A Research Paper Presented to the Faculty of The Department of History-Political Science

Silliman University

Dumaguete City

Government Response to Risk Factors affecting Covid-19

Healthcare workers within Dumaguete City.

Submitted to:

Prof. Maria Editha Enumerabellon

Submitted by:

Dela Pena, Heinz Ulrich A.

Esmane, Myco Danerry V.

Tampol, Caleb John

Prof. John Nuico

Prof. Maria Editha Enumerabellon

Research Adviser
 Table of Contents

Chapter I
- Background of the Study
- Introduction
- Theoretical Framework
- Statement of the Problem
- Scope and Limitations
- Conceptual Framework
- Significance of the Study
- Definition of Terms

Chapter II
- Review of Related Literature

Chapter III. Research Design

- Research Methodologies
- Research Design
- Sources of Data

Chapter IV
- Presentation, Analysis and Interpretation of Data

Chapter V
- Summary of Findings, Conclusion and Recommendation
- Summary of findings
- Conclusion
- Recommendations
- Bibliography

1. Data Analysis
2. Discussion
3. References

CHAPTER I
 Background of the Study

SARS-CoV-2 is the virus that causes COVID-19. It belongs to the coronavirus family,
which includes common viruses that cause everything from head or chest colds to more serious
(but rare) diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory
syndrome (MERS). Coronaviruses spread quickly through droplets that you project out of your
mouth or nose when you breathe, cough, sneeze, or speak, just like many other respiratory
viruses.
Coronaviruses acquire their name from the spike proteins that protrude from them, giving them a
crown-like appearance. These spike proteins are crucial to the virus's biology. The spike protein
is the portion of the virus that hooks to a human cell and allows it to infect it, allowing it to
proliferate and spread to additional cells. Antibodies that target these spike proteins can protect
you from SARS-CoV-2.
According to Amnesty International, the Philippine government must act quickly to
address the country's COVID-19 situation, which has resulted in thousands of people being
unable to obtain sufficient healthcare. Following a substantial increase in hospitalizations and
new cases since March, hospitals are still at risk of being overburdened.

"The Philippine government's persistent failure to provide an effective response over a year into
the pandemic is a significant human rights problem," said Amnesty International's Deputy
Regional Director Emerlynne Gil. "Using all available resources, the authorities must offer
healthcare without discrimination."

"Without further delay, specific steps to protect those most affected, particularly health workers
and those most at danger, must be done." Furthermore, the government must cease its attacks on
human rights advocates and campaigners, which only exacerbates an already severe situation."

With approximately 116,000 new COVID-19 cases documented as of this writing, the
Philippines has the second largest number of new cases in Southeast Asia. COVID-19 has
infected nearly 1 million people since the outbreak began, and 17,000 people have died as a
result of the virus.

Since October 2020, the country's daily total has risen steadily, reaching almost 15,000 new
cases on 3 April 2021, the highest number since the epidemic began in March 2020. The number
of daily deaths in April 2021 was likewise the highest on record.

Introduction

The present COVID-19 pandemic has impacted all of us. However, depending on our
status as individuals and as members of society, the pandemic's impact and repercussions are
perceived differently. While some people strive to adjust to working online, educating their
children, and getting food through Instacart, others are forced to be infected in order to keep
civilization running. Our many social identities and the social groupings to which we belong
define our social inclusion and, as a result, our vulnerability to epidemics.

Theoretical Framework
The study's concept is centered on how we treat frontline healthcare workers and how we
see the advantages they can receive after having risked their health to deliver a high-risk service
to combat covid-19. A sense of responsibility to alleviate patients' suffering and the need to make
aggressive measures to protect the entire country from the virus was prevalent across health-care
providers' descriptions of their lived experiences fighting COVID-19. In the face of an unknown
disease and unknown hazards, health-care providers from Dumaguete City dreaded infection and
worried about their families, but they nonetheless applied to join the fight, took up their
responsibilities, focused on their jobs, and demonstrated a sense of unity and professional
dedication.

