Abstract
BACKGROUND: Testing and isolation are crucial measures to control infectious diseases, yet limited research has examined inequalities in the impact of these measures on individual earnings. This study aimed to assess whether income loss during COVID-19 self-isolation varied by workers' employment type in South Korea. METHODS: Cross-sectional data were collected via online surveys from March to September 2022. The analysis included 1,064 employees who tested positive for COVID-19, aged 20-65. Employment types were categorized as standard or non-standard, with the latter encompassing temporary, part-time, and atypical arrangements (multi-party employment arrangements or dependent self-employment). Multivariate logistic regression was used to examine the association between employment type and income loss during COVID-19 self-isolation. The mediating roles of access to paid sick leave and the level of compensation provided were assessed through a counterfactual framework. RESULTS: Overall, 30.5% of participants experienced decreased earnings while self-isolating due to COVID-19 infection. After adjusting for covariates, non-standard workers were three times more likely (adjusted odds ratio 2.96 [95% confidence interval 2.10-4.15]) to experience this income loss compared to standard employees. Among non-standard worker subgroups, atypical workers faced the highest risk (4.06 [2.52-6.55]), followed by part-time (3.02 [1.78-5.13]) and temporary workers (2.25 [1.44-3.51]). This disparity in income loss was attributed to two distinct pathways: non-standard workers having less access to paid sick leave (coverage gap) and, when such leave was available, being more likely than standard workers to receive compensation that was insufficient to maintain pre-isolation earnings (adequacy gap). Our mediation analysis indicated that these two pathways contributed almost equally (51% and 49%, respectively) to the observed income disparities. CONCLUSION: Both expanding access to paid sick leave and ensuring adequate compensation rates are needed to enable non-standard workers to comply with pandemic control measures without fear of income loss.