COVID’s other debilitating impact: Whole families lose income

Artwork by Ed Lustan

MANILA, Philippines—As warnings echoed against deliberate exposure to Omicron, a variant of the COVID-causing SARS Cov2 virus, to develop immunity, health reform advocate Dr. Tony Leachon also raised the alarm over another debilitating impact of the disease—loss of income by families.

While several studies have pointed out that the dominant Omicron variant can be less severe than Delta, it can infect more people faster. In the case of a household setup, it can infect an entire family, according to Leachon.

“It’s sad that Omicron can affect a whole family,” Leachon said.

While there could be no severe symptoms or deaths in many cases of Omicron infection, Leachon said the impact of family members from the same household getting COVID is also dire.

“Now, six infected persons, none of them can go to work even though they are mild, it is still debilitating,” he explained.

“Whether it is a mild or severe case, the rule in the workforce is that when you are COVID-19 positive, you can’t report for work,” he said.

“It can be mild, but the impact is destructive since the family can’t work,” he added.

Some workers, who tested positive for COVID, can get paid sick leaves, meaning they can still receive their salaries or benefits despite being unable to work as they isolate for many days or weeks after contracting the disease.

But some employees—as well as workers like public utility drivers, street vendors, and the like—who rely on day-to-day income or salary and have no paid sick leave, face the specter of income loss as they battle against COVID-19.

National Statistician Claire Dennis S. Mapa, at a recent briefing, said the employment picture was improving. In October 2021, Mapa said at least 43.83 million Filipinos have jobs. In November 2021, the figure jumped to 45.48 million.

The numbers also showed that jobs in November 2021 were 1.89 million higher than 43.59 million in September 2021.

Graphic: Ed Lustan

But underemployment continued to plague Filipino workers. According to Mapa, at least 534,000 Filipinos had been added to the ranks of what the Philippine Statistics Authority chief said were “visibly underemployed.” The increase—between October and November 2021—was nearly double the increase in number of visibly underemployed workers between September and October 2021—293,000.

A costly struggle

Contracting COVID, whether due to Omicron, Delta, or other variants, is a costly ordeal.

A study by Dr. Scarlett Mia S. Tabuñar and Dr. Tamara Michelle P. Dominado, of the Department of Energy Medicine at the University of the Philippines-Philippine General Hospital (UP-PGH) published last year in Acta Medica Philippina—a peer-reviewed general medical and health science journal published by the UP Manila, gave an overview of the hospitalization expenses of COVID-19 patients in PGH alone.

Graphic: Ed Lustan

Data from the study showed that the overall total expenditure for 691 COVID patients admitted in both charity and pay wards from April 15 to Aug. 14, 2021 was P160,756,150.48.

A huge portion—around 74 percent—was spent on 532 patients in the charity ward amounting to P118,186,236.95.

Private COVID patients in the pay ward accounted for 26 percent of all patients with expenses of P42,569,913.53 in the same period.

Graphic: Ed Lustan

According to the study, lab, pharmacy, and PPE expenses of health care workers make up the biggest share of overall spending for both charity and private ward patients—51 percent. Labs eat up most of the expense at P27,982,788. Pharmaceuticals followed at P27,735,841.50 and PPEs at P26,120,129.

Majority of patients, who settled their hospital bills out-of-pocket, was below 60 years old with payments ranging from P25,899 to P44,428.63 per individual.

Out-of-pocket paying patients above 60 years old shelled out a range of P4,050.60 to P39,920.20.

Graphic: Ed Lustan

The study, however, said patients older than 60 and PGH employees were qualified for 20 percent and between 30 and 50 percent discounts through PhilHealth coverage. This, the researchers said, “could explain the resulting lower out-of-pocket payments for senior citizens.”

The most out-of-pocket payment came from 51 patients in the 19-30 age group with Php 44,428.63 each.

On the other hand, the least out-of-pocket payment was from four patients older than 91 years old—only P4,005.60—“which can also be due to it having the least number of patients afflicted with COVID-19.”

READ: Surviving COVID-19: A costly struggle

According to Leachon, COVID-related hospital bills could reach P3 million depending on the severity of the case.

