Paid sick leave (or paid sick days or sick pay) refers to paid time off from work that workers can use to stay home to tackle their health needs without losing pay. Some policies allow sick time for ill family members or health and safety need related to domestic violence or sexual assault. When sick workers can stay home to recover, it lowers the contagion risk, making the workplaces healthier and the worker more productive. The paid sick days decrease the productivity loss when employees work sick, called presenteeism, estimated to cost the national economy $ 160 billion annually in 2002 (Stewart et al., 2003). Sick leave prevents disease and illness, for example, saving employers from $0.63 to $1.88 billion in reduced flu-like conditions related to absenteeism costs per year from 2007 to 2014, in 2016 dollars. The authors conclude, “these findings might help employers consider paid sick leave (PSL) as an investment rather than as a cost without any return” (Asfaw et al., p. 1 2017). Paid sick days also reduces turnover, and thus decreases the costs of advertising, interviewing, and training of new hires.

Instead, contagion risks are highest in those services where workers deal with the public and where, unfortunately, workers are often not allowed sick days. For example, 70 percent of women fast-food workers report going to work at least once in the recent year coughing, vomiting, or having a fever or other serious symptoms. Eighty-six percent of these fast-food workers were without PSL (Hart Research Associates, 2016).

In Europe (Sander & Scheil-Adlung, 2010) report, “looking at labor productivity in terms of GDP per hour worked, it is evident that high expenditure on paid sick leave pays off: Norway’s labor productivity rate in GDP per hour worked is estimated at US$ 75.20. In contrast, Greece's rate is 32.2, and the UK's is 44.90. Thus, high expenditure on paid sick leave can be linked to significantly higher economic production rates. These gains more than balance out the expenditure on paid sick leave.” Naturally, PSL is one of the many factors influencing productivity.

The US and S. Korea are the only nations among OECD countries that do not have national laws and requirements for PSL. Instead, there has been a strong regional response in the US, where 13 states and 23 local jurisdictions have passed PSL laws. In 2019 in the US, a total of 76 percent of all civilian workers had some form of paid sick leave. The average cost of PSL to employers was $0.42 per employee hour worked. That still means that more than 33 million Americans did not have access to a single day of paid sick leave. For management, professional and related jobs, the workers with PSL reach 91 percent; however, it drops to 61 percent for the service workers. Looking at the wage categories, the lowest 25 percent of wage earners have only 51 percent access to PSL, and for the lowest 10 percent of wage earners, it goes down to 31 percent. (US Bureau of Labor Statistics, 2020).

The workers who need PSL the most have the least access. They cannot afford a day without pay and are often in danger of losing their jobs if they take a day off. Low-wage workers and workers of color are less likely than higher-wage and white workers to have paid leave.

The lack of national paid leave policies, and legislation in the US left workers and the public unprepared for the Covid-19 crisis. In response to the pandemic, Congress passed the first national paid leave law, included in the Families First Coronavirus Response Act, which covers private employers with fewer than 500 employees and certain public employees. It assumes that large employers already provide PSL. The law allows workers up to two weeks of emergency paid sick leave at the employee’s regular rate of pay where the worker is quarantined; and two-thirds of the rate for a need to care for an individual subject to quarantine. In addition, up to ten weeks of paid expanded family and medical leave are allowed at two-thirds of the employee's regular pay rate to care for a child whose school or childcare provider is closed. Employers receive tax credits to offset the costs of providing the paid leave (Bales, 2020). At the outbreak of a pandemic, private employers cannot be expected to pay sick leave as prevention requires that many stay home instead of coming to work. Like the US, many OECD countries have temporarily taken over sick pay obligations in case of sickness due to Covid-19 and pay in the case of quarantine.

The report concludes “that paid sick leave can be a particularly effective tool during de-confinement, as part of rigorous testing, tracking, tracing and isolating strategy. However, this requires a system that covers the entire workforce and with a focus on return to work" (OECD, p 2020). Covering the entire workforce involves including workers in non-standard dependent employment, such as casual and zero-hour contracts, freelancers, gigs, and informal workers. Most importantly, the report also advises that in the future:

“Structural paid sick leave reforms will have to reappear on the agenda when the pandemic passes, consisting of:

  • permanently improving access to paid sick leave for the entire workforce;
  • promoting prevention of sickness and the return to work of recovered workers;
  • preparing for future pandemics by improving the adaptability of paid sick leave systems” (OECD, p 2 2020).

