To curtail the spread of COVID-19, the message that the Centers for Disease Control and Prevention is sharing with people who are sick but do not require hospitalization is: “stay home...isolate yourself.” This is an easy suggestion to embrace those of us who can afford to stay home and do not have to worry about the impact of not working on receiving a paycheck. But for the millions of workers in this country without access to paid sick leave, a choice to work sick or don’t work and don’t get paid is no choice at all.

There is no federal law requiring that workers receive paid sick leave. According to the National Conference of State Legislatures, less than a dozen states and Washington D.C. provide paid sick leave. Some cities also provide paid sick leave to qualified individuals, but estimates are that 27 percent or 32 million private-sector workers in the U.S. are unable to take a single paid sick day.

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Most of these employees work in small businesses or low wage jobs, especially in the fast-food industry, and they know if they do not work, they do not get paid.

It is not surprising, therefore, that not being able to stay home has been correlated with prior outbreaks. Data from the 2009 H1N1 flu outbreak shows that of the almost 26 million employees at the time who may have had the virus, 8 million did not take any time off.

I was one of the millions of Americans who tested positive for H1N1. Thankfully, I was employed at an institution that afforded me the flexibility and time to stay home until I was better.

Paid sick leave is not only critical for decreasing the spread of infectious diseases, but also for public health broadly. Multiple health impact assessments (HIAs) — a tool that provides a health lens through which to examine proposed policies, programs, and programs — have been conducted on proposed paid sick leave policies in states like Vermont, Massachusetts, and California.

Together these health impact assessments have shown tremendous benefits of paid sick leave policies for health including decrease spread of infectious diseases, especially in childcare and foodservice settings (thus, also mitigating the spread of food-borne illnesses), lower health care costs, and reduced emergency department use. Evaluations of paid sick leave policies have demonstrated benefits for workforce stability and increased productivity. These policies are most beneficial for low-wage and part-time workers, and employees of small businesses.

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Immediate action is needed to help contain the growing spread of COVID-19 as well as prepare us for future outbreaks that are destined to occur. Let’s not miss another opportunity to galvanize the public and call on policymakers to pass laws that provide paid sick leave for all America’s workers, including those who work part-time and at small businesses. Congress can lead in this area and move forward the Healthy Families Act. T

his bill requires employers nationwide with 15 or more employees to provide at least one hour of earned paid sick leave for every 30 hours workers (up to a maximum of 56 hours per year). When passed this law will not cover everyone but it will provide a large proportion of the roughly 32 million workers without access to paid sick leave a real choice — to stay home when sick. Let’s finally recognize the paid sick leave policy as a public health policy and an integral component of this country’s preparedness efforts.

Keshia M. Pollack Porter is the Associate Dean for Faculty and Director of the Institute for Health and Social Policy at the Johns Hopkins Bloomberg School of Public Health. The views expressed by this author are her own and are not the views of the Johns Hopkins University.