Statement of the Problem

Difficulty of Healthcare Access

- The mishandling of the epidemic has resulted in a serious lack of access to healthcare,
which has proven more acute in recent weeks, amid a renewed increase of COVID-19 cases.
Hospitals are being overburdened, according to health officials, due to a lack of beds and
insufficient health personnel. Unpaid benefits and a lack of medical-grade personal protective
equipment are other problems for workers (PPE). Metro Manila and the adjacent provinces of
Bulacan, Cavite, Laguna, and Rizal have been under harsher quarantine measures for the
previous few weeks, after numerous hospitals reported 'critical' occupancy rates following a
spike in COVID-19 cases. "Seeing hundreds of ambulances and private vehicles waiting outside
hospitals is heartbreaking. Inside are persons with COVID-19 and their families, some of whom
are dying while waiting for medical attention. Others are transported to other medical facilities
located hundreds of kilometers away, only to be turned away owing to a shortage of healthcare
capacity," said Emerlynne Gil, Amnesty International's Deputy Regional Director. Dr. Pauline Convocar,
an emergency medical specialist for both public and commercial hospitals, told Amnesty International
about the Philippines' lack of preparedness in health care, which has been a problem for decades but has
been exacerbated by the pandemic. Military personnel have been chastised for leading the government's
pandemic response agency rather than public health specialists.

Healthcare workers at risk.

-Accusations that the government mismanaged COVID-19 emergency funding has driven
Filipino healthcare workers to breaking point. Protesters assembled in front of the Department of
Health on September 1st, wearing safety gear, to demand the release of unpaid financial
compensation and an increase in state money to hire more palliative care professionals. Health-
care professionals in the Philippines are chronically underfunded, underpaid, and overworked. If
these difficulties aren't addressed, the profession may face a mass departure in the near future.
Hospitals in the Philippines are overburdened, and COVID infections are on the rise on a regular
basis. In the Philippines, the more contagious delta variety of coronavirus is the most common,
causing substantial issues for the healthcare system. Despite the fact that 34.1 million vaccine
doses have been administered, only 13.1 percent of the population has been fully immunized.
Infection rates are at an all-time high, with 16,000 daily infections, up 20% from the previous
week. The Philippines' cumulative case numbers have topped two million, and the archipelago
has recorded over 33,000 fatalities out of a population of 108 million people since the first
COVID-related fatality outside of China. Workers on the front lines are particularly vulnerable.
"You are exposed to the virus when you work in a hospital during a pandemic like COVID-19,"
said Jao Clumia, union president at St. Luke's Medical Center. "It's as though you've already put
one foot in the grave." Many people hoped that the pandemic would result in significant reforms
in the health-care system. Instead, it has exacerbated existing problems. Filipino healthcare
salaries are significantly lower than those of other professionals in Southeast Asia, according to a
survey undertaken by information aggregator iPrice Group. According to the data, nurses in the
Philippines earn 57 percent less than those in Vietnam, the next lowest-paying country.
Singaporean nurses are said to make 480 percent more than Filipino nurses, with monthly
salaries of $1,000 and $6,500, respectively. Despite the fact that the Philippines is a prominent
exporter of healthcare workers, local supply is struggling to keep up with demand due to the
pandemic. According to the Philippine Private Hospitals Association, roughly 40% of palliative
care professionals in private hospitals quit last year, and the delta variant is expected to
exacerbate this trend. Dr. Takeshi Kasai, the World Health Organization's regional director for
the western Pacific, warned the Philippine government in a report with the Australian
Broadcasting Corporation to guarantee that its healthcare personnel are receiving enough
support. "Surges are driving health systems dangerously close to what we term the red line in
some locations," Dr. Kasai warned. He warns that if ICU capacity is exceeded, hospitals will be
unable to provide essential care. Protests in front of the Department of Health are seen by many
frontline employees as important to force a change in circumstances. "Does the government
believe we want to be protesting in the streets?" "We'd rather be caring for our patients in our
hospitals," a frontline worker told Deutsche Welle. Protests appear to be having an effect.

