A new normal of staying home sick is impossible in America.
On a recent Thursday, my wife and daughter tested positive for the coronavirus (although my wife tested negative the day before). I felt fine but stayed home from work and spent the weekend indoors looking after my isolating family members. Early Sunday morning my throat felt sore. I tested negative but stayed home from work on Monday despite testing negative again that day. On Tuesday I was positive.
I suspected I had COVID-19 as soon as my symptoms started; I lived with people who had it. The negative tests were not reassuring. They were decision-making tools, but they weren’t the only data points that mattered.
A negative rapid antigen test means that you are not contagious with the coronavirus at the time of the test. It does not guarantee that you will not be contagious after a short period of time. People should stay home if they feel ill, regardless of what is causing their illness. This should be the new post-pandemic norm. Unfortunately, too few are doing this, and that is a major reason the virus is spreading right now.
Many Americans have already stayed home far more than they would like in the past two years. Proms, graduations and weddings have resumed and few want to miss another milestone because of a runny nose, especially when they get a negative rapid test.
But more importantly, many may want to stay at home but cannot.
Too many people cannot afford to miss another day of work. Even if sick leave regulations became more generous at the beginning of the pandemic, those days are over for most. Fewer people can now work from home. Even fewer can continue to ask to miss work because they have some mild symptoms that may or may not be COVID.
The United States is the only wealthy country in the world workers are not guaranteed paid sick leave or sick leave. According to a 2020 report by the Center for Economic and Policy Research, some countries (Canada, France, Italy and Japan) have public insurance schemes that provide workers with benefits even when they are on short-term sick leave. Other countries such as Greece, Ireland and Spain require employer protection in addition to state insurance. Even more (Denmark, Finland, France, Iceland, Norway and Sweden) have paid leave under collective agreements.
Some countries are more generous than others. If a person falls ill with COVID or any other illness in Switzerland or Australia, they are guaranteed a full 10 days of paid sick leave. In the Netherlands there are guaranteed to be seven. In Japan just under five; in France between three and four; and in the UK just over one.
Only in the United States are we not guaranteed paid days off.
Of course, just because companies aren’t required to offer paid vacations doesn’t mean some don’t offer them. The reason I was able to stay at home was because my employer is quite generous with their paid time off. Many Americans are not so lucky.
While most workers have sick leave, it is woefully insufficient. The average number of paid days off per year is seven. One in five employees has fewer than five days a year. However, such workers have full-time jobs. Many Americans work part-time or by the hour and have no paid sick leave at all. Even States and cities that have regulations Requiring some paid sick leave tends to focus on companies of a certain size and workers with a certain number of hours worked.
Those who are least financially affluent, those who have the most difficulty accessing health care and those most at risk for COVID complications are often affected who lack this advantage. This is especially true for minority communities.
and research confirms that workers without paid sick leave are more likely to go to work when they are ill.
This is the adult situation. Dealing with sick children is even more difficult. It’s one thing to take time off work when you’re sick. It is much more difficult to take time off to stay at home with a sick child. Less than a quarter of the workers have any type of paid family leave. While some may point to the Family Medical Leave Act, it only provides unpaid leave and requires tedious completion of paperwork for approval, including a medical certificate explaining why a worker’s presence is required to care for a family member.
Having more than one child increases the likelihood that you will have to repeatedly take time off, not to mention the fact that parents often get sick from the children they look after. The dreaded “rolling COVID” diagnoses within families can often result in more than five to ten days off for parents as they take turns caring for themselves and their children.
Unfortunately, small children are constantly ill. Studies show that children can spend more than three months in the first three years infected and sick. That’s more sick time than almost all parents. School-age children are also likely to be affected many colds a yearand anyone could be COVID.
Since children are more likely to be symptomatic than adults, staying home every time they have a symptom that could potentially be COVID would likely be detrimental to their education. All the more reason to focus on other protective measures in schools, such as quality ventilation, ubiquitous and repeated testing, and certainly covering up when children have symptoms. This would relieve the parents and give them other defenses to prevent their children from getting and spreading infections. In most locations none of this happens.
This pandemic is far from over and it will not be the last we will face. Going out while you are symptomatic, even if you have a negative rapid test, is dangerous to others. Going to work sick is not a feat, but a sign of a sick system.
Aaron E Caroll is a Distinguished Professor of Pediatrics at Indiana University School of Medicine and Chief Health Officer of Indiana University. He blogs about health research and policy at The Incidental Economist. This article originally appeared in The New York Times.