Paid Sick Days Save Lives

by Gaibrie Stephen

Gaibrie Stephen is an Emergency Physician working in the Peel Region and a member of Decent Work and Health.

Edited by Alexandra Simpson.

“Doc, I can’t stay here— I have to go home. I have to work in the morning.” These are the words I’ve heard more than once as an emergency physician both while I was in training and now as an independent emergency physician. It is usually what’s said by my patients before I brief them on the risks and benefits of leaving against medical advice (AMA). I’ll run through the list of risks: worsening disease, incomplete diagnosis, disability and potentially even death. My patient will then look at me and say something along the lines of, “I know. I have to leave because I can’t afford to miss work”. Some of my patients will manage to keep well at home. This would be the best case scenario. Many return to the emergency department in a worse condition than they left. 

I’m trained to identify medical emergencies. Every time a person I’ve identified with an emergency signs out of the ER because they “can’t miss work” it’s clear— our system is built not for workers to thrive, but for workers to barely survive while big corporations continue to benefit from their labour.

The situation I have just described does not have to be the case. Access to paid sick days means workers would be afforded the dignity to take time to recuperate from illness. Paid sick days, quite literally, could save lives. 

COVID-19 has accelerated the movement for paid sick days and this has been justified by how much workplaces have been a hotspot for transmission. In Peel, where I practice emergency medicine, over 66% of COVID-19 cases from September to December 2020 were linked to a workplace outbreak. One in four individuals went to work with symptoms1. Just in the past month we saw the shutdown of Amazon’s factory in Peel region because of an outbreak of the virus. 

It isn’t difficult to appreciate how paid sick days might have an impact in the pandemic. The ability to take time off from work without economic impact empowers workers to stay home. Early COVID-19 infections can be minimally symptomatic and can present with a headache, a scratchy throat or a small runny nose. The Canada Recovery Sickness Benefit (CRSB), the federal program for income support, requires that workers miss 50% of their work week in order to be eligible. For workers who are living paycheck to paycheck, losing a day or two of income might mean they won’t be able to pay rent or feed their families. Furthermore, CRSB has been known to have weeks of delay before payments are made to workers. 

The idea that paid sick days curb pandemics isn’t radical. The World Health Organization recognizes that, “the absence of paid sick days forces ill workers to decide between caring for their health or losing jobs and income”2. We know that workers without paid sick leave are 1.5 times more likely to go to work with an illness. An analysis of the H1N1 pandemic from 2009 found that an absence of paid sick leave likely contributed to an excess of seven million infections in the pandemic and over 1300 deaths. 

Despite the evidence for paid sick days, 58% of Canadians do not have access to a single day of paid sick leave. As few as 10% of low income workers have paid sick leave and we know that the majority of these workers are of racial minorities3

The pandemic has also drawn attention to the lack of value assigned to unpaid care work of which women disproportionately bear the burden. Full time Canadian women took approximately 1.5 times more days off from work than men in 2020 to fulfill caregiving responsibilities4. The feminist economic recovery plan for Canada identifies that paid sick days is a gender disparity issue and includes legislating paid sick leave as a key recommendation in closing the disparate outcomes in women in this pandemic5

Not only will paid sick days save lives during the pandemic but it will have a strong impact on decent work for years to come. The reality is that many people living in Canada have been keeping their head just barely above water financially, even prior to the pandemic. For many of my patients who are barely surviving pay-check to pay-check, one brief day of illness is all it takes to collapse their financial security. It is really difficult in Canada to achieve a decent quality of living on the current minimum wage, especially considering the increasingly unaffordable housing market and soaring student debts. As a result, people are experiencing more economic hardship than the generations before them. 

Paid sick days are the absolute minimum with regards to decent work standards, especially in a pandemic where we are telling people to “just stay home”. Despite the overwhelming evidence and the ongoing spread of Covid-19 in the workplace impact of a lack of paid sick leave, the movement for paid sick leave has been met with inaction at every level of government. My practice of medicine has made this abundantly clear; that paid sick days are fundamental to protecting individual and community health in this global health crisis. 

Want to get involved in advocating for paid sick days? Here’s some resources to learn more.

1. Decent Work and Health

Before It’s too Late: How to close the paid sick days gap during COVID-19 and beyond

2. Fight for $15 and Fairness (Sign up for updates)

1 1 in 4 Covid Cases Found Through Contract Tracing in Peel Were Those Who Went to Work Sick. Data Reveals How Ontario’s Lack of Paid Sick Legislation Fails Vulnerable Workers.

2 The Case for Paid Sick Leave. WHO. (2010)

3 “Before It’s too Late: How to close the paid sick days gap during COVID-19 and Beyond”.

4 “Work Absence of Full Time Employees by Geography”.

5 “Feminist Recovery Plan”.