President Rodrigo Duterte has responded to the public's outrage by directing the health and
budget ministries to pay medical professionals what they are owed. Duterte instructed
Department of Health Minister Francisco Duque III to pay healthcare workers "whatever money
there is" in a public address. "Give the perks that nurses in both the government and the private
sector are requesting," Duterte remarked. "The volunteers should be compensated. "To avoid
becoming the virus's new epicenter, the government will have to act quickly. The first step is to
ensure that critical healthcare employees receive enough support and financial recompense.
 Scope and Limitations

This study mainly focuses on the government's response to the risk factors affecting
Covid-19 healthcare workers in Dumaguete City… And how the government grants credits to
persons (Frontliners) who sacrifice their own health and families in order to reduce the number
of Covid-19 cases in both government and private hospitals in Dumaguete City. The responses of
Dumaguete City's local government units to all healthcare workers are critical in containing the
spread of infections in the city. In this study, we also identified emotional, psychological and
physical factors that may affect the healthcare workers. To mitigate the impact of the COVID-19
pandemic, the local government unit of Dumaguete through its Inter-Agency Task Force on
Emerging Infectious Diseases outlined different quarantine measures wherein each level has a
corresponding degree of rigidity from keeping only the essential businesses open to allowing all
establishments to operate at a certain capacity and this will also minimize the increasing number
of Covid-19 in the jurisdiction of Dumaguete city.

Significance of the Study

What has the government done for our healthcare worker’s safety?

The significance of this study will bring light to what options and benefits healthcare workers
have in terms of their safety, as well as divulging what the Philippine government has done for
the risk reduction and safety of the “Front liners” the healthcare workers of the Philippines.

Definition of terms

Covid-19/Corona Virus - Coronavirus disease (COVID-19) is an infectious disease caused

by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate
respiratory illness and recover without requiring special treatment. Older people, and those with
underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease,
and cancer are more likely to develop serious illness.

Health Workers - Health workers are people whose job it is to protect and improve the health of
their communities. Together these health workers, in all their diversity, make up the global
health workforce. It describes the size and distribution of the workforce, and some of its
characteristics, including how much it costs.
PPE - Personal protective equipment, commonly referred to as "PPE", is equipment worn to
minimize exposure to hazards that cause serious workplace injuries and illnesses. These injuries
and illnesses may result from contact with chemical, radiological, physical, electrical,
mechanical, or other workplace hazards. Personal protective equipment may include items such
as gloves, safety glasses and shoes, earplugs or muffs, hard hats, respirators, or coveralls, vests
and full body suits.

Front liners – A front liner is a frontline worker, especially in healthcare and other essential,
often public-facing jobs

DOH - The Department of Health (abbreviated as DOH; Filipino: Kagawaran ng Kalusugan) is

the executive department of the Government of the Philippines responsible for ensuring access to
basic public health services by all Filipinos through the provision of quality health care and the
regulation of all health services and products

IPC - Infection prevention and control (IPC) is a scientific approach and practical solution
designed to prevent harm caused by infection to patients and health workers. It is grounded in
infectious diseases, epidemiology, social science and health system strengthening. IPC occupies
a unique position in the field of patient safety and quality universal health coverage since it is
relevant to health workers and patients at every single health-care encounter.

Conceptual Framework

Government
Risk Factors
Response

Healthcare
Workers

Covid- 19

Chapter 2
 Review of Related Literature

The Risks that “Healthcare workers” encounter amidst the Covid-19 pandemic have
grown exponentially, so much that multiple papers and discussion amongst leading health
organizations have proven that our “Frontliners” are under more danger than we originally
thought. Some of the literature we have reviewed and will be presented here is broader than
Dumaguete city but they tackle the issue at hand just as well. This is a statement from Amnesty
International “Specific measures to protect those most affected, including health workers and
those most at-risk, must be taken without further delay. Furthermore, the government must stop
attacking human rights defenders and activists, a practice that only makes a dire situation worse.”
The same sentiments can be found in a report from the organization for world peace, they say
Filipino hospitals are reaching peak capacity, and daily COVID infections are mounting rapidly.
The dominant strain of coronavirus in the Philippines is the more contagious delta variant, which
is immensely challenging for the Filipino healthcare system. So far, 34.1 million vaccine doses
have been administrated, and only 13.1% of its population is considered fully vaccinated.
Infection rates are hitting record highs, with daily infections averaging at 16,000 – 20% higher
than last week. After the Philippines saw the first COVID-related death outside of China, its total
case numbers have breached two million, and out of a population of 108 million, the archipelago
has recorded over 33,000 fatalities.

