The blog of the Urban Institute
May 1, 2020

Expanding Paid Sick Leave Could Help Combat the Coronavirus and Support Workers’ Economic Stability

Policymakers are weighing options for the next legislative package to address the COVID-19 pandemic. Expanding paid sick leave to cover more workers could help slow the spread of the virus and support the economic stability of essential workers.

Here’s what the research says.

Paid sick leave reduces the spread of disease, lowers worker absenteeism, and supports preventive medicine

Studies indicate paid sick leave can have important positive effects on public health by helping reduce the spread of contagious diseases.

Following the 2009–10 H1N1 pandemic, access to paid sick leave increased the likelihood that ill workers stayed home; reduced the economic burden associated with staying home for minorities, women, and families; and potentially helped control the spread of influenza. One study estimated that the lack of workplace policies like paid sick leave during H1N1 increased the number of cases of influenza-like illnesses by 5.0 million, including 1.2 million cases among the US Hispanic population.

As we summarize in our new report on paid medical leave, more recent research shows paid sick leave can significantly lower the general flu rate and overall worker absenteeism by reducing the spread of influenza-like illnesses. Reduced absenteeism because of paid sick leave could have saved employers $630 million to $1.88 billion per year, in 2016 dollars.

Paid sick leave is also associated with a significantly higher likelihood of seeking preventive medical care, like vaccines. One study found that even when workers know they face greater medical risks, as many essential workers do now, they are significantly less likely to receive preventive health screenings if they don’t have paid sick leave. And workers with paid sick leave are less likely to visit emergency rooms.

New federal paid sick leave law is historic but leaves out many

The pandemic has resulted in the first-ever national legislation on paid sick leave. The Families First Coronavirus Response Act requires employers to provide workers with two weeks of paid sick for a worker’s own illness, quarantining, or caring for a family member under specific circumstances related to COVID-19. The law provides an additional 10 weeks of paid leave to care for a child at home because of child care or school closures. The rate of pay a worker receives depends on which type of leave is taken. But exclusions and exemptions added during negotiations and rulemaking by the US Department of Labor significantly reduced the number of workers who qualify for leave from the legislation.  

Workers not entitled to sick leave include employees of companies with 500 or more workers and health providers and emergency responders whose employers elect to exclude them. This means potentially tens of millions of workers could be left out.

In addition to excluding and exempting many workers from sick leave coverage, the law also does not provide longer paid medical leave, meaning even workers with a confirmed or presumed COVID-19 diagnosis are not entitled to leave beyond the initial two weeks of sick leave. This is important, as we’ve learned that serious cases of COVID-19 often last weeks.

Fortunately, as policymakers contemplate another legislative package to address COVID-19, they have an opportunity to fill in these gaps. Expanding paid sick leave to cover more workers is an evidence-based way to slow the spread of COVID-19, increase the likelihood that workers seek necessary treatment, and reduce the hardship associated with taking sick leave, particularly for many essential workers who earn wages near the federal poverty level. Slowing the spread of the disease would not only help save lives but also lessen the economic disruption from the virus.

In the long term, a comprehensive approach to paid sick leave and paid family and medical leave is needed. Proposals like the Healthy Families Act and the Family and Medical Insurance Leave (FAMILY) Act would cover more workers and establish sustainable financing mechanisms to fund worker benefits. And although they’re especially critical now, these benefits are needed to permanently close the gaps in our social safety net exposed by the current pandemic.

Marietta Diaz, 30, who works in medical device sales, sits in her living room in Wellington, Florida, on March 23, 2020. She is in quarantine after testing positive for novel coronavirus (Covid-19). Diaz still has 12 days of mandatory quarantine and finds it hard to pass the time. (Photo by ZAK BENNETT/Zak BENNETT/AFP via Getty Images)

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As an organization, the Urban Institute does not take positions on issues. Experts are independent and empowered to share their evidence-based views and recommendations shaped by research.