(AP) — The global coronavirus pandemic has created a huge need for health care in the U.S., but it also is delivering a devastating financial blow to that sector.

COVID-19 worries have kept patients away from doctors’ offices and forced the postponement and cancellation of non-urgent surgeries. The pandemic also has shut down large portions of the American economy, leaving many would-be patients without insurance or in a financial pinch that makes them curb spending.

All of this has forced hospitals, health systems and doctors to lay off staff, cut costs and hope a return to normal arrives soon.

Health care provided the biggest drag on the U.S. economy in the first quarter. Spending on care fell at an annual rate of 18%.

In many cases, hospitals that lose those profitable surgeries are gaining COVID-19 patients — and losing money on them.

The American Hospital Association estimated in a recent report that the nation’s hospitals and health systems will collectively lose more than $36 billion from March to June treating hospitalized COVID-19 patients.

When adding factors like lost revenue from postponed surgeries, the total balloons to more than $200 billion, said the association.