Among the other lessons learned from the pandemic, in a separate study, Boesch concludes that “in order to address the full spectrum of workers' medical and caregiving needs, especially for workers with disabilities and those with long-term coronavirus effects, policymakers must design two compatible permanent paid leave policies—short-term paid sick leave, and long-term paid family and medical leave—that are comprehensive of all the reasons workers need leave” (Boesch, p 4 2020).

Recent polling on a bipartisan basis indicates that 69 percent of voters believe that it would have been helpful to the country today if we had a national paid family and medical leave policy implemented before the Covid-19 outbreak (Lake and Carpenter, 2020).

Even during the Trump presidency, Democrats have been working on PSL legislation. In March of 2019, Senator Patty Murray (D-WA) and Representative Rosa L. DeLauro (D-CT-3) introduced the Healthy Families Act (S.840 & H.R.1784) that “provides paid sick and unpaid sick leave for employees to meet their own medical needs and those of their families” (US Congress, 2020). The advantages of the proposed law are summarized at the Family Values at Worksite.

The key characteristics for understanding and evaluating paid leave legislation, according to (Boesch 2020), include:

  • the degree that all workers are covered;
  • the inclusion of short and long term paid leaves;
  • sufficient duration of leaves;
  • adequate wages across all types of leaves;
  • the inclusive definition of family to acknowledge various caregiving relationships;
  • employment protections for workers who use paid leave;
  • effective outreach, education, oversight, and enforcement.

Considering the benefits to national health, the economic and health advantages for workers, and the increase in productivity and decline in turnover for the businesses – paid sick leave appears to be a win-win-win situation. Instead, we have a situation where 33 million workers who need PSL the most have no access. Many of our frontline food and transportation workers do not have a single day of sick pay. Is this the America we want? With the pandemic still raging in the US and the new Biden administration’s favorable outlook towards workers, it is urgent to make PSL available to all.


Asfaw, A., Rosa, R., & Pana-Cryan, R., 2017, Potential Economic Benefits of Paid Sick Leave in Reducing Absenteeism Related to the Spread of Influenza-Like Illness. Journal of Occupational and Environmental Medicine, 59(9), 822-829, September.
Bales, R., 2020, Covid-19 and Labour Law: US, Italian Labour Law e-Journal, Special Issue 1, Vol. 13 (2020) Covid-19 and Labour Law: A Global Review, ISSN 1561-8048, Boesch, D., 2020, The Urgent Case for Permanent Paid Leave, Report of Center of American Progress, September 1.
Congress, 2020, 116th Congress, S.840 - Healthy Families Act, Congress Government site.
Hart Research Associates. (2016, November 11). Survey Findings on Sick Days for Women Fast Food Workers. Nationwide online survey of 1,217 women age 16 and older who work in fast-food restaurants in a non-managerial position, conducted from July 22 to 27, 2016. Retrieved December 16, 2020, from National Partnership for Women & Families.
Lake, C. & Carpenter R., Attitudes toward Paid Family and Medical Leave during the COVID-19 Pandemic (Washington: Lake Research Partners and Chesapeake Beach Consulting, 2020).
OECD, 2020, Tackling coronavirus (Covid 19) Contributing to a global effort. Paid sick leave to protect income, health, and jobs through the Covid-19 crisis.
Sander L., & Scheil-Adlung, X., 2010, Evidence on Paid Sick Leave: Observations in Times of Crisis, Intereconomics, Volume 45, 2010 · Number 5 · pp. 313–321.
Stewart, W. F., Ricci, J. A., Chee, E., Morganstein, D. (2003, December). Lost Productive Work Time Costs from Health Conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine, 45(12), 1,234-1,246. Retrieved December 16, 2020.
US Bureau of Labor Statistics, 2020, Table 31: Leave Benefits: Access Civilian Workers, March 2020, National Compensation Survey: Employee Benefits in the United States, March 2020.