We used data from the first 2½ years of the pandemic to forecast total economic losses from the pandemic over four years, from January 2020 through December 2023.

Our team used economic modeling to approximate the revenue lost because of mandatory business closures at the beginning of the pandemic.

We also used modeling to assess the economic consequences of the many changes in personal behavior that continued long after lockdown orders were lifted, such as the tendency to voluntarily avoid restaurants, theaters and other crowded places.

The greatest losses stemmed from workplace absences and lost sales. The latter were due primarily to closed stores, reduced air travel and limited public gatherings.

At the height of the pandemic, in the second quarter of 2020, our survey found that air travel fell by nearly 60%, indoor dining by 65% and in-store shopping by 43%.

The three sectors that lost the most over the first 30 months of the pandemic were air travel, dining, and health and social services, which contracted by 57.5%, 26.5% and 29.2%, respectively.

These losses were offset to a degree by surges in online purchases, a series of large government stimulus and relief packages, and an unprecedented expansion of the number of Americans working from home, many of whom were able to keep doing jobs that might otherwise have been cut.

From 2020 through 2023, the net economic output of the United States is expected to amount to about $103 trillion. If not for the pandemic, that figure would have been about $117 trillion, according to our analysis — nearly 14% higher in inflation-adjusted 2020 dollars.

We also estimated what the cost of the pandemic would have been if fewer or more people had died of COVID because of more or less successful public health strategies over the first 2½ years of the pandemic.

Direct health care expenses during that period, driven mostly by hospitalization, were about $214 billion.

In the best-case scenario we analyzed, in which 65,000 Americans would have died from January 2020 through June 2022, health care costs would have been about a tenth of that figure, $20 billion.

In the worst-case scenario we analyzed, assuming about 2 million died during that period, health-related expenses would have been $365 billion.

While we found that most economic losses from the pandemic were not because of direct health care expenditures, these scenarios show how widely those losses could have varied depending on the nation’s response.

This underscores the need for better preparation for similar or even worse pandemics in the future.

Economic losses could be reduced by more careful assessments of the need for mandatory closures, better communication about risk to reduce unnecessary avoidance of public spaces, and more targeted and better administered fiscal stimulus.

The COVID-19 pandemic’s economic consequences for the United States are unprecedented by most measures. The estimated toll on the nation’s gross domestic product is twice that of the Great Recession, 20 times that of the 9/11 terrorist attacks and at least 40 times that of any other disaster to befall the country in the 21st century.

Although the federal government has now lifted the COVID emergency declaration, the pandemic continues to affect the U.S. economy. The labor force participation rate, for example, has only recently neared pre-pandemic levels.

Our analysis was limited to the pandemic’s standard economic effects.

We didn’t estimate a vast array of indirect costs, such as lost years of work because of premature deaths and long COVID, physical and mental health effects on the population, and the learning loss experienced by students. All of that suggests costs even greater than the astounding loss we documented.

Jakub Hlávka is an assistant research professor of health policy and management at USC’s Price School of Public Policy and a fellow at the USC Schaeffer Center for Health Policy and Economics and the Center for Risk and Economic Analysis of Threats and Emergencies (CREATE). Adam Rose is a research professor at the Price School and director emeritus of CREATE.