Graphic: Ed Lustan

“It depends on the severity of the COVID—mild, moderate or severe. Range equals 1 million to 3 million,” Leachon told INQUIRER.NET in an interview last year.

It should be noted that hospital costs for COVID can differ depending on the hospital—public or private—and the region or area where the patient is admitted.

Cash assistance halted

In April last year, the Employees’ Compensation Commission (ECC) approved the inclusion of COVID-19 on its list of compensable work-related diseases.

The ECC’s COVID-19 cash assistance program offers COVID-19 positive workers additional cash assistance worth P10,000. In case of work-related death due to COVID-19, qualified beneficiaries may get P15,000 cash assistance.

ECC Board Resolution No. 21-04-14, lists several conditions for workers to qualify for the assistance, including:

• There must be a direct connection between the agent or event and the worker based on epidemiological criteria and occupational risk (e.g. health care workers, screening and contact tracing teams, etc.)
• The tasks assigned to the worker would require frequent face-to-face and close proximity interaction with the public or with confirmed cases for health care workers
• Transmission occurred in the workplace
• Transmission occurred while commuting to and from work.

READ: COVID-19 now listed among compensable work-related diseases — ECC

However, on Jan. 22, ECC executive director Stella Zipagan-Banawis announced that online applications for COVID-19 cash assistance have been temporarily halted due to pending requests from 2021.

Graphic: Ed Lustan

“We are not receiving online applications at the moment since we are still processing pending applications we received last year, because our budget ran out last year,” Banawis said at a Laging Handa briefing.

“We will finish our backlog first before we reopen our online application for cash assistance,” she added.

Graphic: Ed Lustan

Rolling a dice

Leachon’s recent statement came after a study showed that during the last surge of COVID cases due to the Delta variant in the United States, unvaccinated COVID survivors were better protected than those who were vaccinated and not previously infected.

The authors of the study, however, warned against depending on infection for protection, considering the higher risks to unvaccinated persons, who were not previously infected, of hospitalization, long-term impact and death.

The finding has been added to the discussion on the relative strengths of natural versus vaccine-acquired immunity against COVID.

READ: Natural immunity more potent than vaccines during US Delta wave—study

Last week, Vaccine Expert Panel (VEP) chair Dr. Nina Gloriani warned the public against voluntarily exposing themselves to SARS-CoV-2 to gain natural immunity against the dreaded disease.

Graphic: Daniella Marie Agacer

“It could be fine if your breakthrough infection is mild to maybe moderate because you will have a boosted immunity, but if that will be a severe disease, that is not good,” Gloriani said.

“So we should not voluntarily get ourselves infected. That should not happen,” she said.

“I don’t think the doctors will say that you should get yourselves exposed to the virus so you can get natural immunity. If you will get exposed, it should happen naturally and not deliberately,” according to Gloriani.

“We don’t want a deliberate infection because you don’t know what may happen to you,” she added.

READ: Vaccine expert warns against deliberate COVID-19 infection

Deliberately contracting the disease, according to Leachon, is like rolling a dice—you never know the outcome or what you will get from it.

“You will never know what you will get if you deliberately get infected. It is more dangerous than having vaccine-induced immunity,” he said.

He added that getting protection from COVID vaccines, instead of intentionally contracting the disease, will prevent long-term effects of the disease which, he said, can be found in 20 to 30 percent of patients.

Among the common symptoms of post-COVID conditions, according to the US Centers for Disease Control and Prevention (CDC), are:

• difficulty breathing or shortness of breath
• tiredness or fatigue;
• symptoms that may get worse after physical or mental activities
• difficulty thinking or concentrating (also known as “brain fog”)
• cough
• chest or stomach pain
• headache
• heart palpitations
• joint or muscle pain
• pins-and-needles feeling
• diarrhea
• sleep problems
• fever
• lightheadedness
• rash
• mood changes
• changes in smell or taste
• changes in menstrual period cycles

The US CDC said individuals may experience any or a combination of any of the symptoms for weeks or months after being infected with SARS-CoV-2.

“Although most people with COVID-19 get better within weeks of illness, some people experience post-COVID conditions,” the CDC said.

“Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19,” it added.

TSB