Why Paid Sick Leave Is Essential

Paid sick leave protects businesses, health care, and the public

Dr. Tom Frieden
4 min readMar 11, 2022


Photo Credit: Polina Tankilevitch / Pexels

Awards for “Perfect attendance” should be an idea of the past.

Everyone gets sick, but not everyone can afford to take time off from work to get better. Workers often find themselves caught between a rock and a hard place when they get sick: Stay home and lose a paycheck or the job entirely, or go to work and risk spreading an infection to others.

The tsunami of omicron kept more workers sick at home than at any other point in the pandemic, and serves as a reminder why paid sick leave should be universal. According to a new Census Bureau survey, 21% of all working adults in the United States missed at least one day of work between January 26 and February 7 due to Covid: Either they had Covid, were caring for someone with Covid, or had to stay home because their child’s school or daycare was closed.

Despite one-fifth of the American workforce staying home sick during those two weeks, no federally mandated sick leave was available for workers. The United States is just one of 11 countries around the world lacking federal paid sick and family leave programs.

At the onset of the pandemic, short-term state laws and the Families First Coronavirus Response Act required most employers to provide their workers with up to two weeks of paid sick leave for specified Covid-related reasons, as well as 12 weeks at two-thirds pay for parents to care for children whose schools were closed. However, these measures were temporary, with most laws expiring in late 2020 or early 2021.

Although employers must offer unpaid sick leave by federal law, paid sick leave is not guaranteed for a large portion of Americans. Lowest-income workers, who are most dependent on regular paychecks, are the least likely to have paid sick leave. They are also the least likely to have their jobs protected if they do take any time off.

A permanent national program to provide all workers with paid sick leave would protect public health. It would give workers the time they need to recover from illness or to care for family members while limiting community transmission of infectious diseases. This would reduce the strain on our nation’s health systems and increase the financial security of individuals and households.

Why is paid sick leave so important?

In addition to providing economic relief for low-wage workers, paid sick leave can help slow the spread of Covid and other infectious diseases by encouraging people to stay home when they don’t feel well.

Paid sick leave can also go a long way toward encouraging healthy behaviors. A study by the Kaiser Family Foundation found that employees are more likely to get vaccinated if their employers provide paid time off to get the vaccine and paid sick leave for any symptoms they may experience due to the vaccine. The easier and more accessible sick leave is, the more freedom and flexibility employees will have to make regular doctor appointments to improve their own health as well as the health of their communities.

Even prior to Covid, research has shown that without paid sick leave, employees are more likely to go to work sick, skip preventive health measures, and spread infectious diseases.

Disparities in paid sick leave

Low-wage, essential workers are more likely to get Covid, face a higher risk of mortality and severe illness, and suffer disproportionately from non-communicable diseases — but often face the most barriers to paid sick leave. As of March 2022, 94% of workers in the top 25% of income earners have paid sick leave compared to 35% of workers in the bottom 10% of income earners.

Source: New York Times and Bureau of Labor Statistics

Right now, only four states mandate paid sick leave for Covid-related illnesses. Around 80% of adult workers in the United States have some access to paid sick leave, either through local government provisions or directly from their employers. However, this is usually limited to just a few days per year and is often insufficient to cover the time needed to recover from serious illness.

Women and people of color, who are disproportionately employed in frontline jobs that carry greater risk of exposure, have been hit the hardest by the health and economic impacts of the pandemic. They are also less likely to be covered by paid sick leave policies than other, more advantaged workers.

Moving forward

The pandemic should galvanize action to establish federally mandated paid sick leave — not just for Covid, but for all illnesses.

The largest global health threat of our lifetime should be an impetus for action. This is a now-or-never opportunity to invest in and advocate for policies that make the world safer and healthier. One important action we can take is to ensure that everyone, regardless of income, location, or prior health conditions, is guaranteed paid sick leave.



Dr. Tom Frieden

President and CEO, Resolve to Save Lives | Former CDC Director and NYC Health Commissioner | Focused on saving lives. twitter.com/drtomfrieden