The variants

These are variants, mutants more infectious and deadlier than the original COVID virus. Doctors have taken notice, and people should be warned.

Pulmonologist Maricar Limpin, vice president of the Philippine College of Physicians, says that since the arrival of the variants, there have been numerous cases of COVID-positive patients coasting along through an asymptomatic or mild infection, only to suddenly deteriorate into a severe case and dying, sometimes within just a day.

Dr. Rontgene Solante, head of the Adult Infectious Diseases and Tropical Medicine Department of the San Lazaro Hospital, also notes an increasing number of infections that start not with respiratory symptoms or loss of sense of smell – the usual signs of COVID – but with other common afflictions such as diarrhea.

This poses a problem: how can you tell if your diarrhea is not your usual LBM but something that requires you to get an RT-PCR test for COVID? If you wait a few days before taking the test and getting a positive result, you could end up infecting your entire household, some of your co-workers and other people.

One or two of those you infect could be similar to the new cases described by Doctor Limpin, and end up dead.

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Yesterday we lost one of our provincial correspondents to cardiac arrest suspected to be linked to COVID-19. Raymund Catindig, 56, covered Northern Luzon for The STAR. He wasn’t tested for COVID.

We condole with his family and pray for his soul. Mourning is difficult enough; COVID raises the decibel of suffering a hundred times more. There are no proper goodbyes; there are no final hugs. The body is snatched away from you, and quickly wrapped completely to prevent even one last look. Your loved one, healthy until just about a week ago, is driven to the crematorium where the waiting line might allow for a mass or novena before the body is popped into the flames. By the time the cremation is over, the bereaved are still in a state of shock. The heartbreak and flood of tears come later, in waves, at unexpected moments.

The bereaved who are infected themselves suffer the worst, isolated in a room to prevent contagion, deprived of human solace and alone in their grief.

By this time, every resident of Metro Manila, epicenter of this evil pestilence, must have had at least a second-hand brush with the sorrow inflicted by COVID.

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You feel sorry for those whose work requires them to directly confront COVID – but also awed and grateful that they keep at it, at the constant risk of getting the virus and infecting their loved ones.

In the news this week was the death due to COVID of the city health officer of Muntinlupa, Dr. Maria Teresa Tuliao. The report said she succumbed to the coronavirus only about a week after testing positive.

She was 57. These variants are claiming people in their 50s, 40s or even younger. And healthcare workers or those close to them tragically account for an inordinately large share of the fatalities. In Baguio City, a 31-year-old doctor in a call center company died of COVID complications on March 9, just three days after being admitted to a hospital. Scores of other doctors, nurses and other frontline health workers have succumbed to COVID. We salute and thank them for their service.

Dr. Jaime Almora, president of the Philippine Hospital Association, said hospitals are suffering from the resignations almost daily of healthcare workers who are bone-weary from fighting this plague, or who have previously been infected and worry about getting sick again. Seeing the disease up close, especially with the spread of the variants, adds to their anxiety.

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Almora told “The Chiefs” on One News last Tuesday that in this terrible surge, hospitals are now also afflicted with “personnelitis” and “financialitis.”

Private hospitals provide 60 percent of healthcare services nationwide. The government says the combined capacities of government and private hospitals are still enough for the surge.

Almora, however, stresses that there is a difference between capacity – meaning bed space and related facilities – and capability to handle the COVID surge, especially in terms of healthcare personnel and equipment for critical care.

Apart from the difficulty in hiring additional healthcare staff and replacing those who have left, hospital owners have long complained about their unpaid claims to the Philippine Health Insurance Corp. After Almora’s group wrote to PhilHealth on March 29 about the problem, a meeting was held a week later, during which PhilHealth promised a partial payment of 60 percent of the claims.

But the debit credit payment scheme is in limbo. Almora says they have to apply for the facility and sign an undertaking. He asks: why should the creditor be the one to sign an undertaking? It’s the opposite in banking.

While PhilHealth and the hospitals continue negotiations, the Department of Health has warned that hospitals cannot turn away patients, whether suffering from COVID or other diseases. Almora laments the policy “disconnect” between the DOH and PhilHealth.

“We’re being made to suffer at this time,” he sighs. “Tine-threaten kami ng DOH, pero binabayaran ba kami ng PhilHealth?”

Hospitals, he stresses, cannot turn away serious COVID cases. But mild and asymptomatic patients may have to wait for space in the COVID wards.

Almora sniffs at the proposal for hospitals to provide home care services to COVID patients whose mild symptoms qualify them for home isolation.

If regular hospital claims cannot be settled by PhilHealth, he says, it would be even tougher to seek reimbursement for home care services, which are more complicated to track.

With hospitals cool to this option, people will continue to flock to hospitals as soon as they test positive for COVID, worried about their illness deteriorating overnight and leading to their demise.

And with the hospitals full in this variant-fueled surge, we are certain to see more deaths.