Frontline workers are especially at risk. “When you work in a hospital during a pandemic
like COVID-19, you are exposed to the virus,” Jao Clumia, union president of St. Luke’s
Medical Center, said. “It’s as if you have one foot in your grave already.” We have also found
that the compensation for the “Healthcare workers” aren’t up to standard. They risk their own
lives for no more than a stipend that doesn’t do them justice. This is a statement from Inquirer
writer Cristina Eloisa Baclig the coronavirus pandemic laid bare the sacrifice of the country’s
health workers and also the state of their financial health. “Lauded as heroes in scrubs, these
medical professionals on the frontline of the battle to keep COVID-19 cases from getting out of
control had been through exhaustion and being overwhelmed by often 24-hour work. Many have
lost their lives, falling victims themselves to the disease which has no known cure yet.” We have
determined after careful research and deliberation that our Healthcare workers are not being
compensated justly for the perilous tasks that they perform.
The World Health Organization (WHO) calls on governments and health care leaders to
address persistent threats to the health and safety of health workers and patients. “The COVID-
19 pandemic has reminded all of us of the vital role health workers play to relieve suffering and
save lives,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “No country,
hospital or clinic can keep its patients safe unless it keeps its health workers safe. WHO’s Health
Worker Safety Charter is a step towards ensuring that health workers have the safe working
conditions, the training, the pay and the respect they deserve.” The pandemic has also
highlighted the extent to which protecting health workers is key to ensuring a functioning health
system and a functioning society. The Charter, released today for World Patient Safety Day, calls
on governments and those running health services at local levels to take five actions to better
protect health workers. These include steps to protect health workers from violence; to improve
their mental health; to protect them from physical and biological hazards; to advance national
programs for health worker safety, and to connect health worker safety policies to existing
patient safety policies.
The Department of Health (DOH) on Sunday reported Php 15,719,085,923 worth of
benefits for healthcare workers has been disbursed as of November 26, 2021. This is based on
the latest, reconciled figures reflected in the Statement of Allotment, Obligation and Balances
(SAOB) and is part of the Php 16,229,088,025.2 total amount disbursed as updated last
November 23, 2021, of which the difference is for reconciliation. The DOH said that Php
7,915,760,434 Special Risk Allowance (SRA) of 486,585 healthcare workers has been disbursed
covering the period December 20, 2020 to June 30, 2021. While Php 6,555,957,185 was
disbursed as SRA and active hazard duty pay (AHDP) was released last year for 315,652 and
390,662 healthcare workers, respectively. Additionally, meals, accommodation, and
transportation (MAT) benefits worth Php 1,231,098,680 have been received by 103,413
healthcare workers. “The Department is committed to recognizing the important contribution of
our healthcare workers in the fight against COVID-19, hence we aim to provide them with the
compensation and benefits they deserve as stated in Republic Act 11494 or the Bayanihan to
Recover as One Act. We are continuously coordinating with local government units to fast track
the disbursement of remaining SRA funds to eligible healthcare workers for the period of
December 20, 2020 to June 30, 2020,'' said Administration and Financial Management Head
Undersecretary of Health Leopoldo Vega. The DOH added that pending requests for additional
SRA funds for Batch 5 and Batch 6 shall be evaluated by DBM once releases for the previous
batches have been fully disbursed. Meals Accommodation and Transportation Benefit
Meanwhile, the DOH clarified that under Bayanihan 2, the provision of MAT benefits was for
the convenience of healthcare workers, and to protect their families who are at risk of contracting
COVID-19 as they travel from their homes to health facilities. “MAT benefits for healthcare
workers were to be provided as actual transportation arrangements, accommodation, and meals
in order to lessen their burden from traveling from their homes to work and vice versa. We also
wanted to keep their families safe, to prevent healthcare workers from potentially infecting their
family members at home by providing MAT,” explained Usec. Vega. As these benefits were
originally intended to be provided in-kind or as actual services, health facilities that were not
able to disburse these amounts for such purpose, have opted to return unspent funds to the DOH
before the year ended, to prevent reversion of funds to the Treasury. These funds, in turn, were
used by the DOH to support other requirements for the pandemic response. Recognizing that a
number of healthcare workers have not been able to receive the MAT benefits, the DOH is
continuously working with DBM and OP to secure funding and appropriate authority to provide
the MAT retroactively to those who have yet to receive it. Proposed Benefits for HCWs The
DOH further explained that healthcare worker benefits have certain limitations as to their scope
and coverage period. In the case of the AHDP, it can no longer be granted beyond December 19,
2020. While the grant of SRA is only until June 30, 2021. Moreover, under Bayanihan 2
entitlement to SRA has been limited to those directly catering or exposed to COVID-19 patients
as clarified by the Department of Justice, thus the said benefit cannot be provided to all
healthcare workers. Given these limitations, the DOH has supported ongoing legislative
initiatives for the continued provision of benefits for our healthcare workers. The Department is
also improving and streamlining its processes to ensure that benefits are equitably and promptly
distributed.
Atty. Dante A. Gierran, CPA said stated that, at the onset of the COVID-19 pandemic,
PhilHealth had taken the lead in protecting Filipinos against financial catastrophe through
national health insurance. In particular, recognizing the crucial role of health workers in the
pandemic response, PhilHealth Circular No. 2020-0011 was approved to ensure full financial
risk protection for hospitalization due to COVID-19 during the state of public health emergency.
Pertinent to the said Circular, health workers hospitalized due to COVID-19 are eligible to avail
of the COVID-19 benefits for inpatient case management, whether admitted in a public or
private facility. As the pandemic remains a rapidly evolving situation, PhilHealth is currently
reviewing its policies and benefit packages. Meanwhile, in the interim, the said Circular shall
remain in full force and effect and PhilHealth shall continue to provide full financial risk
protection among public and private health workers who have contracted COVID-19 until further
notice. For faster processing of claims, we request health care providers to provide a copy of the
result of the SARS-CoV-2 test done on the patient together with other required documents when
filing a claim for full financial risk protection. Additional documents such as copies of clinical
charts may be requested if deemed necessary for claims evaluation.

