Obama administration officials and lawmakers are just starting to talk about how the country will pay for the U.S. Ebola response, but Dr. Thomas Frieden says the impact of a major infectious disease outbreak can be tremendous.

Frieden tried to give members of Congress an idea of how big the costs can be by describing the effects of the 2002-2003 Severe Acute Respiratory Syndrome (SARS) outbreak. SARS infected more than 8,000 people in the Asia-Pacific region and killed 775.

Unlike Ebola, SARS has a mortality of less than 10 percent, not 50 percent, but, like the Ebola virus, the virus that causes SARS spreads mainly through person-to-person bodily contact and through contact with particles of bodily fluids, such as saliva. 

“SARS disrupted travel, trade and the workplace,” Frieden said. In the Asia-Pacific region alone, SARS caused more than $40 billion in economic loss, Frieden said.

Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), talked about the economic impact of the SARS outbreak in written testimony for a House Energy & Commerce subcommittee hearing on the U.S. public health response to the Ebola outbreak.

Congress recently gave the CDC $30 million of the $45 million the agency had requested for efforts to expand disease detection and management centers in other countries, but Congress told the CDC to use the money mainly to pay for the Ebola outbreak response. The CDC must tell Congress if it uses the money to fight other diseases.

In addition to building its own disease tracking centers, the United States needs to help strengthen the public health infrastructure in places like West Africa, Frieden said.

“This Ebola epidemic shows that any vulnerability could have widespread impact if not stopped at the source,” Frieden said.

Now, in the United States, the hospitals treating patients who have Ebola are using costly infection control measures. Frieden said, for example, that the CDC is recommending that a hospital have a full-time worker be responsible solely for the oversight, supervision and monitoring of effective infection control while an Ebola patient is in the hospital.

None of the hearing witnesses talked about how the country will pay for the increased infection control efforts, or efforts to put people exposed to Ebola in isolation or quarantine, in the written versions of their testimony.

For affected facilities, Ebola costs could be high enough to affect costs for patients with other conditions, or limit administrators’ ability to participate new or changing Patient Protection and Affordable Care Act (PPACA) programs, such as accountable care organizations or the ICD 10 diagnostic code conversion effort.

See also: SARS Underscores the Limits Of Insurance Underwriting