Flatten pandemic curve with paid sick leave for all
Two weeks ago marked a sombre milestone in the COVID-19 pandemic in Canada as the death toll passed 10,000. Since then, there have been 500 more deaths across the country, and record numbers of new cases.
As health providers, we have spent the last eight months encouraging patients to wear masks, wash their hands and stay home while sick. Despite our encouragement and messaging from public health officials, we're still faced with a daunting death toll projection of 16,000 patients by the end of the year.
We urgently need to strengthen measures to prevent another 6,000 deaths. Paid sick days are a critical, but thus far underutilized tool in the public health response to the COVID-19 pandemic.
No province has expanded access to paid sick days to curb the spread of COVID-19. A very real pandemic has exposed the deadly gaps in paid sick leave. While nobody could have predicted COVID-19, its disproportionate impact was entirely predictable. The biggest outbreaks of the first wave were in long-term care homes, meat processing plants, and farms — where essential workers, disproportionately racialized and migrant, are denied essential workplace protections such as paid sick leave.
Ten thousand deaths, taken together, are hard to appreciate. In the ER, we have cared for these patients one at a time — often elderly men and women who have been infected with COVID-19 in homes that are meant to keep them safe. We've provided resuscitative and palliative care for patients who picked up COVID-19 at nursing homes, often in the setting of an outbreak that started with staff before spreading like wildfire to patients. A majority of workers in long-term care homes are racialized women whose working conditions — lowpay, multiple jobs and no paid sick days — put them and those they care for at high risk of COVID-19 transmission.
As clinicians, our day-to-day focus is on emergency care for individual patients, but a pandemic is a collective emergency that requires collective solutions at all levels. On Oct. 28, Chief Public Health Officer Dr. Theresa Tam recommended paid sick leave as an area for action in a new report on Canada's response to COVID-19.
The evidence is overwhelming that paid sick days save lives. Drawing on years of research, the Decent Work and Health Network released a report in August outlining the benefits of paid sick days for both public health and the economy: reduced infections at work and school, improved vaccination rates, reduced emergency department visits, and economic benefits for workers and small businesses.
A recent study published in Health
Affairs found that states in the U.S. with access to paid sick leave had about 400 fewer new cases of COVID-19 per day.
Many U.S. jurisdictions, from New York to Colorado, have expanded paid sick days during COVID-19 (even Donald Trump's government passed federal legislation, albeit with major gaps undermining its effectiveness). But governments across Canada have failed to expand paid sick days before a second wave that everyone knew was coming.
The federal government has provided the Canada Recovery Sickness Benefit for people who miss 50 per cent of their work hours in a week because they are sick or need to self-isolate. But this benefit is actually a retroactive income support which, while useful in its own regard, is no substitute for paid sick days.
Effective paid sick days must be universally available to all workers, fully paid with no loss of income, and immediately accessible without bureaucratic barriers — something provincial governments could immediately achieve by mandating paid sick days in employment standards. In the midst of the second wave, paid sick days are not a panacea. But they are a life-jacket that help our patients stay afloat and socially distant, rather than falling under and bringing others with them.
More than 250,000 people across the country have been infected and more than 10,000 have died, and we'll never know how much lower these numbers might have been had paid sick days been available to all. But we do know that paid sick days could help reduce the next 100,000 infections and the next 6,000 deaths.
How many people have to get infected or die before governments expand paid sick days for all?