capital (ventilators and ICU beds) and labor (doctors, nurses and other healthcare workers) to provide needed care.[1] To gauge the surge capacity of the US healthcare workforce, the authors calculate how much additional care could be provided if clinicians increased their workloads to 60 hours per week.[2] They use data from the 2015-2017 American Community Survey, which surveys 1% of the US population each year, and records workers’ occupation and weekly hours.[3]
The table below shows national-level statistics, with a focus on three occupations: physicians, registered nurses, and respiratory therapists, who provide intubation and ventilation management for COVID-19 patients with breathing difficulties.[4] The US has 237 physicians per 100,000 people, who work the equivalent of 4.3 12-hour shifts per week, and thus provide 1,022 clinician-shifts per 100,000 people per week. If physicians increased their capacity to 60 hours, or five 12-hour shifts, per week, they could provide an additional 163 clinician-shifts, or 16% more care. Registered nurses provide a baseline of 2,111 clinician-shifts per 100,000 people per week. Because they work fewer hours at baseline, they could increase their capacity by an additional 1,276 clinician-shifts per 100,000 people or 60% by working five shifts per week. Respiratory therapists’ surge capacity is proportionally similar.
Surge capacity varies substantially by region. Physician surge capacity, measured in clinician-shifts per 100,000 people per week, is nearly twice as large in the Northeast as the Midwest or Deep South. Surge capacity for registered nurses is highest in the Midwest, and lowest in the Southwest. Respiratory therapist surge capacity is highest in the Great Plains and the South. The Southwest has relative low surge capacity for all three occupations.
Some clinicians have the training to care for COVID-19 patients. Others could be cross-trained to provide this care. Even clinicians who are not appropriate for cross-training can fill in for coworkers who have been shifted to COVID-19 care, as could retired workers who have training and experience but have higher COVID-19 mortality risk.[5] As some states have already started doing,[6] easing licensing restrictions can give hospitals the flexibility to better cope with this unprecedented spike in demand.
[1] Ferguson, Neil M., et al. March 16, 2020. “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand.” London: Imperial College COVID19 Response Team.
[2] The authors choose 60 hours because this is the average amount that physicians report working per week during the ages when they are in training. This training is notorious for requiring long hours, but these hours are apparently manageable for a period of months or a few years.
[3] The authors restrict their analysis to those working in hospitals and physicians’ offices, as these industries are most relevant for COVID-19 care.
[4] Data on additional occupations are shown in the Appendix.
[5] https://khn.org/news/help-wanted-retired-doctors-and-nurses-don-scrubs-again-in-coronavirus-fight/
[6] E.g., https://malegislature.gov/Bills/191/S2615 and http://www.op.nysed.gov/COVID-19Volunteers.html