Chapter III. Research Design

Research Methodologies

-Respondent and Sampling Procedure

The respondents of the research are the Medical Health Workers and Frontliners tasked in
combating the Coronavirus Disease or commonly known as COVID 19.
• Medical Health Workers, those health workers assigned in Clinics, Hospitals and Quarantine
facilities such as Doctors, nurses, Radiologic and medical technicians.

-Ethical Considerations
 This research observes the required ethical standards to follow. The respondents affiliated
with this study will be asked for their willingness and availability. Every response made by the
respondents shall be given due respect and, in any circumstance, they feel uncomfortable
regarding the questions they will not be forced to answer the specific question. Also, in times of
refusal to participate in the given survey the researchers shall move onto the next qualified
respondent. The researchers know as well that the privacy of each participant has to be ensured
in accordance with the Data Privacy act of 2012.

-Research Environment

The areas covered by this study are the data gathering procedure and the discovery of
health risks and factors that contribute to the contagious health hazard and the health workers
face in times they expose themselves to infected individuals as well as times they are not
exposed to the virus.
The researchers will be conducting a survey and factor out those infected due to the risks
presented and those not. The research will be presented and confined only to Health Workers and
Frontliners that have direct exposure to the virus.

Sources of Data

Direct Personal Interviews and Observation

Hospitals in Dumaguete City

- Silliman University Medical Center

- Negros Oriental Provincial Hospital
- Ace Doctors Dumaguete
- Holy Child hospital

We asked healthcare workers from these various hospitals in Dumaguete City about how the
hospital and government treats them. What are the ways of the government to bolster their selves
to continue combating covid- 19 even having the possibilities of being infected by this virus, to
strengthen their emotions knowing that there are lots of risk factors in dealing with this type of
virus. Most of the healthcare workers received cash assistance from the government, some are
satisfied and some are still questioning the incentives they have received.

Research Design
 This research uses qualitative approach and descriptive-survey research design. Aiming
to show the figures of the research environment and know the risks and factors the COVID 19
virus poses to Health Workers in Dumaguete City, this type of research design is efficient in
collecting Health Workers observation and their first-hand experience.

Chapter V

Conclusion

Our study highlighted the importance of taking into consideration the experiences and
concerns of frontline healthcare workers during a pandemic. Healthcare workers who are
working in Dumaguete City during the Covid- 19 pandemic. We also captured the experiences of
healthcare workers during peak and post peak of the pandemic. How the government gave
assistance to those who have been affected by this virus, and to those healthcare workers in
Dumaguete City who have been affected physically and emotionally. The kind of incentives and
assistance they received from the government to bolster or strengthen their selves while
combating Covid- 19. We also include the risk factors of healthcare workers, the possibilities of
being infected with this virus.